HELICOBACTER-PYLORI GASTRIC INFECTIONS IN CHILDREN

Objectives: Numerous reports have established the association of Helic obacter pylori and recurrent abdominal pain in children. We investigat ed the clinical, bacteriological and therapeutic features of our patie nts seen over a 1 year period. Methods: We investigated 121 children d uring 1992 in Hopital Saint Vincent-de-Paul, Paris. At endoscopy, biop sies were taken and sent for histology and bacteriology and urease tes ting. A decision regarding treatment by amoxicillin and metronidazol w as made after positive results of bacteriology and/or histolgy. Result s: Heliobacter pylori was found in 47 antral biopsies after pathology examination with Giemsa staining alone 16 times, bacterial culture 9 t imes and both methods 22 times. Abdominal pain was the prominent sympt om, occurring in 35.5% of Helicobacter pylori + patients. In 25 of the positive negative patients, a nodular gastritis was observed (53.1%) and in 27.6% of them a weight loss or a delay in weight gain. Few pati ents became after combined treatment with amoxicillin and metronidazol whereas eradication rates after triple therapy with amoxicillin-metro nidazol and H2 antagonist or proton pump blocker were higher. Conclusi on: Helicobacter pylori related gastritis is a common cause of abdomin al complaints in children. The most common symptom is recurrent abdomi nal pain. Antral nodularity is a peculiar endoscopic finding in childr en. Two-drug therapy associating amoxicillin-metronidazol is often ine ffective to eradicate the bacteria whereas eradication rates after tri ple therapy amoxicillin-metronidazol and H2 antagonist or proton pump blocker are higher.