Peptic ulcer disease in liver cirrhosis and chronic hepatitis: impact of portal hypertension

Scand J Gastroenterol. 2014 Sep;49(9):1051-7. doi: 10.3109/00365521.2014.923501. Epub 2014 Jun 5.

Abstract

Objective: The pathophysiology of peptic ulcer disease (PUD) in liver cirrhosis (LC) and chronic hepatitis has not been established. The aim of this study was to assess the role of portal hypertension from PUD in patients with LC and chronic hepatitis.

Materials and methods: We analyzed the medical records of 455 hepatic vein pressure gradient (HVPG) and esophagogastroduodenoscopy patients who had LC or chronic hepatitis in a single tertiary hospital. The association of PUD with LC and chronic hepatitis was assessed by univariate and multivariate analysis.

Results: A total of 72 PUD cases were detected. PUD was associated with LC more than with chronic hepatitis (odds ratio [OR]: 4.13, p = 0.03). In the univariate analysis, taking an ulcerogenic medication was associated with PUD in patients with LC (OR: 4.34, p = 0.04) and smoking was associated with PUD in patients with chronic hepatitis (OR: 3.61, p = 0.04). In the multivariate analysis, taking an ulcerogenic medication was associated with PUD in patients with LC (OR: 2.93, p = 0.04). However, HVPG was not related to PUD in patients with LC or chronic hepatitis.

Conclusion: According to the present study, patients with LC have a higher risk of PUD than those with chronic hepatitis. The risk factor was taking ulcerogenic medication. However, HVPG reflecting portal hypertension was not associated with PUD in LC or chronic hepatitis (Clinicaltrial number NCT01944878).

Keywords: cirrhosis; peptic ulcer disease; portal hypertension; viral hepatitis.

MeSH terms

  • Adult
  • Alcoholism / epidemiology
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Female
  • Hepatitis, Chronic / complications
  • Hepatitis, Chronic / epidemiology*
  • Humans
  • Hypertension, Portal / epidemiology*
  • Hypertension, Portal / etiology
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / epidemiology*
  • Male
  • Middle Aged
  • Peptic Ulcer / chemically induced
  • Peptic Ulcer / epidemiology*
  • Platelet Aggregation Inhibitors / adverse effects
  • Prevalence
  • Risk Factors
  • Smoking / epidemiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Platelet Aggregation Inhibitors

Associated data

  • ClinicalTrials.gov/NCT01944878