Frequency of peptic ulcer in patients having decompensated cirrhosis of liver.

Abstract

Introduction Hepatitis B and C are spreading like an endemic disease in developing countries like Pakistan, due to many reasons. The late diagnosis of HCV and HBV infection has resulted in increased number of patients with decompensated liver disease. One of the common complications of cirrhosis is upper GI bleed caused by peptic ulceration in UK. Local data shows peptic ulceration was the second commonest of the lesions causing upper GI bleed after esophegeal varices. Present study was conducted to determine the frequency of peptic ulcer in patients having decompensated cirrhosis of liver presenting with upper GI bleed, also to emphasize the importance of primary prophylaxis with proton pump inhibitors for prevention of peptic ulcer in these patients. Study design: Descriptive study. Setting: MU-III Allied Hospital Faisalabad. Materials and Methods: Hundred consecutive patients having decompensated cirrhosis of liver were selected according to pre designed proforma and endoscopy was performed to determine the site of bleeding, from Jun to November 2007. Results: This study showed peptic ulcer as the second most important cause of upper GI bleed (34%) after esophegeal varices (57%), also decompensate cirrhotics have increased incidence of peptic ulceration (34%) as compared to general population (8.3%). Also significant relationship between source of upper GI bleed and serum albumin level in patients having decompensated cirrhosis of liver. (P value = .019) was found. Conclusions: There is definitely an increased frequency of bleeding peptic ulcer in patients having decompensated liver cirrhosis as compared to general population necessitating the need of primary prophylaxis of peptic ulcer with proton pump inhibitor in decompensated cirrhotics.