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Association between helicobacter pylori and gastrointestinal symptoms in children

Leo A A Spee1, Marieke B Madderom, Maaike Pijpers

  • 1Erasmus MC, Department of General Practice, PO Box 2040, 3000 CA Rotterdam, Netherlands.

Pediatrics
|February 17, 2010
PubMed

Insights

This review found no link between Helicobacter pylori infection and recurrent abdominal pain in children. Evidence for epigastric pain was conflicting, but a connection was seen with unspecified abdominal pain, though not in primary care settings.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Epidemiology

Background:

  • Recurrent abdominal pain (RAP) and other gastrointestinal (GI) symptoms are prevalent in children.
  • The association between Helicobacter pylori (H. pylori) infection and these symptoms in pediatric populations is debated.
  • Primary care physicians face increasing pressure to test symptomatic children for H. pylori.

Purpose of the Study:

  • To systematically review existing evidence on the association between H. pylori infection and GI symptoms in children.
  • To evaluate the role of H. pylori in pediatric recurrent abdominal pain and other GI complaints.
  • To synthesize findings from diverse study designs to inform clinical practice.

Main Methods:

  • A systematic literature search of Medline and Embase databases was conducted up to July 2009.
  • Studies involving children up to 18 years of age assessing H. pylori and GI symptoms were included.
  • Methodologic quality was assessed, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for meta-analyses.

Main Results:

  • Thirty-eight studies (23 case-control, 14 cross-sectional, 1 cohort) were included, with overall low methodologic quality.
  • Pooled ORs showed no significant association between H. pylori and recurrent abdominal pain (RAP) in children.
  • Conflicting evidence existed for epigastric pain; a positive association was found for unspecified abdominal pain (UAP) in hospital-based studies, but not in primary care settings.

Conclusions:

  • There is no clear association between H. pylori infection and recurrent abdominal pain in children.
  • Evidence regarding H. pylori and epigastric pain in children is inconsistent.
  • While a link between H. pylori and unspecified abdominal pain was suggested, it was not confirmed in primary care patients.
Abstract

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