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Symptoms of gastritis due to Helicobacter pylori in children
1Division of Pediatric Gastroenterology and Nutrition, University of South Alabama, Mobile, 36640-0130, USA.
Insights
Helicobacter pylori (H. pylori) infection in children often presents similarly to non-H. pylori gastritis. However, H. pylori is linked to antral nodularity and duodenal ulcers, warranting its investigation during endoscopy.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
Background:
- Helicobacter pylori (H. pylori) infection is a common cause of gastritis and peptic ulcer disease in children.
- Clinical presentation of H. pylori gastritis can overlap with gastritis from other causes, complicating diagnosis.
Purpose of the Study:
- To compare the clinical and endoscopic presentation of gastritis associated with H. pylori infection versus gastritis without H. pylori in pediatric patients.
- To identify distinguishing features that may aid in the diagnosis of H. pylori gastritis in children.
Main Methods:
- Retrospective review of medical records for 296 children undergoing esophagogastroduodenoscopy.
- Analysis of clinical symptoms, family history, endoscopic findings, and H. pylori status.
Main Results:
- H. pylori gastritis was identified in 8% (23/296) of children; 51 had non-H. pylori gastritis.
- Children with H. pylori gastritis showed higher rates of antral nodularity (43%) and duodenal ulcers (17%).
- Periumbilical pain was significantly less common in H. pylori gastritis (4%) compared to non-H. pylori gastritis (31%).
Conclusions:
- While many symptoms are similar, specific endoscopic findings like antral nodularity and duodenal ulcers suggest H. pylori infection.
- Periumbilical pain is less indicative of H. pylori gastritis in children.
- Testing for H. pylori is recommended for children undergoing endoscopy for upper gastrointestinal mucosal disease evaluation.
Abstract:
Infection due to Helicobacter pylori may be associated with gastritis and peptic ulcer disease in children. The aim of this study was to compare the presentation of gastritis due to H pylori with that of gastritis not associated with H pylori infection. The medical records of 296 children who had esophagogastroduodenoscopy were reviewed; 23 (8%) had H pylori gastritis, and 51 had primary gastritis without H pylori infection. Of patients with H pylori, 43% had antral nodularity and 17% had duodenal ulcers. The incidence of epigastric pain, nocturnal pain, postprandial pain, family history of peptic ulcer disease, water brash, vomiting, weight loss, fecal occult blood, and hematemesis was similar between both groups. Periumbilical pain was less common in children with gastritis than epigastric pain, and pain in the periumbilical region was present in only 4% of children with H pylori infection, compared with 31% of patients who had gastritis without H pylori infection. The presence of H pylori should be sought in children having endoscopy for evaluation of upper gastrointestinal mucosal disease.