Role of helicobacter pylori infection in children with recurrent abdominal complaints: The Brussels experience

Over a period of 6 months we investigated the incidence of Helicobacter pylori infection in 48 consecutive children (mean age: 8 years, 11 months; range 2 to 15 years; 20 males, 28 females) undergoing upper gastrointestinal tract endoscopy. The indications for endoscopy were: chronic (nonspecific) abdominal pain (n: 38), vomiting (n: 2), hematemesis (n: 2), and others (n: 6). The mean duration of symptoms ranged from less than 1 day (hematemesis) to 5 years. In addition to the endoscopy, a lactose H²- breath test, a biology, stool culture, abdominal radiograph and dietary history were performed in all patients, except those with hematemesis. Helicobacter pylori infection was diagnosed in 10 out of 48 (20.8%) patients; constipation in 6 patients; lactose-intolerance in 7 patients; psychosomatic complaints in 13 patients; other diagnosis in 7 patients; and no diagnosis in 5 patients. All Helicobacter pylori positive patients were treated with a combination of amoxycillin and colloidal bismuth subcitrate; eradication was obtained in 70% of patients. In the children with Helicabacter pylori infection, the macroscopic study of the antral mucosa was normal in 70% of patients and the nodular gastritis could be visualized in 30% of patients, Antral histology showed a chronic active gastritis in all children with Helicobacter pylori infection, and in one child with no Helicobacter pylori (p< 0.001).