The Korean Journal of Internal Medicine : 23:16-21, 2008 Helicobacter pylori Infection and Peptic Ulcer Disease in Patients with Liver Cirrhosis Dong Joon Kim, M.D., Hak Yang Kim, M.D., Sung Jung Kim, M.D., Tae Ho Hahn, M.D., Myoung Kuk Jang, M.D., Gwang Ho Baik, M.D., Jin Bong Kim, M.D., Sang Hoon Park, M.D., Myung-Seok Lee, M.D. and Choong Kee Park, M.D. Department of Internal Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea Background/Aims : We investigated the prevalence and relationship of peptic ulcer disease and Helicobacter pylori infection to liver cirrhosis. Methods : We examined 288 patients with liver cirrhosis, 322 patients with non-ulcer dyspepsia, and 339 patients with peptic ulcer disease. Rapid urease test and Wright-Giemsa staining were used for diagnosis of H. pylori infection. Results : The prevalence of peptic ulcer disease in patients with cirrhosis was 24.3%. The prevalence of peptic ulcer disease in patients with cirrhosis divided into Child-Pugh classes A, B, and C was 22.3%, 21.0%, and 31.3%, respectively (p >0.05). The prevalence of H. pylori infection in the patients with cirrhosis, non-ulcer dyspepsia, and peptic ulcer without chronic liver disease were 35.1%, 62.4%, and 73.7%, respectively (p <0.001). The prevalence of H. pylori infection did not differ depending on whether there was peptic ulcer (35.6%) or not (34.9%) in patients with liver cirrhosis (p >0.05). The prevalence of H. pylori infection in patients with hepatitis virus-related liver cirrhosis and in the patients with alcohol-related liver cirrhosis was 42.5% and 22.0%, respectively (p <0.001). The prevalence of H. pylori infection in patients with Child-Pugh classes A, B, and C liver cirrhosis was 51.5%, 30.5%, and 20.0%, respectively (p<0.001). Conclusions : Factors other than H. pylori may be involved in the pathogenesis of peptic ulcer disease in the setting of liver cirrhosis. Key Words : Helicobacter pylori; Liver cirrhosis; Peptic ulcer INTRODUCTION Chronic liver disease and its complications are major health problems. Peptic ulcer disease is one of the most frequently observed complications in patients with liver cirrhosis. Although the incidence and prevalence of peptic ulcer disease appear to be increased in cirrhosis, the underlying mechanism of peptic ulcer disease in cirrhosis is unclear1-3). In the general population, Helicobacter pylori infection is central to the pathogenesis of peptic ulcer disease4, 5). However, the role of H. pylori infection in the pathogenesis of peptic ulcer disease in cirrhotic patients still remains to be elucidated. Many studies have suggested a role for H. pylori infection in the pathogenesis of peptic ulcer disease in cirrhotic patients, but several studies have found no relationship6-24). Moreover, there is debate concerning the relationship between H. pylori infection and the etiology or severity of cirrhosis. The aim of this study was to define the prevalence of peptic ∙Received : October 11, 2007 ∙Accepted : February 11, 2008 ∙Correspondence to : Dong Joon Kim, M.D., Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, 153 Gyo-dong, Chuncheon 200-704, Korea Tel : 82-33-242-5876, Fax : 82-33-241-8064, E-mail : djkim@hallym.ac.kr *This study was supported by Hallym University Research Fund.