Can Hellicobacter Pylori Infection Increase the Risk of Variceal Bleeding in Patients with Liver Cirrhosis?

Abstract

Background and Study Aims: Gastro-oesphageal varices carry high risk of bleeding which may be fatal in some circumstances. Many patients with varices have Helicobacter pylori (H.pylori) infection in their gastric mucosa. The relationship between H.pylori infection and the incidence of upper GIT bleeding was not well studied. Our study was aimed to study the role of H.pylori infection in gastro-oesphageal variceal bleeding. Patients and Methods:The subjects were 392 cirrhotic patients who were admitted to the Zagazig University Hospital to treat their gastro-oesphageal varices, consisted of 190 with upper GIT bleeding (bleeder group) and 202 with non bleeding episodes but came for prophylactic purposes either primary or secondary prevention (non bleeder group). For the diagnosis of H. pylori infection, rapid urease test was done for endoscopic gastric biopsies.Results: Gastro-oesphageal variceal bleeding was seen in 31.6 % (n = 60) of the H.pylori infected patients and in 68.4% (n = 130) of the no infected patients (total number was 190 patients) (P < 0.001). The H.pylori infection was associated with low incidence of bleeding in patients with gastro-eosphageal varices. Conclusion:These results suggest that H.pylori infection may have a protective effect against gastro-esophageal variceal bleeding.