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Helicobacter pylori, hypergastrinaemia, and recurrent abdominal pain in children
W A McCallion1, A G Bailie, J E Ardill
1Royal Belfast Hospital for Sick Children, Department of Medicine, Queen's University of Belfast, Northern Ireland.
Insights
This study found no link between Helicobacter pylori infection, elevated gastrin levels, and recurrent abdominal pain in children. High H. pylori prevalence was noted, but it did not correlate with childhood abdominal pain.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Clinical Research
Background:
- The relationship between Helicobacter pylori infection and recurrent abdominal pain (RAP) in children remains debated.
- Hypergastrinemia, an elevation in gastrin levels, is a potential factor linking H. pylori to RAP.
Purpose of the Study:
- To investigate if hypergastrinemia contributes to recurrent abdominal pain in children diagnosed with H. pylori gastritis.
- To assess the association between H. pylori infection, gastrin levels, and RAP in a pediatric cohort.
Main Methods:
- A cross-sectional study involving 439 children aged 4-13 years.
- Assessed H. pylori infection using anti-Helicobacter immunoglobulin G (IgG) via ELISA and measured fasting plasma gastrin.
- Collected data on the history of recurrent abdominal pain (RAP).
Main Results:
- H. pylori seropositivity was found in 29% of children, a higher prevalence than typically reported in developed countries.
- While seropositive children had significantly higher mean fasting gastrin levels (117 ng/L) than seronegative children (52 ng/L), no significant difference in gastrin was observed between seropositive children with and without RAP.
- No association was established between childhood H. pylori gastritis, hypergastrinemia, and recurrent abdominal pain.
Conclusions:
- Childhood H. pylori gastritis and associated hypergastrinemia do not appear to cause recurrent abdominal pain.
- The observed increase in circulating gastrin in children with H. pylori gastritis is more pronounced than in adults.
- Further research may be needed to understand the high H. pylori prevalence in this pediatric cohort.
Abstract:
The association between Helicobacter pylori and recurrent abdominal pain (RAP) is controversial. In this cross-sectional study, the authors aim to determine whether hypergastrinaemia causes RAP in children with H pylori gastritis. In 439 children age 4 to 13 years (mean 7.3 years) attending for nongastrointestinal day-case surgery, anti-Helicobacter immunoglobulin G (IgG) was identified in serum by an enzyme-linked immunosorbent assay (ELISA) method validated in children and fasting plasma gastrin was measured. A history of RAP was sought. One hundred twenty-seven children (29%) tested seropositive for H pylori. Fifty-one seronegative children (16.3%) and 22 seropositive children (17.3%) gave a history of RAP. The mean fasting gastrin in seronegative children was 52 ng/L compared with 117 ng/L in seropositive children (P < .001). The mean fasting gastrin in seropositive children with RAP (124 ng/L) was not significantly different from that of seropositive children without RAP (115 ng/L). The high prevalence of H pylori seropositivity in this study is at variance with other reported paediatric data from the developed world. No association between childhood H pylori gastritis, hypergastrinaemia, and RAP was found. In children with H pylori gastritis, the increase in circulating gastrin (mean 140% increase) is greater than that seen in adults (50% increase).