Title: Eradication of Helicobacter pylori that contributes to hepatogenic ulcer is beneficial to
the healing of hepatogenic ulcer
Version: 1 Date: 25 Feb 2024
Reviewer:  Abdullah Ozgur Yeniova
Reviewer's report:
The study titled “Eradication of Helicobacter pylori that contributes to hepatogenic ulcer
is beneficial the healing of hepatogenic ulcer” was reviewed according to the publication
guidelines of journal BMC Gastroenterology. First of all when I read the manuscript; I heard
first time the term “Hepatogenic ulcer”. Thus I made a search from Pubmed. The concept of
“ Hepatogenic gastroduodnal ulcer” was described firstly in 1964. There is almost no studies
regarding this issue in last decade. But I raised a question about the relationship between
Hepatogenic ulcer and Helicobacter pylori. When a liver cirrhosis patient have an ulcer and
colonized by Helicobacter pylori, how can we define this ulcer is not due to Helicobacter pylori.
I think this issue is the most important part of this manuscript. Authors must consider this
and write the discussion carefully about and they must refer to the studies that were published
in 1970s and 1960s even if most of them are not written in English. For example the first
study also asked the same question “ Is there a hepatogenic ulcer” (Strobach G, Wildhirt E. [Is
There a Hepatogenic Ulcer?]. Deutsche medizinische Wochenschrift. 1964;89:2241-4)  I did
not find this study furthermore it is written in German. Other wise; the questions whether HP
contributes to the ulcer pathogenesis in liver cirrhosis patient and we can diagnose these patients
as “hepatogenic ulcer” are worth to reseach. The manuscript can be published after revisions.
Revisions that must be corrected can be found below
1) Authors mentioned about the results of the study in introduction section. ( Page 2 line 52-
53) these sentences must be deleted
2) Authors explained how rapid urease test is done ( page 3 line 83- 90) I think this is unnecessary
because rapid urease test is a routine laboratory test and authors may give areferance intead of
explaining how it works detailly I suggest to delete this part but it is up to authors.
3) Authors must explain why do perform two test for HP diagnose. Both of the test have a
sensitivity above % 80 and they are routinely used by clinicians for their daily practice
4) Authors did not give treatment to 30 patients with HP and hepatogenic ulcer. I think itmat
raise an ethical problem because if one patient is diagnosed with HP, individual must receive a
treatment whether or not HP can be eradicated because HP is accepted as most significant risk
factor for gastric cancer.
5) Table 1 should be prepared again with p values appropriately
6) Why authors prefer” rabeprazole plus amoxicillin and  levofloxacin” for eradication of HP.
They may refer to the studies that shows the effectivity of this regimen
7) What is “FU group”. Authors did not give a abbreviation for “FU”. Did they mean “Functional
Dyspepsia and the abbreviation is “FD” ?
Title: Eradication of Helicobacter pylori that contributes to hepatogenic ulcer is beneficial to
the healing of hepatogenic ulcer
Version: 1 Date: 25 Feb 2024
Reviewer:  Abdullah Ozgur Yeniova
Reviewer's report:
The study titled “Eradication of Helicobacter pylori that contributes to hepatogenic ulcer
is beneficial the healing of hepatogenic ulcer” was reviewed according to the publication
guidelines of journal BMC Gastroenterology. First of all when I read the manuscript; I heard
first time the term “Hepatogenic ulcer”. Thus I made a search from Pubmed. The concept of
“ Hepatogenic gastroduodnal ulcer” was described firstly in 1964. There is almost no studies
regarding this issue in last decade. But I raised a question about the relationship between
Hepatogenic ulcer and Helicobacter pylori. When a liver cirrhosis patient have an ulcer and
colonized by Helicobacter pylori, how can we define this ulcer is not due to Helicobacter pylori.
I think this issue is the most important part of this manuscript. Authors must consider this
and write the discussion carefully about and they must refer to the studies that were published
in 1970s and 1960s even if most of them are not written in English. For example the first
study also asked the same question “ Is there a hepatogenic ulcer” (Strobach G, Wildhirt E. [Is
There a Hepatogenic Ulcer?]. Deutsche medizinische Wochenschrift. 1964;89:2241-4)  I did
not find this study furthermore it is written in German. Other wise; the questions whether HP
contributes to the ulcer pathogenesis in liver cirrhosis patient and we can diagnose these patients
as “hepatogenic ulcer” are worth to reseach. The manuscript can be published after revisions.
Revisions that must be corrected can be found below
1) Authors mentioned about the results of the study in introduction section. ( Page 2 line 52-
53) these sentences must be deleted
2) Authors explained how rapid urease test is done ( page 3 line 83- 90) I think this is unnecessary
because rapid urease test is a routine laboratory test and authors may give areferance intead of
explaining how it works detailly I suggest to delete this part but it is up to authors.
3) Authors must explain why do perform two test for HP diagnose. Both of the test have a
sensitivity above % 80 and they are routinely used by clinicians for their daily practice
4) Authors did not give treatment to 30 patients with HP and hepatogenic ulcer. I think itmat
raise an ethical problem because if one patient is diagnosed with HP, individual must receive a
treatment whether or not HP can be eradicated because HP is accepted as most significant risk
factor for gastric cancer.
5) Table 1 should be prepared again with p values appropriately
6) Why authors prefer” rabeprazole plus amoxicillin and  levofloxacin” for eradication of HP.
They may refer to the studies that shows the effectivity of this regimen
7) What is “FU group”. Authors did not give a abbreviation for “FU”. Did they mean “Functional
Dyspepsia and the abbreviation is “FD” ?
Please review this paper.
user
Title: Eradication of Helicobacter pylori that contributes to hepatogenic ulcer is beneficial to
the healing of hepatogenic ulcer
Version: 1 Date: 25 Feb 2024
Reviewer:  Abdullah Ozgur Yeniova
Reviewer's report:
The study titled “Eradication of Helicobacter pylori that contributes to hepatogenic ulcer
is beneficial the healing of hepatogenic ulcer” was reviewed according to the publication
guidelines of journal BMC Gastroenterology. First of all when I read the manuscript; I heard
first time the term “Hepatogenic ulcer”. Thus I made a search from Pubmed. The concept of
“ Hepatogenic gastroduodnal ulcer” was described firstly in 1964. There is almost no studies
regarding this issue in last decade. But I raised a question about the relationship between
Hepatogenic ulcer and Helicobacter pylori. When a liver cirrhosis patient have an ulcer and
colonized by Helicobacter pylori, how can we define this ulcer is not due to Helicobacter pylori.
I think this issue is the most important part of this manuscript. Authors must consider this
and write the discussion carefully about and they must refer to the studies that were published
in 1970s and 1960s even if most of them are not written in English. For example the first
study also asked the same question “ Is there a hepatogenic ulcer” (Strobach G, Wildhirt E. [Is
There a Hepatogenic Ulcer?]. Deutsche medizinische Wochenschrift. 1964;89:2241-4)  I did
not find this study furthermore it is written in German. Other wise; the questions whether HP
contributes to the ulcer pathogenesis in liver cirrhosis patient and we can diagnose these patients
as “hepatogenic ulcer” are worth to reseach. The manuscript can be published after revisions.
Revisions that must be corrected can be found below
1) Authors mentioned about the results of the study in introduction section. ( Page 2 line 52-
53) these sentences must be deleted
2) Authors explained how rapid urease test is done ( page 3 line 83- 90) I think this is unnecessary
because rapid urease test is a routine laboratory test and authors may give areferance intead of
explaining how it works detailly I suggest to delete this part but it is up to authors.
3) Authors must explain why do perform two test for HP diagnose. Both of the test have a
sensitivity above % 80 and they are routinely used by clinicians for their daily practice
4) Authors did not give treatment to 30 patients with HP and hepatogenic ulcer. I think itmat
raise an ethical problem because if one patient is diagnosed with HP, individual must receive a
treatment whether or not HP can be eradicated because HP is accepted as most significant risk
factor for gastric cancer.
5) Table 1 should be prepared again with p values appropriately
6) Why authors prefer” rabeprazole plus amoxicillin and  levofloxacin” for eradication of HP.
They may refer to the studies that shows the effectivity of this regimen
7) What is “FU group”. Authors did not give a abbreviation for “FU”. Did they mean “Functional
Dyspepsia and the abbreviation is “FD” ?
assistant