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Helicobacter pylori-positive gastritis in pediatric patients with chronic inflammatory bowel disease
K L Kolho1, H Rautelin, H Lindahl
1Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland.
Insights
Helicobacter pylori (H. pylori) colonization is uncommon in children with inflammatory bowel disease (IBD). This study found no H. pylori infections in pediatric IBD patients, contrary to general population rates.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Immunology
Background:
- Gastritis is frequently observed in pediatric patients diagnosed with inflammatory bowel disease (IBD).
- The specific relationship between gastritis and Helicobacter pylori (H. pylori) infection in IBD patients remains incompletely understood.
Purpose of the Study:
- To investigate the prevalence of H. pylori infection in pediatric patients with IBD.
- To determine if H. pylori colonization differs in children with IBD compared to the general pediatric population.
Main Methods:
- Serum samples from 47 pediatric IBD patients were tested for H. pylori IgG and IgA antibodies using enzyme immunoassay.
- Esophagogastroduodenoscopy was performed on 40 patients.
- H. pylori seroprevalence was assessed at diagnosis and during follow-up (mean 3.5 years).
Main Results:
- None of the pediatric IBD patients exhibited serologic or histologic evidence of H. pylori infection.
- This finding was unexpected given the known prevalence of H. pylori in the general Finnish pediatric population (approx. 10%).
Conclusions:
- Permanent H. pylori colonization appears to be rare in children suffering from inflammatory bowel disease.
- Further research may be needed to elucidate the complex interplay between H. pylori, gastritis, and IBD in pediatric populations.
Background:
Gastritis is a common finding in patients with inflammatory bowel disease. However, the association of gastritis with Helicobacter pylori is unclear in these patients.
Methods:
The prevalence of antibodies for H. pylori in serum was determined in 47 pediatric patients with inflammatory bowel disease (19 with Crohn's disease, 21 with ulcerative colitis, and 7 with unclassified disease). H. pylori antibodies of the IgG and IgA classes were measured by enzyme immunoassay in 24 patients at the time of diagnosis of inflammatory bowel disease and in 23 more patients during the follow-up of inflammatory bowel disease (mean follow-up, 3.5 years; range 1-10 years). Esophagogastroduodenoscopy was performed on 40 patients during the examination for inflammatory bowel disease.
Results:
In contrast to earlier findings, no patient was determined to be positive for H. pylori, either in serologic or histologic examination. This negative finding was unexpected, because it is known that approximately 10% of asymptomatic Finnish children have antibodies for H. pylori in serum and approximately 10% of analyses of specimens obtained in gastric antral biopsies obtained at the Hospital for Children and Adolescents, Helsinki, Finland, are positive for H. pylori.
Conclusions:
Permanent colonization of the stomach with H. pylori is unusual in children with inflammatory bowel disease.