Helicobacter pylori infection and gastroesophageal reflux in children

V V Lupu1, A Ignat1, G Ciubotariu1

  • 1Pediatrics Department, University of Medicine and Pharmacy 'Gr. T. Popa', Iasi, Romania.

Insights

Helicobacter pylori (H. pylori) infection may slow the development of esophagitis in children with gastroesophageal reflux. This study found H. pylori was more common in mild esophagitis (LA grade A) than severe (LA grade B).

Area of Science:

  • Pediatric Gastroenterology
  • Microbiology
  • Gastroenterology

Background:

  • Gastroesophageal reflux (GER) is a common condition in children.
  • The role of Helicobacter pylori (H. pylori) infection in GER and its complications, such as esophagitis, is debated.
  • Some studies suggest H. pylori may have a protective effect against GER.

Purpose of the Study:

  • To investigate the association between H. pylori infection and gastroesophageal reflux in children.
  • To explore the relationship between H. pylori and the severity of esophagitis in pediatric GER patients.
  • To determine if H. pylori influences GERD parameters like pH-metry scores.

Main Methods:

  • A cohort of 72 children diagnosed with GER via 24-hour esophageal pH monitoring was studied.
  • Upper endoscopy with gastric biopsies was performed to detect H. pylori using rapid urease testing, bacteriology, and histology.
  • Esophagitis severity was graded using the Los Angeles classification, and GER was assessed using the Boix-Ochoa score.

Main Results:

  • H. pylori infection was present in 26.39% of the children.
  • H. pylori infection was significantly more prevalent in children with Los Angeles grade A esophagitis (34.04%) compared to grade B (12%).
  • H. pylori presence was associated with lower pH-metry scores, indicating reduced GER, and was not a significant factor in GER itself.

Conclusions:

  • H. pylori infection does not appear to be a significant factor in the development of gastroesophageal reflux in children.
  • The findings suggest an inverse relationship between H. pylori and esophagitis, with the bacteria potentially slowing esophagitis development.
  • The higher prevalence of H. pylori in mild esophagitis supports the hypothesis of a protective role against severe esophageal inflammation.

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