Various aspects of peptic ulcer in patients with liver cirrhosis

Introduction. The occurrence of peptic ulcer in patients with liver cirrhosis is intriguing due to its frequency and complexity. The aim of the present study was to investigate the incidence of peptic ulcer in patients with liver cirrhosis. Results. It was found that in these patients the usual aggressive factors of the gastric environment do not play a major role in ulcerogenesis; however, researches noticed the importance of reduced mucosal defense which, in portal hypertension, has the features of hypertensive portal gastropathy. The presence of Helicobacter pylori infection in these patients is lower, compared to other patients with peptic ulcer. The prevalence of Helicobacter pylori infection decreases with the severity of liver cirrhosis. Non-steroidal anti-inflammatory drugs play an important role in peptic ulcer bleeding in cirrhotic patients, but the data are limited and contradictory. Peptic ulcer bleeding is the most frequent etiology of nonvariceal bleeding and it is associated with a great number of complications. Conclusion. Helicobacter pylori infection cannot be considered the key risk factor for the development of peptic ulcer in patients with liver cirrhosis. The role of non-steroidal anti-inflammatory drugs is accepted, although the data are controversial. The treatment of peptic ulcer in cirrhotic patients is identical to the treatment of peptic ulcer in patients without liver cirrhosis, except in cases of bleeding ulcers. There are specific therapeutic protocols for peptic ulcer bleeding in patients with liver cirrhosis.