Upper gastrointestinal disease, Helicobacter pylori and recurrent abdominal pain

Over a 5-y period, 396 children complaining of recurrent abdominal pain (RA P) underwent upper gastrointestinal endoscopy in order to identify any unde rlying organic pathology and determine the prevalence of Helicobacter pylor i (H. pylori) infection. Histologically confirmed mucosal inflammation was found in 338 out of 396 children (85.4%); in 113 of 396 patients (28.5%), H . pylori was identified on the gastric mucosa. Significant discriminating f actors between H. pylori positive and negative children with RAP included a ge (mean age for positive 11 y vs. 8.1 y for negative, p < 0.01) and gender (male gender predominance in the H. pylori positive, p < 0.001). No signif icant difference was found between H. pylori positive and negative groups r egarding incidence and character of the presenting symptoms. All H. pylori positive children (100%) had abnormal histology compared with 225 out of 28 3 negative ones (79.5%). Histologically confirmed gastritis was the most pr ominent finding in H. pylori positive children compared with H. pylori nega tive (98.2% vs. 19%, p < 0.001). Conversely, oesophagitis was more common i n H, pylori negative children (47.7% vs. 27.4%, p < 0.001). The incidence o f peptic ulcer was higher in H. pylori infected patients than in the H. pyl ori negative group (5.3% vs. 1%, p < 0.05). Our data suggest that gastroint estinal pathology is more common than previously thought in children with R AP, while H. pylori infection is a relatively important factor in the etiol ogy of upper gastrointestinal inflammation in RAP syndrome.