Helicobacter Pylori Infection in Children with Relapsing Abdominal Pain

Overview

Background:
Recurrent abdominal pain occurs in 10°Jo children representing one of the most difficult differential diagnostic problems in paediatrics.The aim of the work was to evaluate the significance of Helicobacter pylori (HP) infection in recurrent abdominal pain and the efficacy of treatment.Results: The authors evaluated the clinical course and the eft'icacy of specific treatment in 185 children aged 4 to 18 years with recurrent abdominal pain, who had undergone endoscopy for clinical signs of ulcer of the stomach or duodenum. Circulating antibodies against HP were proved in 170 patients (91.9%, HP+ group), while there were no antibodies found in 15 patients (8.1 %, HP- group). Histology of the bioptic specimen revealed pathologic changes in 171 patients (159 children from HP+ group and 11 patients from HP- group). Specific therapy was indicated in 160 children (149 from HP+ and 11 patients from HP- group), with direct proof of HP bacteria in bioptic specimen. Efficacy of specific treatment was evaluated repeatedly after 6 weeks, 6 months and 1 year after the end of treatment. In the majority of patients, clinical signs dissapeared as soon as 6 weeks after the onset of medication, but the decline of antibody levels was less rapid. After the first 6 weeks there were no more antibodies present in 16 patients and in 72 there was an obvious decrease of the titre, while 1 year after the end of treatment there were no antibodies found in 62 patients and in 18 children lower titres of circulating antibodies was recorded.Conclusions: The results of the study show, that: 1) HP infection in children may nesup in recurrent abdominal pain, 2) HP antibodies represent an important test in a suspected organic cause of abdominal pain, but positive results may not prove, and negative titre does not rule out the possibility of HP infection, 3) for the correct diagnosis gastroduodenal endoscopy incl. with acquirement of biopsy is important, 4) follow up of the clinical course and the titre of HP antibodies provide sufficient data for evaluating the efficacy of specific treatment.

Key words:
Helicobacter pylori, Helicobacter pylori antibodies IgG, chronic gastritis, treatment of Helicobacter pylori infection