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Abstract
Introduction Peptic ulcer disease (PUD) is more prevalent in patients with advanced chronic liver disease (ACLD) than in the general population. Helicobacter pylori (Hp) infection is the main aetiological factor in PUD. This study aims to assess the incidence, testing rate and eradication of Hp infection and PUD in patients with ACLD, along with the clinical impact of complicated PUD.
Methods This retrospective study included patients with ACLD followed at the outpatient clinic of Unidade Local de Saúde de Braga between 2018 and 2022. The incidence, testing and eradication rates of Hp infection were assessed, as well as the presence of uncomplicated and complicated PUD.
Results Of the 740 patients with ACLD, 295 (40%) were tested for Hp through oesophagogastroduodenoscopy (EGD) with gastric biopsies, of whom 125 (42%) tested positive for Hp. Of these, 53 patients (42%) underwent eradication. The EGD revealed PUD in 56 of the 295 patients (19%). In the multivariate analysis, Hp positivity (OR 2.328; p=0.007), alcohol consumption (OR 1.911; p=0.038) and no statin intake (OR 3.649; p=0.013) were independent predictors of uncomplicated PUD. Of the total 740 patients, 30 (4.1%) had complicated PUD (bleeding/perforation). 6 months after a complicated PUD episode, 12 patients (33%) had de novo/further hepatic decompensation, and 8 patients (27%) died due to decompensated ACLD.
Conclusions The rate of Hp testing in patients with ACLD is low, while the incidence of Hp and PUD was high. Complicated PUD has significant morbidity in patients with ACLD. The testing and eradication of Hp in patients with complicated PUD are insufficient.
- HELICOBACTER PYLORI
- CIRRHOSIS
- GASTRIC AND DUODENAL ULCERS
Data availability statement
Data are available on reasonable request. The data that support the findings of this study are available on request from the corresponding author TC. The data are not publicly available since it can contain information that could compromise the privacy of research participants.
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Data availability statement
Data are available on reasonable request. The data that support the findings of this study are available on request from the corresponding author TC. The data are not publicly available since it can contain information that could compromise the privacy of research participants.
Footnotes
TC and FVC contributed equally.
Contributors TC and FVC contributed equally and shared the first authorship. TC and FVC were responsible for the data analysis, data collection and drafting of the manuscript. SRS and DC were responsible for the collection and analysis of the data and helped draft the manuscript. DF and ACC were responsible for the design of the study, interpretation and critical revision of the work for important intellectual content. All authors approved the final version to be published. ACC is the guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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