Peptic ulceration in patients with chronic liver disease

A prospective study was undertaken to determine the frequency of peptic ulceration in different forms of chronic liver disease and the effect of corticosteroid treatment. One hundred sixty-three patients with chronic liver disease underwent upper gastrointestinal endoscopy, 106 for investigation of dyspeptic symptoms and the remaining 57 for assessment of the presence of varices. Twenty-four peptic ulcers were found (14.7%), 12 duodenal, 8 gastric, and 4 prepyloric. Ulcers were found in 5 of 15 patients with hepatitis B surface-antigen-positive chronic active liver disease (33%), 10 of 46 patients with alcoholic liver disease (22%), 5 of 35 with primary biliary cirrhosis (14%), 2 of 19 with miscellaneous chronic liver diseases (10%), and 2 of 25 with cryptogenic cirrhosis (8%). Ulcers were not demonstrated in any of the 23 patients with hepatitis B surface-antigen-negative chronic active hepatitis. Thirty-one patients were receiving prednisolone therapy, 5 had peptic ulcer compared with 19 of the remaining 132 patients. This difference was not significant. Fifty-nine patients presented with gastrointestinal bleeding on 88 separate occasions. Peptic ulcer was the cause in 6% of these. In chronic liver disease peptic ulcers occurred with differing frequencies in different forms of the disease. This was unaffected by corticosteroid therapy. Peptic ulcers were rarely the cause of gastrointestinal bleeding.

Peptic ulceration in patients with chronic liver disease Journal Articles