Campylobacter pylori-related gastrointestinal disease in children

Abstract

Over a one-year period, 95 children and adolescents presenting with epigastric pain and/or vomiting, and without associated risk factors for development of peptide disease, underwent endoscopic antral biopsies for pathologic diagnosis and to detect presence of Campylobacter ss. pylori (C. pylori). Additional biopsies of the esophagus, stomach, and duodenum were obtained for histologic evaluation. C. pylori was identified in 16 patients (16.8%), all of whom had evidence of acute and/or chronic gastritis. Significant discriminating factors between C. pylori-positive and -negative subjects included age at presentation (positive vs negative = 14.6 vs 9.9 years, P less than 0.01), biopsy-confirmed gastritis (100% vs 30.4%, P less than 0.001), and diagnosis of duodenitis alone (0% vs 46.8%, P less than 0.001). Risk for bacterial colonization was significantly higher in the presence of endoscopic gastritis (P less than 0.001). Among C. pylori-positive patients, none responded to standard antiulcer therapy (H2-receptor antagonists, antacids). Symptomatic and histologic remission was achieved utilizing combined therapy with bismuth subsalicylate and antibiotics. Seven of 79 C. pylori-negative patients with biopsy-proven gastritis who responded poorly to antisecretory therapy had the organism identified in follow-up antral biopsies; these patients improved clinically following treatment for C. pylori. These data suggest that C. pylori is a significant factor in the etiology of upper gastrointestinal tract inflammatory disease in pediatrics, and presence of the organism should be evaluated, particularly in children with evidence of acute and/or chronic gastritis.

Helicobacter pylori Infection and Recurrent Abdominal Pain in Turkish Children

“…In addition, no specific symptomatology was seen in H. pylori ‐positive children with RAP. In another study [21], conversely, children without RAP had H. pylori infection more frequently than those with RAP.…”

“…Glassman et al. [21] and Mahony et al. [22] assessed the presence of abdominal pain and vomiting in children undergoing upper endoscopy.…”

Recurrent abdominal pain of gastro-intestinal origin

“…Several studies show an association between H. pylori and antral gastritis in children [9,11,15,18,24,30]. Chronic recurrent abdominal pain and vomiting appear to be a major presenting symptom in children colonised with H. pylori [14].…”

A Population‐Based Survey on Gastrointestinal Tract Symptoms and Helicobacter pylori Infection in Children and Adolescents

“…H. pylori, motility disorders) suggests that RAP is a description and not a single, homogeneous diagnosis [6]. The most frequent gastrointestinal complaint in children with H. pylori gastritis at endoscopy was recurrent abdominal pain [11][12][13][14][15]. Since 1986, when Helicobacter pylori infection was first described in pediatric patients [11], many endoscopic series supported the association between the infection and gastro-duodenal pathology in children [11- 14].…”

“…Since 1986, when Helicobacter pylori infection was first described in pediatric patients [11], many endoscopic series supported the association between the infection and gastro-duodenal pathology in children [11- 14]. However, abdominal pain was not more frequent in H. pylori-positive than in H. pylori-negative children submitted to endoscopy [15,17,18], if ulcer was not present [19], even if a trend in some series was evident [18]. The most frequent gastrointestinal complaint in children with H. pylori gastritis at endoscopy was recurrent abdominal pain [11][12][13][14][15].…”