Suggestive parameters for eradication therapy in children with Helicobacter pylori gastritis

The relationship between Helicobacter pylori (H. pylori) infection and recurrent abdominal pain in children is still controversial. H. pylori-infected children with recurrent abdominal pain generally do not require treatment. However, benefit of treatment has been known to produce dramatic improvements in some patients. Furthermore, H. pylori-infected is associated with growth retardation, iron deficiency anemia and thrombocytopenia. The objective of this study was to find suggestive parameters for eradication of H. pylori gastritis. From 1992 to 2004, medical records of 42 children diagnosed as having H. pylori infection by endoscopy were retrospectively reviewed. Of those 42 patients, there were 36 patients with H. pylori gastritis without gastric or duodenal ulcer (85.7%), and 6 patients with ulcers (14.3%). Children with H. pylori gastritis were divided into 2 groups: responsive and unresponsive. Data including the duration of abdominal pain, endoscopic finding, histology, treatment, outcome and final diagnosis were collected. Additional data were obtained by telephone and letters. Of 36 patients, there were 24 and 12 patients in responsive and unresponsive groups, respectively. Three patients with anemia were all presented in the responsive group. Those experiencing abdominal pain less than 3 months more commonly belonged to the responsive group (P = 0.21). Marked erythema of gastric mucosa was only seen in the responsive group (P = 0.136). All cases of chronic moderate-active gastritis appeared in the responsive group (p = 0.03). In conclusion, iron deficiency anemia and chronic moderate-active gastritis should be the suggestive parameters for eradication therapy in children with H. pylori gastritis.