title: Gastroduodenal ulcer and erosions are related to portal hypertensive gastropathy and recent alcohol intake in cirrhotic patients.
abstract: Gastroduodenal ulcers and gastroduodenal erosions are particularly frequent in cirrhotic patients, but their precise cause is unclear. The aim of this study was to identify pathogenic factors associated with ulcers and erosions in patients with cirrhosis. We studied 64 consecutive patients with cirrhosis referred for gastroscopy. The severity of portal hypertensive gastropathy was graded with an endoscopic score. H. pylori status was determined by histological examination of gastric biopsy samples or by the [13C] urea breath test. The daily alcohol intake within the preceding week was recorded. The Child-Pugh score was determined. Fifteen patients had gastroduodenal ulcer and 20 had gastroduodenal erosions. Cirrhosis was related to alcohol in 44 patients and hepatitis B or C virus in 14 patients. The portal hypertensive gastropathy was graded as severe in 12 patients and mild in 25 patients. H. pylori infection, found in 37 patients, was not related to the gastroduodenal lesions. Univariate and multivariate analysis showed the links between gastroduodenal erosions and hypertensive gastropathy and recent heavy drinking. Gastroduodenal ulcer was independently associated only with the severity of the gastropathy. In conclusion, in these patients with cirrhosis, the presence of gastroduodenal ulcer was significantly related to hypertensive gastropathy but not to H. pylori infection. Recent alcohol intake favored the occurrence of gastroduodenal erosions.
authors.affiliation: Service d'Hépatologie et de Gastroentérologie, Hopital Henri Mondor, AP-HP, Université Paris XII, 51 Avenue du Maréchal De Lattre de Tassigny, F-94010 Créteil, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Auroux
authors.forename: Dominique
authors.initials: D
authors.lastname: Lamarque
authors.forename: Françoise
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: Lionel
authors.initials: L
authors.lastname: Deforges
authors.forename: Marie Thérèse
authors.initials: MT
authors.lastname: Chaumette
authors.forename: Jean Philippe
authors.initials: JP
authors.lastname: Richardet
authors.forename: Jean Charles
authors.initials: JC
authors.lastname: Delchier
mesh_terms: D000428:Alcohol Drinking; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis; D016480:Helicobacter pylori; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013272:Stomach Diseases / Q000150:complications*