The Effect of Helicobacter pylori Eradication on Gastric Juice and Blood Ammonia Concentrations and on Visual Evoked Potentials in Cirrhotics

ABSTRACT Background. The primary source of ammonia is the gut. Ammonia can also be generated by the urease activity of Helicobacter pylori in the gastric mucosa. The aim of this study was to investigate the effect of H. pylori eradication on blood and gastric juice ammonia levels and on visual evoked potential (VEP) recordings in cirrhotic patients. Materials and Methods. Male patients with cirrhosis and H. pylori infection were prospectively evaluated. All patients were given triple regimen for eradication for 10 days. Gastroscopy together with gastric juice sampling for ammonia and mucosal sampling for H. pylori status was performed before and after therapy. Gastric juice and blood ammonia levels were measured and VEP recordings were obtained before and after treatment. Results. Twenty‐seven patients were included in the study. Patients with overt clinical hepatic encephalopathy were excluded from the study. Twenty‐four out of twenty‐seven patients became H. pylori‐negative after the treatment. Ammonia measurements and VEP recordings were evaluated in the 24 patients in whom eradication was successful. A slight but statistically significant decrease in blood and a considerable decrease in gastric juice ammonia levels were observed after treatment [from 44.23 µmol/l to 41.6 µmol/l compared with 3234 µmol/l to 2709 µmol/l, respectively (p .05). Conclusions. Helicobacter pylori eradication in cirrhotics decreases blood and gastric juice ammonia concentrations whereas it does not provide an improvement in VEP recordings.