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Helicobacter pylori chronic gastritis in children: to eradicate or not to eradicate?
Roberta Buonavolontà1, Erasmo Miele, Daniela Russo
1Department of Pediatrics, University Federico II, Naples, Italy.
Insights
Triple therapy for Helicobacter pylori-associated chronic active gastritis in children did not improve symptoms but reduced inflammation. Spontaneous H pylori eradication did not occur within one year.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Helicobacter pylori-associated chronic active gastritis (H pylori-ACAG) is a significant pediatric condition.
- Effective treatment strategies for H pylori-ACAG in children require further investigation.
Purpose of the Study:
- To compare the efficacy of triple eradication therapy against symptomatic therapy for H pylori-ACAG in children.
- To assess the impact of H pylori eradication on gastritis and symptoms.
Main Methods:
- A randomized controlled trial involving 31 children with H pylori-ACAG.
- Group A received triple eradication therapy (n=16); Group B received symptomatic therapy (n=15).
- Follow-up included assessment of macroscopic appearance, H pylori density, inflammation, activity, and symptoms at 1 year.
Main Results:
- Triple therapy significantly improved macroscopic appearance and reduced H pylori density, chronic inflammation, and activity compared to symptomatic therapy.
- No significant difference in dyspeptic symptoms was observed between the groups after 1 year.
- H pylori infection persisted in all children not receiving eradication treatment.
Conclusions:
- Eradication of H pylori infection does not correlate with immediate improvement in dyspeptic symptoms in children.
- Spontaneous H pylori eradication is unlikely within a 1-year timeframe.
- Non-eradicated H pylori infection is associated with persistent chronic inflammation in pediatric gastritis.
Objective:
To evaluate the efficacy of triple eradication therapy versus symptomatic therapy in children with Helicobacter pylori-associated chronic active gastritis (H pylori-ACAG).
Study Design:
Symptomatic patients with H pylori-ACAG (n=31) were randomly assigned into two groups: (1) patients infected with H pylori who were treated with triple eradication therapy (n = 16); and (2) patients infected with H pylori who were treated with symptomatic therapy (n=15).
Results:
After 1 year of follow-up, macroscopic appearance was significantly different in group B (P=.023), and chronic inflammation, H Pylori density, and activity were significantly higher in group B than in group A (P=.022, .007, and .002, respectively); however, we did not find a significant difference in the symptoms comparing both groups (P=.287). After 1 year of follow-up, we observed the persistence of the H pylori infection in all children who had not received eradication treatment.
Conclusions:
There is no correlation between eradication of H pylori infection and improvement of dyspeptic symptoms. Self-eradication does not occur within 1 year of follow-up. A trend toward a higher rate of chronic inflammation in noneradicated children at 1 year limited the time of our study.
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