Helicobacter pyloriinfection and gastroesophageal reflux in children

Abstract

Some studies suggest that Helicobacter pylori (H. pylori) infection would be a protective factor for the gastroesophageal reflux. The aim of this study was to explore this fact. A group of 72 children, admitted in a pediatric gastroenterology regional center in Northeast Romania, diagnosed with gastroesophageal reflux by 24-hour continuous esophageal pH monitoring (results were interpreted using the Boix-Ochoa score), underwent upper endoscopy with gastric biopsy to detect the presence of H. pylori by the rapid urease testing and for bacteriological and histologic examination. 19 children (26.39%) had H. pylori infection, while 53 (73.61%) did not. The grade of esophagitis was classified according to the Los Angeles classification system. Out of 47 children with esophagitis A, 16 (34.04%) had H. pylori infection, while out of the 25 children with esophagitis B, only 3 (12%) had H. pylori infection, with statistic significance (χ = 54.69, P << 0.05, 95% confidence interval [CI]). Regarding the value of the Boix-Ochoa score, it appears that the presence of the H. pylori determines lower pH-metry scores (F = 8.13, P = 0.0015, 95% CI). The presence of the H. pylori was not an important factor in the gastroesophageal reflux. On the other hand its relationship with esophagitis appears to be inverse ratio. The fact that the H. pylori presence is statistically greater in the grade A esophagitis could confirm the hypothesis that the bacteria would slow down the development of the esophagitis.

Prevalence of Helicobacter pylori is still high among symptomatic Bulgarian children

“…Whether H. pylori infection is positively or inversely associated with GERD in pediatric patients is still a topic of controversy [17][18][19]. Almost half of the children with duodenal ulcer were H. pylori-positive versus only 14.5% of those with GERD, which can support the understanding about an inverse association between H. pylori infection and GERD [1,17]. However, it is noteworthy that H. pylori eradication is not a cause of GERD and does not exacerbate the disease [1]; therefore, treatment of the infection should not be avoided in this patient group.…”

Helicobacter pylori in children

“…(OR 1.76, 95% CI 1.1–2.94). Lupu et al . performed 24 hour‐pH‐metry and upper endoscopy in 72 children (19 H. pylori positive) and did not find a relation between H. pylori status and reflux disease.…”

Review: Prevalence and dynamics of Helicobacter pylori infection during childhood

“…The cross‐sectional studies on H. pylori infection in symptomatic children as detected by histology are summarized in Figure [references: ] . H. pylori prevalence estimates vary greatly (3%‐76%) with an overall random‐effects regression model estimate of 39% (95% CI: 35%‐43%).…”