Effect of Helicobacter Pylori Eradication on Hepatic Encephalopathy

Ammonia has still essential role in pathogenesis of encephalopathy. It is probable that helicobacter pylori (H. pylori) infection leads to hyperammonemia and aggravates the hepatic encephalopathy via urease activity or its effect on zinc level. This study was aimed to assess the effect of H pylori eradication on hepatic encephalopathy. In a cross-sectional study, 42 cirrhotic patients with encephalopathy were enrolled the study. For evaluation the encephalopathy, flapping tremor, number connection test (NCT) and grade of encephalopathy was determined for all of the patients. The prevalence of H pylori infection was evaluated based on positive serology by ELAISA method (Genesis Kit, UK), and/or rapid urease test (RUT) during endoscopic evaluation. One month later, after treatment, grading of encephalopathy, NCT and flapping tremor was evaluated again and data were analyzed by software SPSS. Serologic evaluation or RUT showed that 30 patients of 42 (71.42%) were positive for H pylori. In comparison between pre and post treatment, grade of encephalopathy and NCT were reduced significantly but alteration in flapping tremor was not statistically significant. Our results indicate that eradication of H pylori may lead to improve the grade of hepatic encephalopathy and NCT.