A Study on the Correlation between Infection with Helicobacter Pylori and Hepatic Encephalopathy in Patients with Chronic Liver Disease
Journal Title: IOSR Journal of Pharmacy and Biological Sciences (IOSR-JPBS) - Year 2016, Vol 11, Issue 1
Abstract
Background: Hepatic encephalopathy is a complex neuropsychiatric syndrome occurring in patients with severe hepatic insufficiency. A multitude of factors and pathogenic processes appear to be operative, with the accumulation of toxic products in the brain, originating from the gut, not metabolized by the diseased liver, being the most important factor. Objectives: To find out whether there is any correlation between the gastric ammonia concentration and Helicobacter pylori infection of the stomach. To find out whether there is any correlation between the gastric ammonia and blood ammonia concentration and occurrence of hepatic encephalopathy in Helicobacter pylori infected subjects. Materials And Methods: A comparative, case-control study between June 2014 and June 2015 where 50 cases (chronic liver disease with hepatic encephalopathy) and 50 controls (chronic liver disease without hepatic encephalopathy) were selected from the indoors and outpatients of the departments of Medicine, Gastroenterology of R.G. Kar Medical College. Arterial and gastric ammonia level, RUT test for H. pylori detection and psychometric testing were performed for hepatic encephalopathy detection. (signature, construction of a standard 5-pointed star), subtraction of serial sevens, Number Connection Test (NCT) and Line Tracing Test(LTT). Result: The mean arterial blood ammonia level in patients with hepatic encephalopathy was 73.220± 23.234 (Range: 20-100) umol/L and that in patients without hepatic encephalopathy was 19.080± 5.337 ( Range : 11- 35) umol/L. The difference in the two groups was highly significant (p=<0.0001). The mean Gastric Juice Ammonia level in patients with hepatic encephalopathy was 2.367± 0.7467 mmol/L (Range: 0.50 – 3.5) and that in patients without hepatic encephalopathy was 1.242± 0.2936mmol/L ( Range : 0.75 - 2) The difference was significant (p=< 0.0001). The prevalence of H. pylori infection was found to be significantly higher in those patients having chronic liver disease who presented with encephalopathy than who were in the control group ( i.e without encephalopathy). ( 67% VS 33%, p=0.0327 ) Conclusion: There is a positive correlation between H. pylori infection of the stomach and the gastric juice ammonia concentration in patients with chronic liver disease. There is significant correlation between the gastric juice ammonia concentration and the occurrence of hepatic encephalopathy in-patients with chronic liver disease. There is significant correlation between H. pylori infection of the stomach and the occurrence of hepatic encephalopathy in patients with chronic liver disease.
Authors and Affiliations
1Nag Arindam, 2Mandal ch Bidhan, Hembram Anjan, 4Debnath Partho,
Keywords
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- DOI 10.9790/3008-11132533 .
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