Fifty patients with chronic hepatic
encephalopathy (HE) were divided
according to endoscopic and
histopathological findings into
Helicobacter pylori (H.pylori) positive
(Group-A No. 30) and H.pylori
negative (Group-B No. 20). Ten
cirrhotic patients without HE nor
H.pylori were chosen as cirrhotic
control group, (Group-C). Groups-A
and B were treated for HE. Group-A
was also treated with anti- H.pylori
triple therapy regimen. Both
intragastric and plasma levels of
ammonia were assessed before and
after treatment. Eradication of
H.pylori in 80 % of group-A patients
correlated positively with the
decreased both ammonia levels and
with clinical improvement. Also,
ammonia levels were found to be
correlated well with the grade of liver
disease according to Child's
Classification. Group-B had
undetectable gastric juice ammonia
level with in significant decrease of
ammonia plasma level after HE
treatment (p>0.05).
From these results it was
concluded that H.pylori has a strong
association with ammonia levels in
patients with chronic HE, so strategy of HE management should include
H.pylori diagnosis and eradication to
improve the net result of therapy of C,
HE management. |
