Helicobacter pylori in Children

Abstract

Purpose: Although the prevalence of Helicobacter pylori infection is high in Perú, information in children is still sparse. This study reports the clinical and histopathological features of Helicobacter pylori (HP) infection in children at Cayetano Heredia University Hospital in Lima, Perú. This is the second similar study in our country that describes HP infection findings in a paediatric population. Methods: Information on endoscopies and biopsies from medical records and biopsy reports from July 2003 to October 2005 were obtained. The study population is mainly composed of children attending the Pediatric Gastroenterology Ambulatory Service. Results: 101 endoscopies and 51 biopsies were done in this period. Main indications for upper gastrointestinal endoscopy were: Upper abdominal pain (21), gastritis (15), abdominal recurrent pain (3), dysphagia (9), esophagitis (15), foreign body ingestion (6), chronic diarrhoea (1), upper gastrointestinal bleeding (24), caustic ingestion (4) and iron-deficient anemia (3). Endoscopic findings were: Esophageal varices (2), nodular gastritis (19), neoplasia (1), gastric ulcer (1), duodenal ulcer (5), gastritis (37), esophagitis (25), foreign body (5) and normal (6). In the 51 biopsies, HP prevalence was 59%(29 out 51 patients). HP-positive patients in average were older (10.7 versus 7.0 years, range 1 to 15 years, p < 0.05). Abdominal pain and upper gastrointestinal bleeding were the most frequent symptoms. Endoscopic nodular gastritis were HP status dependent (48.2 versus 13.6%, p < 0.05). All ulcers were HP positives. Histopathological findings in HP positive included more chronic and active severe inflammation. Dysplasia and intestinal metaplasia were absent in our biopsies, irrespective of HP status. Conclusions: A high prevalence of HP infection among children with gastrointestinal complaints was found. All ulcers were HP positive. Metaplasia and dysplasia were absent. Impact of eradication therapy still needs to be evaluated.