Gastric antral erosions and Helicobacter pylori infection in cirrhotic patients: a pilot controlled study of oral bismuth vs ranitidine therapy.

A controlled study was performed comparing bismuth and ranitidine oral therapy in the treatment of chronic antral erosions and chronic active gastritis and in clearing Helicobacter pylori in cirrhotic patients. Forty four patients took part in the randomized study. H pylori was present in more than 50% of the patients in the study. There was a close association between the presence of H pylori and inflammatory activity of gastritis at an antral level (p less than 0.001). CBS was significantly better than ranitidine in clearing H pylori (p less than 0.001) and reducing inflammatory activity of gastritis (p less than 0.001). This reduction was related to H pylori clearance. No action of the two medications was observed in improving endoscopic findings of erosive gastritis. H pylori clearance did not influence amelioration of endoscopic chronic erosive antral gastritis (EG) in cirrhotic patients. These findings suggest that H pylori does not seem to play a pathogenetic role in the aetiology of EG in cirrhotic patients while it represents an important factor in determining and maintaining the inflammatory activity of histologically confirmed gastritis in these patients.