Helicobacter pylori infection in patients with liver cirrhosis: facts and fictions.
Helicobacter pylori infection could play a role in different clinical alterations observed in cirrhosis, from gastroduodenal lesions to hepatic encephalopathy. Although its prevalence in cirrhotics is similar to that in controls, H. pylori infection is responsible for the increased prevalence of peptic ulcer observed in these patients. The ammonia production by H. pylori urease does not seem to increase blood ammonia levels during cirrhosis, indicating that its role in hepatic encephalopathy could be marginalized in clinical practice. Dual and triple therapies have been shown to be equally effective for H. pylori eradication in these patients.
Zullo
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Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Via E. Morosini, 30, 00153 Rome, Italy. zullo@tiscali.it
Hassan
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Morini
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D000641:Ammonia / Q000378:metabolism; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016480:Helicobacter pylori / Q000378:metabolism*; D006501:Hepatic Encephalopathy / Q000378:metabolism / Q000382:microbiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000382:microbiology*; D009853:Omeprazole / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors
D000897:Anti-Ulcer Agents; D000641:Ammonia; D009853:Omeprazole