The Prevalence of Helicobacter Pylori Infection in Patients with Liver Cirrhosis with Peptic Ulcer Disease with and without Symptoms in a Rural Tertiary Care Centre in South India
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 5
Abstract
Introduction: Liver cirrhosis is a major health problem world-wide and peptic ulcer is a condition that is commonly seen in patients with liver cirrhosis. Helicobacter pylori infection remains one of the most common conditions in Liver cirrhosis patients. This study was done to ascertain the presence of H. pylori in patients with liver cirrhosis being treated a tertiary care hospital in rural part of South India, in both symptomatic and asymptomatic peptic ulcer disease patients. Methodology: All consecutive patients with liver cirrhosis with or without obvious symptoms of peptic ulcer disease (PUD), attending the gastroenterology department of a rural tertiary care center in Southern India was serially recruited after taking written informed consent to join the study. Liver cirrhosis was diagnosed by history, clinical examination, deranged liver function tests (LFT), prolonged prothrombin time (PT), Ultrasound abdomen and upper GI endoscopy showing varices and/or portal gastropathy. The severity of liver disease was classified as per Child -Pugh criteria. The etiology of liver disease was documented. Duodenal ulcer was diagnosed by endoscopy (well defined defect in the first or second part of the duodenum). Gastric ulcer was diagnosed by endoscopy (well-defined defect in the antrum, pylorus or body of the stomach). Results: Primary end point of our study, prevalence of Helicobacter pylori in patients with liver cirrhosis attending to the gastroenterology department in a rural tertiary care centre in South India with peptic ulcer disease both in symptomatic and asymptomatic patients was 53.6 % (52). Our secondary end point, prevalence of endoscopy proved peptic ulcer in patients with liver cirrhosis, was found to be 10.3% . Surprisingly all the 10 patients with ulcers were asymptomatic. Conclusion: Significant prevalence of asymptomatic peptic ulcer disease and also the prevalence of H.Pylori in patients with liver disease. Bleeding peptic ulcer can cause significant mortality and morbidity in these patients and efforts must be made to treat peptic ulcer disease before complications occur.
Authors and Affiliations
Dr. Jayan M Gopinath MD,DM, Dr. Sanjoy Joseph George MD, Dr. Abel K Samuel Johnson MD
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