Portal hypertensive gastropathy; the role of helicobacter pylori infection

ABSTRACT

This study was conducted on 60 patients, 54 men and 6 women, aged 30 to 65 years [mean 42.1] with chronic liver disease and portal hypertension as evidenced by the presence of esophageal varices. In addition, 20 patients, 15 men and 5 women, aged 25 to 68 years [mean 39.3] having non-ulcer dyspepsia and no evidence of chronic liver disease were admitted as a controls. All patients were subjected to full clinical assessment, liver function tests, abdominal ultrasonographic examination, and upper gastrointestinal endoscopy. All patient's group had endoscopic evidences of portal gastropathy. Multiple antral biopsies were taken from all patients and controls and sujected for hisopathological examination to assess the presence of portal gastropathy, the degree of H.pylori colonization, the presence and the degree of inflammatory gastritis. The results showed high prevalence of H.pylori in both patients and controls. However, the grade of colonization was significantly higher in patient's group. The majority of patients [95%] showed histological manifestations of both portal gastropathy and inflammatory gastritis. On the other hand, 65% of the controls had no gastritis, and all showed no evidence of portal gastropathy. The severity of gastritis and gastric erosions was significantly correlated to the degree of H.pylori colonization. The latter was not correlated to the presence of variceal bleeding nor to occerrence of encephalopathy. It was concluded that, gastric mucosa of patients with portal hypertension is not inhospitable for H.pylori and in contrast H.pylori infection is more likely to be associated with more colonization and gastric mucosal lesions