AUTHOR=Alarfaj Sumaiah J. , Abdallah Mostafa Sally , Abdelsalam Ramy A. , Negm Walaa A. , El-Masry Thanaa A. , Hussein Ismail A. , El Nakib Ahmed Mohamed 

TITLE=Helicobacter pylori Infection in Cirrhotic Patients With Portal Hypertensive Gastropathy: A New Enigma?

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.902255

DOI=10.3389/fmed.2022.902255

ISSN=2296-858X

ABSTRACT=<p>The relationship between <italic>Helicobacter pylori</italic> (<italic>H. pylori</italic>) infection and Portal hypertensive gastropathy (PHG) is still a debatable matter. The aim of this study is to find out how common <italic>H. pylori</italic> infection is in cirrhotic patients with PHG and to see if there’s a link between <italic>H. pylori</italic> infection and PHG severity. Out of 340 cirrhotic patients who had upper Gastrointestinal Tract (GIT) endoscopy for early varices screening, 160 cirrhotic patients were selected and divided into 2 groups; 80 cirrhotic patients with PHG (cases) and 80 cirrhotic patients without PHG (controls). Gastric biopsies were taken from all enrolled patients for histological evaluation for the presence or absence of <italic>H. pylori</italic> infection. <italic>H. pylori</italic> was found in 44 cirrhotic patients (55%) who had PHG (cases), compared to 22 cirrhotic patients (27.5%) who did not have PHG (controls). The prevalence of <italic>H. pylori</italic> infection was significantly higher in patients with PHG (<italic>p</italic> &lt; 0.001). The severity of PHG was associated with <italic>H. pylori</italic> infection (<italic>p</italic> &lt; 0.001). The response to eradication therapy of <italic>H. pylori</italic> infection was must better in patients without PHG (<italic>p</italic> = 0.045). By multi-variant analysis, <italic>H. pylori</italic> infection, splenic diameter, and portal vein diameter were independent predictors for PHG presence. After treating <italic>H. pylori</italic> infection in patients who tested positive for <italic>H. pylori</italic>, there was a significant reduction in PHG severity (<italic>p</italic> &lt; 0.001). Patients with PHG have a greater prevalence of <italic>H. pylori</italic> infection. PHG is more severe in patients infected with <italic>H. pylori</italic>. To improve PHG severity, cirrhotic patients must have their <italic>H. pylori</italic> infection eradicated.</p>