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STUDY TO EVALUATE ROLE OF HELICOBACTER PYLORI INFECTION IN THE PATHOGENESIS OF MINIMAL HEPATIC ENCEPHALOPATHY AND EFFECT OF ITS ERADICATION AT MAYO HOSPITAL LAHORE

Dr Huma Masood, Dr Humna Fatima, Dr Sharoon Shahzad

Background and Aim Helicobacter pylori (H. pylori) bacteria’s main activity is to convert urea to ammonia, but in patients with liver cirrhosis it has been implicated in causation of hepatic encephalopathy. There has not been enough research in studying the role of H. pylori infection in causation of minimal hepatic encephalopathy (MHE). We looked at the relationship of H. pylori infection with MHE and hyper- ammonemia in patients with liver cirrhosis and the effects of anti-H. pylori treatment in patients with MHE and H. pylori infection. Methods Patients with liver cirrhosis underwent psycho- metric tests for detection of MHE, rapid urease test to look for evidence of H. pylori infection and fasting blood ammonia levels measurements. Patients with MHE were treated with triple-drug anti-H. pylori treatment for one week. Rapid urease test, blood ammonia levels, and psychometric tests were repeated four weeks after treatment. Results H. pylori infection’s occurrence is found more with MHE (63%) than in those without MHE (37%). Blood ammonia levels were significantly higher in patients with MHE than those without. After H. pylori treatment in patients with MHE, blood ammonia levels showed a significant decline and psychometric test results returned towards normal. Conclusion There is a significant association between H. pylori infection and MHE. Anti-H. pylori therapy results in reduction in blood ammonia levels and improvement in MHE in patients with liver cirrhosis.

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