Role of Helicobacter pylori infection in the pathogenesis of minimal hepatic encephalopathy and effect of its eradication

Aujayeb, Avinash; Gupta, Alok; Chandra, M; Koowar, Sciddhartha

doi:10.1007/s12664-011-0087-7

Cited by 23 publications

(24 citation statements)

References 12 publications

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“…They stand in contrast to the findings of smaller studies, which revealed a high prevalence of serologically detected H. pylori infection in cirrhotic patients with overt and occult HE and implied a positive correlation between the severity of HE and the level of H. pylori antibodies, i.e., above or below cutoff [19,20].…”

Section: Discussioncontrasting

confidence: 86%

Prevalence of Helicobacter pylori Infection in Patients with Minimal Hepatic Encephalopathy

Schulz

Schütte

Reisener

et al. 2016

JGLD

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Background: Ammonia is a critical factor in the pathogenesis of minimal hepatic encephalopathy (MHE). Most of the ammonia is from bacterial production in the intestinal tract. Non-absorbable antibiotics and non-absorbable disaccharides are therefore the therapy of choice. A few studies have addressed the effect of ammonia produced by H. pylori in the pathogenesis of MHE. Methods: In this prospective clinical trial, 84 consecutive patients with liver cirrhosis (LC) underwent laboratory, psychometric und neurophysiological testing to determine serological H. pylori status, MHE and blood ammonia levels. Relevant clinical and demographic characteristics were documented. Results: Out of 84 LC patients (83% male), 29% presented with MHE as assessed by critical flicker frequency analysis (CFF). The prevalence of H. pylori infection in the cohort was 21%; 22% of H. pylori-infected patients presented with MHE according to the criterion of a positive CFF result. If the criterion for MHE was a positive CFF and a positive NCT-A result, then 17% of H. pylori positive patients suffered from MHE. The prevalence of MHE in H. pylori-negative patients, based on CFF alone and on the combination, was 30%. A proportion of 19% of the patients with MHE had increased blood ammonia levels. Conclusion: The amount of ammonia produced by H. pylori does not affect venous ammonia levels. Therefore, an additional benefit of H. pylori eradication in the treatment of hepatic encephalopathy in patients with LC is unlikely to occur. Key words: – – – – – . Abbreviations: CFF: critical flicker frequency analysis; GCP: good clinical practice; GI : gastrointestinal; HE: hepatic encephalopathy; H. pylori: Helicobacter pylori; LC: liver cirrhosis; MHE: minimal hepatic encephalopathy; NASH: non-alcoholic steatohepatitis; NCT-A: number connection test-A; NCT-B: number connection test-B; PHES: Psychometric hepatic encephalopathy score.

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Section: Discussioncontrasting

confidence: 86%

Prevalence of Helicobacter pylori Infection in Patients with Minimal Hepatic Encephalopathy

Schulz

Schütte

Reisener

et al. 2016

JGLD

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“…Currently, PPIs are the mainstay treatment option of peptic ulcers in the general population [13]. Helicobacter pylori infection contributes to the development of hyperammonemia [14] and subsequent episodes of hepatic encephalopathy in cirrhosis [15]. H. Pylori eradication has been improved by the use of PPIs-based triple therapy [16].…”

Section: Peptic Ulcer and H Pylori Infectionmentioning

confidence: 99%

“…H. Pylori eradication has been improved by the use of PPIs-based triple therapy [16]. Blood ammonia concentration was significantly reduced after PPIs-based triple treatment in cirrhotic patients [14,15]. Therefore, it might be of value that PPIs can reduce the risk of hepatic encephalopathy development in cirrhotic patients infected with Helicobacter pylori [17] (Figure 1).…”

Section: Peptic Ulcer and H Pylori Infectionmentioning

confidence: 99%

Insights to Indications and Harm of Proton Pump Inhibitors Usage in Patients with Liver Cirrhosis

Wadea¹

2017

GHOA

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“…They found that there was a significant association between H. pylori infection and MHE. Anti-H. pylori therapy results in reduction in blood ammonia levels and improvement in MHE (14). Shaikh et al (2012) determined the frequency of H. pylori in cases of hepatic encephalopathy with liver cirrhosis and found that before and after 10 day H. pylori eradication therapy, there was no significant improvement in HE grade and other parameters.…”

Section: Figure ( 2 )mentioning

confidence: 99%

Study of the Prevelance of Helicobacter Pylori Infection in Patients with Hepatic Encephalopathy in Medical Intensive Care Unit of Zagazig University Hospitals.

Khalifa¹

2016

IJAR

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Role of Helicobacter pylori infection in the pathogenesis of minimal hepatic encephalopathy and effect of its eradication

Abstract: In patients with liver cirrhosis, there is a significant association between H. pylori infection and MHE. Anti-H. pylori therapy results in reduction in blood ammonia levels and improvement in MHE.

Cited by 23 publications

References 12 publications

Prevalence of Helicobacter pylori Infection in Patients with Minimal Hepatic Encephalopathy

Prevalence of Helicobacter pylori Infection in Patients with Minimal Hepatic Encephalopathy

Insights to Indications and Harm of Proton Pump Inhibitors Usage in Patients with Liver Cirrhosis

Study of the Prevelance of Helicobacter Pylori Infection in Patients with Hepatic Encephalopathy in Medical Intensive Care Unit of Zagazig University Hospitals.

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