Epidemiology of asymptomatic peptic ulcer disease diagnosed during screening endoscopy in patients with cirrhosis

J Int Med Res. 2024 Dec;52(12):3000605241305258. doi: 10.1177/03000605241305258.

Abstract

Objective: Asymptomatic peptic ulcer disease (PUD) is frequently overlooked in patients with cirrhosis, who are at increased risk for gastrointestinal complications that can lead to increased morbidity and mortality. We aimed to determine the prevalence and associated factors of asymptomatic PUD identified during screening endoscopy in patients with cirrhosis.

Methods: We conducted a retrospective cross-sectional study among patients with cirrhosis at St. Paul's Hospital Millennium Medical College in Ethiopia. Data were collected using a structured questionnaire from patients' medical charts. A logistic regression model was used to identify predictors of peptic ulcer.

Results: This study included 296 patients, revealing that 19.6% had PUD (95% confidence interval: 13.5-26.4). Significant associations were found between peptic ulcer and Helicobacter pylori infection, moderate and heavy alcohol consumption, and Child-Pugh class C cirrhosis.

Conclusion: We found that patients with liver cirrhosis are more likely to have asymptomatic peptic ulcers. Asymptomatic PUD was linked to H. pylori infection, greater alcohol consumption, and Child-Pugh class C liver disease, highlighting the need for targeted prevention and management strategies to reduce morbidity in patients with cirrhosis, such as eradication therapy for H. pylori and counseling on alcohol use.

Keywords: Peptic ulcer; asymptomatic; chronic liver disease; endoscopy; liver cirrhosis; prevalence.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Female
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / diagnosis
  • Helicobacter Infections* / epidemiology
  • Helicobacter Infections* / microbiology
  • Helicobacter pylori* / isolation & purification
  • Humans
  • Liver Cirrhosis* / complications
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / epidemiology
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Peptic Ulcer* / diagnosis
  • Peptic Ulcer* / epidemiology
  • Prevalence
  • Retrospective Studies
  • Risk Factors