Long-term follow-up of duodenal ulcer in children before and after eradication of Helicobacter pylori

Background: Helicobacter pylori is a well-known cause of chronic antral gas tritis and plays an important role in the pathogenesis of peptic ulcer dise ase in adults. However, because of the relatively low incidence of duodenal ulcer in childhood, few studies have been directed specifically at the rel ation between the treatment of H. pylori infection and duodenal ulcer in ch ildren. An evaluation in a larger patient population is necessary to draw a conclusion. Methods: Twenty-six children with duodenal ulcer and H. pylori antral gastr itis received triple therapy (amoxicillin, bismuth, and metronidazole) to i nvestigate whether eradication of the organisms can promote healing and pre vent relapse of the ulcers in children. Endoscopic examinations were perfor med before, 2 months, and 12 months after the beginning of treatment. Results: H. pylori infection was eradicated in 25 (96%) of the 26 patients who underwent upper endoscopic follow-up. Clinical improvement and ulcer he aling were achieved in 24 (92%) of 26 children. During a mean follow-up of nearly 2 years, the annual ulcer relapse rate was estimated to be 9%. Conclusions: Triple therapy is the treatment of choice for endoscopically p roven duodenal ulcer and histologically proven H. pylori antral gastritis i n children. It strongly supports a causal relation between H. pylori and du odenal ulcer disease in children.