Abstract
The study aimed at demonstration of the possible existence of Helicobacter pylori in tonsils and adenoids and its possible risk sequences. The stomach wall represents the main and commonest habitat for H. pylori since an immemorial time; in a way indicating that mucosa of the stomach is the structure of the body that can recognize that stomach bacterium. Therefore; migration of H. pylori outside the stomach could encode autoimmunity. Tonsils and adenoids are lately discovered as secondary reservoirs for H. pylori in children. Further reports have confirmed the association of adenotonsillar hypertrophy with cytotoxin-associated gene A (cagA) positive H. pylori strains, and emphasized that cagA of H. pylori encodes high immunogenicity. Migration of H. pylori into the circulation could be an open gate for systemic complications; although H. pylori bacteremia is not a recognized behavior of a bacterium used to colonize the stomach, yet H. pylori bacteremia is clearly reported in literature. H. pylori can reside in dental plaques where it can feed on remnants of food in the mouth or bleeding from gums. Therefore; surgery on hypertrophied tonsils while migrating H. pylori strains exist around could attract these strains to gain feeding on the resulting oozing tonsil’s surgical bed with the possible potential risk and sequels of H. pylori bacteremia. 30 children aged 10-12 years with frank symptoms and family history of H. pylori dyspepsia scheduled for surgery because of hypertrophy of tonsils and adenoids were included in the study. They were divided into three equal groups; group 1 followed natural H. pylori eradication therapy and group 2 underwent surgery while group 3 followed antibiotic therapies before surgery. Existence of H. pylori strains was proved in children and parents by specific tests (urea breath test and H. pylori fecal antigen test).All children and parents were found positive for colonic H. pylori strains. Urea breath test was positive in most children. Adenoid/tonsil surgical specimens were mostly positive for H. pylori DNA. Regression of hypertrophy of tonsils was demonstrated in most children of the natural therapy first group and 7 of 10 children escaped surgery. On conclusion, existence of H. pylori should be ruled out and eliminated from the throat by natural measures before surgery of hypertrophied tonsils demonstrating no suppuration or inflammation.
Highlights
Helicobacter pylori remains a challenging worldwide medical problem due to its extreme widespread prevalence and its close relation to many medical challenges [1,2,3,4]
The study included 30 children scheduled for surgery because of hypertrophy of tonsils and adenoids divided in three equal groups, their age ranged between 10-12 years and they were having frank symptoms and family history of H. pylori dyspepsia
Nine children in the first group showed regression of adenoid/ tonsils hypertrophy, relief of throat symptoms and relief of both abdominal upsets and constipation; seven of them escaped surgery while three underwent surgery but their adenoid/tonsils specimens were negative for H. pylori DNA extracts with minimal lymphocytic infiltration in histological assessment and rather average distribution of lymphoid follicles simulating that of normal tonsil’s tissue
Summary
Helicobacter pylori remains a challenging worldwide medical problem due to its extreme widespread prevalence and its close relation to many medical challenges [1,2,3,4]. About 50% of adults in the developed and 80-90% in the developing countries are estimated to be affected by H. pylori [5,6]. Existence of H. pylori is typically life-long unless treated. It has got a clear age-related prevalence; increasing from 10% in those younger than 30 until it reaches a plateau of about 60% in those older than age of 60 or even to about 70% at 50 years of age in higher risk areas [1,7]. Pylori related disease [8,9]. All these reasons contributed to the world's attitude that H.
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