H. pylori eradication lower ulcers in cirrhosis. [Corrected].
OBJECTIVE
The study aimed to investigate whether early Helicobacter pylori (H. pylori) eradication therapy in cirrhotic patients caused a dramatic reduction of recurrent peptic ulcers compared with those treated with a late eradication.


METHODS
We identified cirrhotic patients using the International Classifications of Diseases, Revision 9 (ICD-9-CM). Decompensated cirrhotic patients can apply for a catastrophic illness card and were identified via the ICD-9-CM codes 571.2, 571.5 and 571.6. Compensated cirrhotic patients were identified via the ICD-9-CM codes 571.2, 571.5 and 571.6, after excluded decompensated cirrhotic patients. We categorized patients into early (time lag ≤365 days after peptic ulcer diagnosis) and late (time lag >365 days) H. pylori eradication therapy groups. The end-point was the occurrence of recurrent peptic ulcers. Cox proportional hazards model was used to calculate the hazard ratios (HRs).


RESULTS
Altogether, 154 cirrhotic patients were included in the early H. pylori eradication group and 103 in the late H. pylori eradication group. Cirrhotic patients had a higher risk of recurrent peptic ulcers in the late H. pylori eradication group (HR 1.58, 95% CI 1.09-2.28, P = 0.015). However, the risk of recurrent peptic ulcers in alcoholic cirrhotic patients in both groups (HR 1.47, 95% CI 0.77-2.83, P = 0.247) was similar.


CONCLUSIONS
Early H. pylori eradication is associated with a lower risk of recurrent peptic ulcers in cirrhotic patients. H. pylori eradication is the mainstay for treating cirrhotic patients who have contracted peptic ulcers.
Division of Gastroenterology, Taipei City Hospital Yang-Ming Branch, Taipei, Taiwan, China; Department of Internal Medicine, Taipei City Hospital Yang-Ming Branch, Taipei, Taiwan, China; School of Medicine, National Yang-Ming University, Taipei, Taiwan, China.
Shen-Shong
SS
Chang
Hsiao-Yun
HY
Hu
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000382:microbiology / Q000517:prevention & control*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors
Helicobacter pylori; eradication; liver cirrhosis; peptic ulcer; peptic ulcer hemorrhage; recurrence