P0835 RECURRENT ABDOMINAL PAIN AND HELICOBACTER PYLORI INFECTION IN CHILDREN

Abstract

Introduction: Recurrent abdominal pain (RAP) is a significant problem in the pediatric population [1], and there has been much recent interest in the role that Helicobacter pylori (Hp) might play in this disorder [2], [3], [4]. The purpose of this study was to look at the causes of RAP in children, the prevalence of Hp infection, and the correlation between this infection and upper gastrointestinal inflammation. Methods: This is a cross-sectional study of 135 children aged 4–15 years in the Children’s Hospitals No 1 and No 2 during a 6-month period in 2001. Patients complaining of RAP underwent upper gastrointestinal endoscopy in order to identify any underlying organic pathology and determine the prevalence of Hp infection. Results: Characteristics of the 135 children with RAP include: under 10 years of age (67.4%), girls (55.6%), living in rural areas (52.6%), and from high income-families (64.4%). Histologically confirmed mucosal inflammation was found in 85 out of 135 children (63%), with gastritis (26.7%), duodenitis (16.3%), gastro-duodenitis (14.8%), and oesophago-gastroduodenitis (5.2%). The Hp infection rate (33.6%) increased with abnormal findings by gross examination (p < 0.0001); children with the endoscopic findings of gastritis (p < 0.0001), duodenitis (p = 0.018), gastro-duodenitis (p = <0.0001) and oesophago-gastroduodenitis (p < 0.0001) were infected more commonly. Boys older than 10 years (p = 0.03), pain that wakes the child from sleep (p = 0.003), prolonged pain over 15 minutes (p = 0.023), anorexia (p = 0.04), vomiting (p = 0.044), and gastrointestinal bleeding (p = 0.0002) were all associated with gastrointestinal inflammation on biopsy. Conclusion: Our data suggests that gastrointestinal pathology is more common than previously thought in children with RAP and that gastritis was the most prominent finding. Hp infection is a relatively important factor in the etiology of upper gastrointestinal inflammation in RAP syndrome, especially in gastro-duodenitis. Follow-up studies are needed to determine the role of Hp eradication therapy in children with RAP.