Magnitude and associated factors of Peptic Ulcer Disease among patients with chronic liver disease at St. Paul’s Hospital Millennium Medical Collage: A 21-month retrospective study

Abstract

Abstract Background Chronic liver disease and its complications are major health problems worldwide. Peptic ulcer disease is one of the most frequently observed complications in patients with liver cirrhosis. Factors related to peptic ulcer development and the causes of increased prevalence of the disease in cirrhotic patients are poorly understood. Objective To assess the magnitude and associated factors of peptic ulcer disease among patients with chronic liver disease at St. Paul’s Hospital Millennium Medical Collage gastrointestinal clinic. Methodology Using a retrospective analytic study design, a cross sectional study was conducted at St Paul’s Hospital Millennium Medical College GI and endoscopy unit. 148 consecutive cirrhotic patients who had upper GI endoscopy and follow up across a 21-month period from September 1, 2017 to June 1, 2019 were included. Their charts were reviewed for socio-demographic and clinical information using a structured questionnaire. Data was analyzed using SPSS version 25 and a pvalue <0.05 was considered significant. Tables and figures were used to describe the results. Results All hundred forty-eight patients (M/F: 106/42, mean age: 38 years) were included in the analysis. Hepatitis B virus (46.6%) and alcohol (18.9%) were the most common causes of cirrhosis. The prevalence of peptic ulcer disease in patients with cirrhosis was 19.6% with duodenal ulcer prevalence of 8.1%. H. Pylori infection (P=0.037), and Child-Pugh class C (P= 0.001) and ascites (P= 0.023) were associated with peptic ulcer in cirrhotic patients. By multivariate analysis, H. pylori infection (OR: 3.65; 95% CI: 1.12– 11.88; P = 0. 032) was independently associated with peptic ulcer. Conclusion and recommendation The study showed that peptic ulcer was present in 19.6% patients of liver cirrhosis. In patients with CLD, who present with upper GI bleeding, ulcer should be considered as an important cause and should be treated. Patients should also be considered for treatment of H. Pylori after stabilization.