The effect of decrease in serum nitric oxide concentration on portal hemodynamics after Helicobacter pylori treatment: an open-label pilot study.
OBJECTIVE
Helicobacter pylori-induced gastritis increases serum nitrate and nitrite concentrations. The relationship between splanchnic hemodynamics and nitrate and nitrite levels has been demonstrated. We aimed to determine the effect of Helicobacter pylori eradication treatment on portal hemodynamics.


METHODS
Nineteen patients with liver cirrhosis and Helicobacter pylori gastritis were included. Nine patients had esophageal varices indicating over portal hypertension. After histopathologic examination of gastric mucosa, Doppler ultrasonographic measurement of the portal veins and serum sampling to determine nitrate and nitrite concentration, treatment for Helicobacter pylori eradication was initiated for each patient. Evaluation of histopathology, Doppler measurements and sampling for serum nitrate and nitrite levels were repeated six weeks after the end of therapy.


RESULTS
The rate of eradication of Helicobacter pylori was 73.7%. The median inflammation score, Helicobacter pylori density, and the median serum concentration of nitrate and nitrite decreased significantly after therapy (p values were 0.021, 0.001, and 0.018, respectively). After treatment, the patients with varices showed significant decreases in serum nitrate and nitrite levels whereas those without varices did not. Considering portal measurements, alteration in the congestion index approached statistical significance (0.15 versus 0.1; p=0 .066) in the patient group with varices.


CONCLUSIONS
Reducing effect of Helicobacter pylori eradication treatment on serum nitrate and nitrite concentration seems to have some beneficial influence on portal hemodynamics.
Serin
Ender
E
Department of Gastroenterology, Başkent University, School of Medicine, Ankara, Turkey. eserin67@yahoo.com
Pourbagher
M Ali
MA
Gümürdülü
Yüksel
Y
Tamer
Lülüfer
L
Ozer
Birol
B
Yilmaz
Uğur
U
D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000097:blood* / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood*; D009573:Nitrites / Q000097:blood; D010865:Pilot Projects; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000187:drug effects; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
D000890:Anti-Infective Agents; D009573:Nitrites; D009569:Nitric Oxide