EFFECT OF H. PYLORI ERADICATION IN HEPERAMMONIEMIA AND HEPATIC ENCEPHALOPATHY IN YEMENI CIRRHOTIC PATIENTS

Background: H. pylori infection promotes the production of ammonia, which is an etiological factor involved in gastric mucosal disorders. This study aims to evaluate the benefit of H. pylori eradication in cirrhotic patients and its effect on H. encephalopathy.

Methods and Materials:  This retrospective study included 79  patients that were included in this study including  43 (54.43 %)  males & 36 (45.56%%)  females conducted at  Specialized  Hepatobiliary and Gastroenterology Research Center in Sana’a, Yemen. The cohort was divided into 3 age groups: one patient  (younger than 20  years old ), 27 patients (20-40  years old) , and  51  patients  (  <  40 years old ) .  All cases are diagnosed as chronic liver disease on the basis of clinical features and laboratory investigations.  Survival of liver disease patients was assessed using Child-Turcotte-Pugh score.

Results:   There were  79  H. pylori-positive cirrhotic patients who received eradication therapy, among whom  H. pylori-eradicated group of patients included 42  patients and the eradication rate was 53.61% (42/79) .  H. encephalopathy rate is 100% in our case.

The results of our  study showed that there was a statistically significant association between the group of cirrhotic patients with   H. pylori eradication and mild elevation of serum ammonia only  (P value  0.019). Furthermore,   there was a statistically significant association between hepatic encephalopathy grade (0-1) and the group of patients with  H. pylori eradication   (P value 0.024).  

Conclusion: H. pylori eradication may be helpful for the treatment and prevention of early grades of hepatic encephalopathy.

Keywords: H. pylori eradication, cirrhosis, ammonia, encephalopathy, Yemen.