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Association between Gastric pH and Helicobacter pylori Infection in Children
Ji-Hyun Seo1, Heung Keun Park1, Ji Sook Park1
1Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Insights
Gastric pH in children is typically normal, but lower pH (hypochlorhydria) is linked to higher Helicobacter pylori urease-test positivity and more severe gastritis.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Histopathology
Background:
- Helicobacter pylori infection is a common cause of gastritis in children.
- Gastric acid secretion and its role in H. pylori infection are not fully understood in pediatric populations.
Purpose of the Study:
- To investigate the relationship between fasting gastric pH and H. pylori infection markers in children.
- To correlate gastric pH with urease-test results and histological findings of gastritis.
Main Methods:
- Collected gastric juice and antral biopsy samples from 562 children (aged 0-15 years).
- Assessed gastric pH, urease-test positivity, and histopathological features (gastritis, H. pylori infiltration) using the Updated Sydney System.
Main Results:
- Fasting gastric pH did not significantly differ by age group.
- Urease-test positivity was significantly higher in children with hypochlorhydria (low gastric pH) compared to those with normal pH (77.8% vs. 31.7%).
- Hypochlorhydria correlated with more severe chronic and active gastritis, but not H. pylori infiltration degree.
Conclusions:
- Fasting gastric pH is generally normal in children across different age groups.
- Hypochlorhydria in children may be associated with increased H. pylori urease-test positivity and more severe gastritis.
Purpose:
To assess gastric pH and its relationship with urease-test positivity and histological findings in children with Helicobacter pylori infection.
Methods:
Fasting gastric juices and endoscopic antral biopsy specimens were collected from 562 children and subjected to the urease test and histopathological examination. The subjects were divided into 3 age groups: 0-4, 5-9, and 10-15 years. The histopathological grade was assessed using the Updated Sydney System, while the gastric juice pH was determined using a pH meter.
Results:
The median gastric juice pH did not differ significantly among the age groups (p=0.655). The proportion of individuals with gastric pH >4.0 was 1.3% in the 0-4 years group, 6.1% in the 5-9 years group, and 8.2% in 10-15 years (p=0.101). The proportions of moderate and severe chronic gastritis, active gastritis, and H. pylori infiltration increased with age (p<0.005). Urease-test positivity was higher in children with hypochlorhydria (77.8%) than in those with normal gastric pH (31.7%) (p<0.001). Chronic and active gastritis were more severe in the former than the latter (p<0.001), but the degree of H. pylori infiltration did not differ (20.9% vs. 38.9%; p=0.186).
Conclusion:
Gastric pH while fasting is normal in most children regardless of age. Urease-test positivity may be related to hypochlorhydria in children, and hypochlorhydria is in turn related to H. pylori infection.
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