HELICOBACTER-PYLORI, HYPERGASTRINEMIA, AND RECURRENT ABDOMINAL-PAIN IN CHILDREN

The association between Helicobacter pylori and recurrent abdominal pa in (RAP) is controversial. In this cross-sectional study, the authors aim to determine whether hypergastrinaemia causes RAP in children with H pylori gastritis. In 439 children age 4 to 13 years (mean 7.3 years ) attending for nongastrointestinal day-case surgery, anti-Helicobacte r immunoglobulin G (IgG) was identified in serum by an enzyme-linked i mmunosorbent assay (ELISA) method validated in children and fasting pl asma gastrin was measured. A history of RAP was sought. One hundred tw enty-seven children (29%) tested seropositive for ii pylori. Fifty-one seronegative children (16.3%) and 22 seropositive children (17.3%) ga ve a history of RAP. The mean fasting gastrin in seronegative children was 52 ng/L compared with 117 ng/L in seropositive children (P < .001 ). The mean fasting gastrin in seropositive children with RAP (124 ng/ L) was not significantly different from that of seropositive children without RAP (115 ng/L). The high prevalence of ii pylori seropositivit y in this study is at variance with other reported paediatric data fro m the developed world. No association between childhood H pylori gastr itis, hypergastrinaemia, and RAP was found. In children with H pylori gastritis, the increase in circulating gastrin (mean 140% increase) is greater than that seen in adults (50% increase). Copyright (C) 1995 b y W.B. Saunders Company