HELICOBACTER-PYLORI-ASSOCIATED GASTRITIS IN CHILDREN

Background. - The role of Helicobacter pylori in chronic gastric and d uodenal ulcer disease has now been proven in adults as well as in chil dren. Material and methods. - H pylori has been looked for during endo scopy in 130 children suffering from recurrent abdominal pain (78 pati ents) or other symptoms (52 patients). Biopsy samples were taken from the antrum and the fundus, and were examined for histology and bacteri ology (Gram staining, urease rest, culture). Results. - H pylori was f ound in 30 cases (H pylori+ group, medium age: 12 years) and was absen t in the 100 other cases (H pylori- group, medium age: 6 years). H pyl ori was present in 27% of children suffering from recurrent abdominal pain and 17% of children with other symptoms. Epigastric location of t he pain and vomiting were equally frequent in both groups. Endoscopic gastritis, often nodular, was noted in 60% of the cases in. the H pylo ri+ group and in 46% in the H pylori- group (NS). Chronic gastritis wa s noted in 90% of the cases in the H pylori+ group, and in 32% of the cases in the H pylori- group (p < 0.01). Culture was positive in 27 ou t of 28 cases (97%) in the H pylori+ group, including 3 cases with neg ative histologic examination. Twenty-two children in the H pylori+ gro up were treated with amoxicillin and metronidazole. Endoscopy performe d about 2 months later showed eradication of H pylori in 63% of the ca ses, associated with disappearance of histologic lesions in 6 out of 1 4 cases and of symptoms in 5 out of 7 cases. Conclusions. - H pylori i s associated with some pediatric cases of antral gastritis. Further st udies are needed to determine the influence of its eradication on symp toms and the interest to search this pathology (by serology) in childr en suffering from chronic abdominal pain.