Improvement of Eradication Therapy in Children With Duodenal Ulcer Associated With Helicobacter Pylori

Abstract

The aim: To evaluate the efficacy of the drug VitD children with H.pylori-associated duodenal ulcer. Materials and methods: Two treatment groups of children with DU were formed: I - 60 children with H. pylori-associated DU, who received the optimal scheme of anti- Helicobacter therapy (AHBT) for Chernivtsi region; II - 62 children with H. pylori-associated DU who received a modified treatment regimen: AGBT + VitD at a dose of 2000 IU / day for 1 month. The effectiveness of the treatment was evaluated taking into account the Relative Risk Reduction (RRR) of the adverse event and Number Needed to Treat (NNT). Results: All children with DU and a positive H. pylori infection test showed changes in serum VitD levels: 81.9% deficiency and 18.1% insufficiency. Successful eradication was achieved in 77.1% of children, in particular in the first group 73.3%, in the second - 82.2%. Predictors of successful eradication are the duration of infection, H. pylori CagA (+), VitD level. When using the VitD treatment regimen in children with DU associated with CagA (+) strain H.pylori, RRR was observed 2.29 times (χ2 = 6.34, pφ<0.05) with NNT 1.59. Conclusions: Due to the reduced level of serum VitD in children with H. pylori-associated DU, it is advisable to include in the treatment regimen the adjuvant component of AHBT in the form of VitD. Predictors of effective eradication of H. pylori are CagA (+) strain of H. pylori, duration of infection and VitD level.

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

“…This may be because boys exercise more, eat too much and eat fast, which leads to excessive and rapid gastric acid secretion, which in turn destroys the duodenal mucosal barrier. Girls have higher estrogen levels, which can stimulate the duodenal mucosa to secrete bicarbonate, enhance mucosal barrier function, inhibit gastric and duodenal juice secretion, and reduce pepsin activity, thus protecting gastrointestinal mucosa to reduce the occurrence of ulcers[ 12 , 13 ].…”