Factors predisposing to peptic ulcer disease in asymptomatic cirrhotic patients

Background: There is a high prevalence of peptic ulcer in cirrhotic patients, but the pathogenesis of peptic ulcer in cirrhosis remains inconclusive. Aim: To investigate factors associated with peptic ulcer and to evaluate peptic ulcer prevalence in asymptomatic cirrhotic patients. Methods: A total of 130 cirrhotics were recruited into the study for endoscopic screening. Data were collected and biochemical tests were done. Doppler ultrasound was used to assess the portal vein velocity and size. Patients underwent endoscopy for the presence of varices and peptic ulcer. Helicobacter pylori infection was confirmed by urease test, histology and C-14-urea breath test. Statistical analysis was performed. Results: Peptic ulcer was detected in 50 (39%) cases. Between peptic ulcer and non-peptic ulcer groups, there were no significant differences in age, sex, alcoholic drinking, smoking, non-steroidal anti-inflammatory drug use, portal vein velocity and size, except for H. pylori infection (P = 0.006), serum albumin (P =0.02) and Child-Pugh score (P = 0.03). By multivariate analysis, H. pylori infection (OR: 3.26; 95% CI: 1.49-7.13; P = 0.003), Child-Pugh classes B (OR: 2.48; 95% CI: 1.04-5.91; P = 0.04) and C (OR: 3.26; 95% CI: 1.2-8.81; P = 0.02) were independently associated with peptic ulcer. Conclusion: H. pylori infection and advanced cirrhosis are important factors associated with active peptic ulcer.