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Helicobacter Pylori infection in children with inflammatory bowel disease: a prospective multicenter study
Emanuele Dilaghi1, Enrico Felici2, Edith Lahner1
1Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy.
Insights
Helicobacter pylori (Hp) infection rates were similar in pediatric patients with and without inflammatory bowel disease (IBD). Hp infection did not impact disease activity or severity scores in IBD patients at diagnosis or after treatment.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Immunology
Background:
- The association between Helicobacter pylori (Hp) infection and pediatric inflammatory bowel disease (IBD) is debated.
- This study investigated Hp infection prevalence in newly diagnosed pediatric IBD patients versus controls.
Purpose of the Study:
- To determine Hp infection rates in pediatric IBD patients compared to non-IBD controls.
- To analyze clinical activity index (CAI) and endoscopic severity score (ESS) differences between Hp-infected and non-infected IBD patients at baseline and 1-year follow-up after eradication therapy (ET).
Main Methods:
- Diagnosis of IBD was based on Porto criteria.
- Gastroscopy was performed at baseline and 1-year follow-up for all patients.
- Clinical activity and endoscopic severity were assessed using validated scores (PCDAI/SES-CD for Crohn's disease, PUCAI/UCEIS for ulcerative colitis).
Main Results:
- 76 IBD patients and 148 non-IBD patients were included.
- Hp infection prevalence was similar in both groups (9.2% in IBD vs. 12.2% in non-IBD; p=0.5065).
- No significant differences in CAI or ESS were found between Hp-positive and Hp-negative IBD patients at baseline or at 1-year follow-up post-ET.
Conclusions:
- Hp infection occurrence does not differ between pediatric IBD and non-IBD patients.
- Hp infection status does not influence IBD activity or severity at diagnosis.
- Eradication therapy for Hp in IBD patients does not lead to worsening of disease activity or severity at one-year follow-up.
Background:
The relationship between Helicobacter-pylori(Hp)infection and inflammatory-bowel-disease(IBD) in pediatric-patients remains controversial. We aimed to assess the Hp-infection occurrence in newly-diagnosed pediatric-patients with IBD compared to no-IBD patients. Additionally, we aimed to examine differences in clinical-activity-index(CAI) and endoscopic-severity-score(ESS)between IBD-patients with and without Hp-infection, at baseline and at 1-year-follow-up(FU), after eradication-therapy(ET).
Methods:
IBD diagnosis was based on Porto-criteria, and all patients underwent gastroscopy at baseline and 1-year FU. For Crohn's-disease(CD) and ulcerative colitis(UC), IBD-CAI and -ESS were classified using PCDAI/SES-CD and PUCAI/UCEIS, respectively.
Results:
76 IBD-patients were included in the study[35 F(46.1%),median-age 12(range 2-17)]. CD and UC were diagnosed in 29(38.2%) and 45(59.2%)patients, respectively, and unclassified-IBD in two(2.6%)patients. Non-IBD patients were 148[71 F(48.0%),median-age 12(range 1-17)]. Hp-infection at baseline was reported in 7(9.2%) and 18(12.2%)IBD and non-IBD patients, respectively(p = 0.5065). The 7 IBD patients with Hp infection were compared to 69 IBD patients without Hp-infection at baseline evaluation, and no significant differences were reported considering CAI and ESS in these two groups. At 1-year FU, after ET, IBD patients with Hp infection improved, both for CAI and ESS, but statistical significance was not reached.
Conclusion:
The occurrence of Hp-infection did not differ between IBD and no-IBD patients. No differences in CAI or ESS were observed at the diagnosis, and after ET no worsening of CAI or ESS was noted at one-year FU, between Hp-positive and -negative IBD patients.
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