The relationship between Helicobacter pylori infection and acid-hematuria syndrome in pediatric patients with gastric augmentation - II

Background/Purpose: The acid-hematuria syndrome, which presents with dysuri a, hematuria, and perineal pain still remains a problem in those patients w ho have undergone bladder augmentation using the gastrocystoplasty techniqu e. Additionally, there is still a question regarding the explanation for po stoperative metabolic problems such as metabolic alkalosis, hypocholoremia, hypergastrinemia, and various complications related to gastritis and pepti c ulcer disease. The aim of this study was to investigate the relation of H elicobacter pylori (HP) infection in this patient group and the relationshi p between HP infection and the above-mentioned clinical problems and compli cations. Methods: In this study, 10 children with a history of previous gastrocystop lasty (five girls, five boys; mean age, 6.75 +/- 2.53 years; range, 2.5 to 12 years) were evaluated. Blood samples for HP detection were analyzed by s erological testing (ELISA technique). Histopathologic studies were performe d for gastric tissue specimens, obtained by endoscopic procedures from the stomach and augmented bladder. Urine pH and serum gastrin levels were measu red in all patients. Results: Regarding the serological studies, four of ten patients had a posi tive ELISA test result (40%). The four patients with HP-positive serologica l test results, were the patients who had acid-hematuria syndrome. These pa tients also had low urine pH levels (mean, 4.5) when compared with those of HP-negative patients. HP-positive patients also had high serum gastrin lev els in comparison with those of HP-negative patients. Conclusions,. The relation between HP infection and problems such as hyperg astrinemia, acid output, and ulcer disease is well known. Our study demonst rates a correlation between the HP-positive gastrocystoplasty patients and the above-mentioned symptoms and complications. Because of the potential ri sk of HP infection, we suggest that HP infection be investigated in patient s with gastrocystoplasty or in candidates for a gastrocystoplasty operation . HP-positive patients should be treated, to reduce the risks of postoperat ive complications. Copyright (C) 1999 by W.B. Saunders Company.