HELICOBACTER-PYLORI INFECTION, GASTRIC-ACID SECRETION, AND INFANT GROWTH

Background: Helicobacter pylori infection is very common in Gambian in fants and children, who are also at risk of chronic diarrhoea and unde rnutrition. Acute H. pylori infection is associated with depressed gas tric acid secretion, and loss of the gastric acid barrier may predispo se to enteric infections. Methods: In a prospective study a noninvasiv e test of gastric acid output (measurement of change in urine acid out put before and after a feed) was performed on a population of Gambian infants at high risk of H. pylori infection. The C-13 urea breath test s was used to measure the prevalence of H. pylori infection and growth was measured by serial anthropometry. Results: In 101 infants aged 3 to 12 months, there was a significant relation between H. pylori infec tion and depressed urine acid output in those aged 6 months, during we aning when growth failure and malnutrition begin. Those infants with s ustained H. pylori infection grew less well than those without. Conclu sions: We speculate that H. pylori, acquired in infancy, could be a '' key that opens the door'' to enteric infection in childhood, leading t o recurrent diarrhoea, malnutrition, and growth failure. (C) 1998 Lipp incott-Raven Publishers.