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Symptomatic response to Helicobacter pylori eradication in children with recurrent abdominal pain: double blind
Merja Ashorn1, Tiina Rägö, Jorma Kokkonen
1Department of Paediatrics, Tampere University Hospital, Tampere, Finland. merja.ashorn@uta.fi
Insights
Eradicating Helicobacter pylori (H. pylori) in children with recurrent abdominal pain did not improve symptoms. Gastric inflammation healing also did not correlate with symptom relief in this study.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Clinical Trials
Background:
- Helicobacter pylori (H. pylori) infection is linked to gastrointestinal symptoms in children.
- Controlled trials on H. pylori eradication's effect on pediatric symptoms are limited.
Purpose of the Study:
- To investigate the relationship between recurrent abdominal pain and dyspepsia and H. pylori infection in children.
- To assess the impact of H. pylori eradication on gastrointestinal symptoms in pediatric patients.
Main Methods:
- A double-blind, randomized controlled trial involving 20 H. pylori-positive children with recurrent abdominal pain.
- Participants received either triple therapy (omeprazole, amoxycillin, clarithromycin) or omeprazole with placebos for one week.
- Symptom assessment, urea breath tests (UBT), and gastroscopy with biopsies were conducted at various follow-up intervals up to 52 weeks.
Main Results:
- H. pylori eradication was achieved in 80% of the triple therapy group versus 0% in the placebo group.
- No significant difference in symptom index reduction was observed between groups at 2 weeks post-treatment.
- At 52 weeks, both groups showed similar symptom index reduction, irrespective of H. pylori eradication or gastritis healing.
Conclusions:
- Eradication of H. pylori and healing of gastric inflammation do not provide symptomatic relief for chronic abdominal pain in children.
- The study suggests that H. pylori may not be the primary driver of chronic abdominal pain in this pediatric population.
Background:
Controlled trials considering the effect of Helicobacter pylori (H. pylori) eradication on gastrointestinal symptoms in children are scant. We aimed to study the connection between recurrent abdominal pain and dyspepsia and H. pylori infection in children.
Study:
This was a double blind randomised controlled trial. Twenty children with recurrent abdominal pain (RAP) being H. pylori positive as measured with the C urea breath test (UBT) were randomized either to receive omeprazole, amoxycillin and clarithromycin (n = 10), or omeprazole and 2 placebos (n = 10) for 1 week after gastroscopy. Symptoms were registered prior to the treatment and at follow up visits 2, 6, 24, and 52 weeks after stopping the treatment. Control UBT was performed on all patients 6 weeks post-treatment and again at the 52 week follow-up visit, when also re-endoscopy with biopsies was done to all participants.
Results:
All infected children had histologic gastritis. Bacterial eradication was achieved in 8/10 in the triple treatment group and in none in the placebo group. There was no change in symptom index in either group at 2 weeks post treatment. At 52 weeks a similar reduction in symptom index was observed in both groups irrespective of the healing of gastritis, which was more commonly achieved along the eradication.
Conclusions:
Bacterial eradication and healing of gastric inflammation does not lead to symptomatic relief of chronic abdominal pain in children.
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