SCREENING FOR HELICOBACTER-PYLORI IN PEDI ATRIC-PATIENTS WITH RECURRENT ABDOMINAL-PAIN

Recurrent abdominal pain (RAP), which is often ascribed to psychologic al factors, can be a symptom of organic disease, in particular of the gastroduodenal tract. ELISAs for IgGs to Helicobacter pylori were perf ormed prospectively in 86 pediatric patients with RAP. Upper gastroint estinal endoscopy was recommended in patients with positive serologic tests and/or symptoms suggestive of a gastroduodenal disease. The ELIS A was positive in 15 cases (17.4%, HP+ group) and negative in 71 (82.6 %, HP-group). The parents of five HP+ patients declined the endoscopic procedure. Of the remaining ten HP+ patients, nine had histologic evi dence of chronic gastritis on antral biopsies, versus Il of the 26 HP- patients who underwent upper gastrointestinal endoscopy. Tests for H. pylori in endoscopy specimens were consistently negative in the HP-pat ients. No differences were found between the HP+ and HP-groups regardi ng age, sex distribution, history, characteristics of the pain, occupa tion of the parents, or living conditions. HP+ patients were more like ly to have tenderness of the gastric area to palpation, to belong to l arge families, and to be from countries of the Mediterranean rim. Sero logic testing is effective for screening patients with RAP for H. pylo ri infection. If further studies demonstrate that H. pylori is associa ted with peptic ulcer or gastric cancer, routine screening for H. pylo ri infection followed by appropriate therapy would be justified in chi ldren with RAP.