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Helicobacter pylori and gastritis in children with abdominal complaints
H I Maaroos1, T Rägo, P Sipponen
1Dept. of Internal Medicine, Tartu University, Estonia.
Insights
Pediatric gastritis, often linked to Helicobacter pylori (HP) infection, is common in children with upper abdominal pain. This mild, superficial inflammation typically affects the stomach
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Histopathology
Background:
- Upper abdominal pain is a frequent complaint in children.
- Helicobacter pylori (HP) infection is a known cause of gastritis in adults.
- The prevalence and characteristics of childhood gastritis and HP infection require further elucidation.
Purpose of the Study:
- To investigate the prevalence of gastritis and Helicobacter pylori (HP) infection in children presenting with upper abdominal pain.
- To characterize the histological features of gastritis in this pediatric population.
- To explore the correlation between gastritis, HP infection, and age.
Main Methods:
- Gastroscopy with biopsies was performed on 178 children with upper abdominal pain.
- Histopathological examination of gastric biopsies assessed for gastritis and associated inflammatory markers.
- Helicobacter pylori (HP) detection in antrum and/or corpus biopsies.
Main Results:
- Gastritis was diagnosed in 61% of children, and HP infection in 58%.
- The majority of gastritis cases showed mild superficial round cell infiltration without mucosal atrophy.
- A good correlation was observed between antral histology and HP presence, with a general increasing trend in gastritis and HP prevalence with age.
Conclusions:
- Gastritis in children with upper abdominal pain is common and often associated with HP infection.
- The findings suggest that HP-related gastritis may be a significant cause of abdominal complaints in children, though further evidence is needed.
- Childhood gastritis appears to be a chronic, superficial process, typically affecting both antrum and corpus simultaneously.
Abstract:
Gastroscopy with biopsies was performed in 178 children with upper abdominal pain. Of them 109 (61%) had gastritis and 104 (58%) Helicobacter pylori (HP) in antrum and/or corpus. Gastritis consisted in most cases (87% of antral and 86% of corpus gastritis) of mild superficial round cell infiltration. Mucosal atrophy was not found. Accumulation of granulocytes was present in 43 patients and lymphonoduli were found in 33 patients, usually in connection with gastritis. Gastritis affected only the antrum in 18%, only the corpus in 5% and both antrum and corpus in 62% of the cases of gastritis. There was a good correlation between morphology and bacteriology in the antrum and a satisfactory one in the corpus. However, in some cases gastritis was present without bacteria and in some cases a normal mucosa was associated with bacteria. Gastritis and HP prevalences showed a general increasing trend with age, but significances were with one exception lacking. It is tentatively concluded that gastritis begins in childhood as a slight and chronic superficial infiltration affecting usually antrum and corpus simultaneously. In the majority of cases gastritis is associated with HP infection, which seems to start the process. It is possible that the HP-related gastritis is a common cause of abdominal complaints in children; however, convincing evidence is lacking.