H. Pylori and Peptic Ulcers in Patients with Liver Cirrhosis

To determine whether Helicobacter pylori (H. pylori) plays a central role in the development of ulcers in patients with liver cirrhosis and peptic ulcers, the authors of “Helicobacter Pylori Is not the Predominant Etiology for Liver Cirrhosis Patients with Peptic Ulcer Disease,” published in the European Journal of Gastroenterology and Hepatology,” identified a cohort of patients with a diagnosis of liver cirrhosis in an inpatient setting based on the presence of International Classifications of Diseases, Revision 9, and Clinical Modification (ICD-9-CM) codes 571.2, 571.5, and 571.6 in their records. Patients whose records did not include those ICD-9-CM codes were designated as not having liver cirrhosis (non-LC).

For the study, investigators identified 9,465 H. pylori-positive patients and 3,418 H. pylori-negative patients and analyzed their records to determine whether liver cirrhosis was an independent factor of lower H. pylori infection rates in patients with peptic ulcer.

The authors identified 102 patients with decompensated liver cirrhosis who also had peptic ulcers (39 were H. pylori-positive, 63were H. pylori-negative). They identified 360 patient with compensated liver cirrhosis who had peptic ulcers (193 H. pylori-positive, 167 H. pylori-negative).

Among patients with no liver cirrhosis who had peptic ulcers, 9,233 were H. pylori-positive and 3,188 were H. pylori-negative.

Analysis of the data revealed that patients with decompensated liver cirrhosis (OR=0.23, P<0.001) and patients with compensated liver cirrhosis (OR=0.48, P<0.001) had lower H. pylori infection rates.

Based on these results, the authors concluded that H. pylori is not the predominant etiology for liver cirrhosis, “especially the decompensated type, either with peptic ulcer disease or with recurrent ulcer disease.”