The role of Helicobacter pylori in children with recurrent abdominal pain.
OBJECTIVE
Our major goals in this study were to determine the prevalence of Helicobacter pylori among Israeli children with recurrent abdominal pain and to establish whether a link exists between eradication of Helicobacter pylori and the recovery from abdominal pain. The alternative target was to examine whether the serological test can replace endoscopy in children.


METHODS
Upper gastrointestinal endoscopy was performed in 80 children with recurrent abdominal pain. During endoscopy, antral biopsies were taken and sent for histological and bacteriological examination.


RESULTS
The prevalence of H. pylori, which was indicated by Gram stain and urease test, was 54%. The positive cases were treated with bismuth combined with amoxycillin and metronidazole. Two months after completion of the treatment, 34 patients were reexamined. Twenty-nine of them (85%) became symptom free, and five (15%) remained symptomatic. These five children were retreated, and they also became symptom free. Eight months after completion of treatment, all 34 patients were reexamined and found to be asymptomatic.


CONCLUSIONS
We found a high prevalence of H. pylori (54%) among Israeli children with recurrent abdominal pain; we also found that symptoms were effectively and significantly reduced by the eradication of H. pylori. The endoscopic examination cannot be replaced by serological test.
Heldenberg
D
D
Department of Pediatrics, Gastroenterology, Pathology, and Microbiology, Hillel-Yaffe Medical Center, Hadera, Israel.
Wagner
Y
Y
Heldenberg
E
E
Keren
S
S
Auslaender
L
L
Kaufshtein
M
M
Tenebaum
G
G
D015746:Abdominal Pain / Q000209:etiology / Q000382:microbiology*; D000293:Adolescent; D000658:Amoxicillin / Q000008:administration & dosage; D000863:Antacids / Q000008:administration & dosage; D000907:Antibodies, Bacterial / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000188:drug therapy; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D009942:Organometallic Compounds / Q000008:administration & dosage; D011237:Predictive Value of Tests; D012008:Recurrence; D012680:Sensitivity and Specificity; D012698:Serologic Tests
D000863:Antacids; D000907:Antibodies, Bacterial; D009942:Organometallic Compounds; D000658:Amoxicillin; C002791:bismuth tripotassium dicitrate