Treatment of Helicobacter pylori in children with recurrent abdominal pain

Background. The role of Helicobacter pylori remains unclear in children wit h recurrent abdominal pain (RAP). In this study children with RAP were incl uded in a double blind treatment study to elucidate whether symptoms disapp ear in children with a H. pylori infection and RAP, if the bacteria are era dicated. Methods. Thirty-seven H. pylori-infected children aged 4.9-14.5 years (medi an 9.8 years) with RAP were included. H. pylori was identified by histology and culture. The children were treated with amoxicillin and metronidazole for 14 days. A re-endoscopy including biopsies for histology and culture wa s done at least one month after the end of treatment. Simple questions for symptoms were asked and blood for serology was repeated 3 and 6 months afte r the end of treatment. During the observation period the results of the re endoscopy and the serology 3 and 6 months after the re-endoscopy were blind ed for 23 patients and opened to 14 of the patients according to the choice of the families. Results. The eradication rates were 81% (30/37) in the total group and 74% (17/23) in the blinded group. The IgG antibodies to H. pylori decreased sig nificantly 3 (p = .03) as well as 6 months after end of treatment (p < .001 ) in children with successful eradication. The number of children with RAP decreased after examination and treatment and the well-being improved after 6 months in almost 95% of the children. However, no correlation was seen b etween eradication of H. pylori and disappearance of RAP, neither after 3 n or after 6 months' observation in the total group of patients (p = .94 and p = .90) or in the blinded group (p = .42 and p = .65). Conclusions. These results do not provide evidence for a causal relationshi p between RAP and H. pylori.