Childhood functional abdominal pain and Helicobacter pylori infection

Like functional gastrointestinal disorders in adults, the exact etiology of childhood functional abdominal pain (FAP) is unclear. Among those proposed etiologies, chronic Helicobacter pylori (HP) infection plays an important role. Therefore, we conducted this study to investigate the relationship of childhood FAP and chronic HP infection.

From 1998 to 2000, pediatric patients referred to our outpatient department under the impression of recurrent abdominal pain were carefully evaluated, and only subjects with FAP were recruited for study. Endoscopic examinations for rapid urease test and histology were performed in each patient, and [13C]-urea breath test was also performed in each patient. Twelve months later, all the procedures were repeated again for follow-up study. Status of FAP and HP infection of each subject was re-evaluated again for further comparisons.

In total, 135 patients participated in the primary survey, and 114 of them were successfully followed 12 months later. The results of primary endoscopic examinations were as follows: 43.7% normal results, 19.3% esophagitis, 15.6% gastroduodenitis, 13.3% peptic ulcer diseases (PUD), and 7.4% nodular gastritis. The overall prevalence of HP infection was 23.7% (32/135) at the primary survey. At the follow-up study, 77 (67.5%) patients still suffered from FAP. Persistence of FAP was noted among 59 of 84 (70.2%) non-HP infected patients, and in 13 (86.7%) of the 15 HP-infected, non-eradicated patients in the follow-up study, which did not show statistical significance (P=0.13).

Aside from subjects with PUD, 72.7% of FAP children suffered from similar symptoms during the 12-month follow-up, and HP infection status did not significantly influence the disease courses.