Helicobacter Pylori Infection in Children with Dyspepsia and Clinical Response to Its Treatment in Qom

The aim of this study was to evaluate the prevalence of helicobacter pylori (H. pylori) infection and its association with endoscopic, histopathological findings, and clinical symptoms of children with dyspepsia referring to Masoumeh Children Hospital of Qom. The eradication therapy of H. pylori infection in children as well as the clinical response to dyspepsia in H. pylori-negative children, were evaluated.

This cross-sectional study was performed on 170 children 4 to 15 years old with dyspepsia referred to Hazrat Masoumeh Hospital in Qom. After recording basic information about children such as age, sex, place of residence, and their disease history, these children were examined by endoscopy. Two biopsy specimens were obtained from the body and the antrum of the stomach. And if the rapid urease test and histology were positive for H. pylori tissue examination, the confirmed H. pylori infection would be considered in the child with H. pylori infection. Consequently, these patients were divided into two groups: H. pylori-positive and H. Pylori-negative. The two groups were compared for clinical signs and symptoms, endoscopic findings, and histological results.

85 patients (49.4%) were male and 87 patients (50.6%) were female. No significant relationship was found between the sex of the patients, place of residence, and H. pylori infection. There was no significant difference between the two groups in gastritis erosive, duodenitis, gastritis erythematosus, esophagitis, and acute inflammation in the antrum. No mass was found in both groups, and no hemorrhagic gastritis, ulcer, duodenal metaplasia, dysplasia, maltoma, H. pylori accumulation, or atrophy was recorded. In H. pylori-positive subjects in 83 patients (95.4%), chronic inflammation in the antrum was mild and in four patients, it was moderate (4.6%). This finding in H. pylori-negative patients, in 31 patients (36.5%) was not found, and in 54 patients (63.5%) was found. There were no significant differences between the two groups in the clinical signs, abdominal pain, heartburn, anorexia, burning, recent weight loss, hematomas, melena, the only clinical symptom of nausea in HP positive patients (37.9%) and HP negative in 46 patients (54.1%) had a significant difference between the two groups. Nodular gastritis was found in the endoscopic evaluation of 27 (31%) patients with H. pylori infection, significantly more than dyspeptic patients (15 cases) who were H. pylori negative.

According to the results of this study, no clinical signs other than nausea were correlated with H. pylori infection. In endoscopic findings, nodular gastritis has a significant correlation with H. pylori positivity, and according to the histopathological evaluation we significantly found more chronic gastritis in H. pylori infection.