Related Experiment Videos
Helicobacter pylori infection in recurrent abdominal pain
F Frank1, T Stricker, T Stallmach
1Department of Pediatric Gastroenterology and Nutrition, University Children's Hospital, Zürich, Switzerland.
Insights
Helicobacter pylori infection is linked to recurrent abdominal pain in children. Effective antimicrobial treatment eradicates the infection and improves symptoms in most cases.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Helicobacter pylori (H. pylori) is a significant cause of chronic gastritis and peptic ulcers in both adults and children.
- Recurrent abdominal pain (RAP) is a common pediatric complaint with various potential etiologies.
- Understanding the role of H. pylori in pediatric RAP is crucial for effective diagnosis and treatment.
Purpose of the Study:
- To investigate the association between H. pylori infection and recurrent abdominal pain in pediatric patients.
- To evaluate the efficacy of a specific antimicrobial regimen in treating H. pylori infections in children.
Main Methods:
- Retrospective analysis of clinical and histopathologic findings in 73 children undergoing upper endoscopy for RAP.
- H. pylori-infected children received treatment with omeprazole, amoxicillin, and clarithromycin.
- Treatment efficacy was assessed using the 13C-urea-breath test.
Main Results:
- H. pylori was identified in 40% (29/73) of children with RAP.
- All infected children exhibited chronic gastritis, and 14% had duodenal ulcerations.
- The triple therapy eradicated H. pylori in 100% of treated patients and resolved symptoms in 80% (15/19) with follow-up.
Conclusions:
- H. pylori-induced gastritis may be a contributing factor to recurrent abdominal pain in children.
- In Switzerland, H. pylori infections are more prevalent among non-Swiss populations.
- Combined antimicrobial therapy is highly effective for H. pylori eradication and symptom improvement in pediatric patients.
Background:
Helicobacter pylori is associated with chronic gastritis and peptic ulcer in adults and in children. The purpose of the present study was to analyze the association of recurrent abdominal pain and H. pylori infection in children and to evaluate the efficacy of antimicrobial treatment in patients with evidence of infection.
Methods:
The clinical and histopathologic findings in children who underwent diagnostic upper endoscopy for recurrent abdominal pain were analyzed retrospectively. Patients with evidence of infection with H. pylori were treated with a combination of omeprazole, amoxicillin, and clarithromycin. Efficacy of treatment was assessed using the 13C-urea-breath test.
Results:
H. pylori was found in histopathologic sections of 29 (40%) of 73 patients undergoing diagnostic endoscopy for recurrent abdominal pain. Five children (17%) were of Swiss ethnic origin, and 24 (83%) were non-Swiss. All the infected patients had chronic gastritis and 4 (14%) had ulcerations in the duodenum. Treatment with omeprazole, amoxicillin, and clarithromycin resulted in eradication of the infection in all and in resolution of the clinical symptoms in 15 (80%) of 19 patients who had a follow-up examination.
Conclusions:
The presented data suggest that gastritis induced by H. pylori may be associated with recurrent abdominal pain and that in Switzerland infections with H. pylori primarily involve persons who are non-Swiss. A combined therapy results in eradication of the bacterium and in improvement of the clinical symptoms in a significant majority of the patients.