Objectives: Novel coronavirus 2019 (corona virus disease 2019 [COVID-19]) binds angiotensin-converting enzyme-2 (ACE-2) receptors to enter the cell. These receptors are widely expressed in the intestine, and COVID-19 may cause gastrointestinal symptoms via these receptors during the course of the disease. Helicobacter pylori is known to increase the expression of ACE-2 receptors in the gastrointestinal tract. The aim of this study was to investigate the effects of H pylori on the presentation and clinical course of COVID-19 infections. Methods: This study was carried out from June 1 to July 20, 2020. Patients diagnosed with COVID-19 infections by PCR tests were included in the study. Antigen screening tests were performed on stool samples to determine the presence of H pylori. All patients were evaluated for manifestations of COVID-19 infection, severity of the course, hospitalized days because of the virus and outcome of the disease process. Results: Of 108 COVID-19 positive patients evaluated, 31 with a mean age of 49.54 ± 17.94 years were H pylori-positive (8 girls [25.8%]) and 77 with a mean age of 47.85 ± 20.51 years; (31 girls [40.3%]) were H pylori-negative. Abdominal pain (19.4% vs 2.6%) and diarrhea (32.3% vs 9.1%) were significantly higher in patients with H pylori than those without (P = 0.007 and P = 0.006, respectively). There was no statistically significant difference between H pylori positivity and the number of hospitalized days, the severity of the course of COVID-19 infection, or the outcome of the disease (P > 0.05). Conclusion: Our results revealed that the findings of abdominal pain and diarrhea strongly correlated with the presence of H pylori in COVID-19 patients.
Background Eradication rates of Helicobacter pylori (H pylori) with standard triple therapy are gradually decreasing all over the world, including in children, due to the development of strains resistant to antimicrobials. Sequential therapy can be used as an alternative method to increase eradication rates. Materials and Methods A total of 75 patients ≥ 8 years of age with H pylori gastritis were included in the study. According to Rome IV criteria, 38 patients had functional abdominal pain and dyspepsia, and 37 patients had alarm findings suggesting organic disease. Patients were treated with a novel sequential therapy consisting of the proton pump inhibitor (PPI)‐lansoprazole (1 mg/kg/day, maximum 30 mg daily), amoxicillin (50 mg/kg/d in two doses, maximum 2 × 1000 mg) for 7 days followed by PPI‐lansoprazole (1 mg/kg/d, maximum 30 mg daily), metronidazole (20 mg/kg/day in two doses, maximum 2 x 500 mg), tetracycline (50 mg/kg/d divided into four equal doses, maximum 4 x 500 mg), and bismuth subsalicylate (262 mg QID in patients ≤ 10 years of age, 524 mg QID in patients > 10 years of age in days 8‐14). Eradication status was evaluated by H pylori stool antigen test 8 weeks after the completion of treatment. Results The mean age of the patients was 15.1 ± 2.4 years and 51 (68%) were female. No patient discontinued therapy due to side effects. All patients had antral gastritis (76.0%) or pangastritis (24.0%). The peptic ulcer rate was 6.6%. Eradication therapy was given to all patients with or without peptic ulcer. H pylori eradication was achieved in 69 (92.0%) patients and symptoms improved in 61 of those eradicated. Conclusions As a first‐line treatment for H pylori eradication in children, administering a novel sequential therapy including bismuth for 14 days provides a high rate of eradication.
<b><i>Background:</i></b> Most studies of the relationship between duodenogastric reflux (DGR) and <i>Helicobacter pylori</i> have reported that the presence of DGR decreases <i>H. pylori</i> colonization, while <i>H. pylori</i> infection increases the frequency of DGR by impairing antroduodenal motility. The present study aimed to investigate the relationship between primary DGR and the prevalence of <i>H. pylori</i> in children, as well as the degree of colonization and the presence and severity of gastritis. <b><i>Methods:</i></b> Included in the study were 410 patients between the ages of 2 and 18 years, referred to the pediatric gastroenterology clinic with complaints of dyspepsia, abdominal pain, and nausea/vomiting, who underwent upper gastrointestinal system endoscopic examination and stomach biopsy. The study group included 60 patients with DGR, while 350 non-DGR patients formed the control group. <b><i>Results:</i></b> The mean age of patients with DGR was 15.7 ± 2.1 years, while the mean age of the control group was 14.2 ± 3.8 years (<i>p</i> = 0.02). Of those with DGR, 50 (83.3%) were girls, while in the control group, 215 (61.4%) were girls (<i>p</i> = 0.001). Of patients with DGR, 16 were <i>H. pylori</i> (+) (26.7%), while in the control group, 168 were <i>H. pylori</i> (+) (48%) (<i>p</i> = 0.002). There was no significant difference between the 2 groups with respect to <i>H. pylori</i> degree of colonization (<i>p</i> = 0.08). Gastritis was present in 56 (93.3%) patients in the DGR group and 322 (92%) patients in the control group (<i>p</i> = 0.72). A significant difference was found between the 2 groups in terms of gastritis severity (<i>p</i> = 0.01). <b><i>Conclusions:</i></b> The mean age of patients with DGR was significantly higher than that of patients without DGR, and DGR was found to be more common in girls. In patients with DGR, <i>H. pylori</i> prevalence was significantly lower than in those without DGR; however, no significant difference was found between the 2 groups with respect to the colonization degree.
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