title: Does disordered upper gastrointestinal motility predispose to Helicobacter pylori colonization of the stomach in children?
abstract: Helicobacter pylori is an important factor in the pathogenesis of chronic gastritis and gastroduodenal ulcer disease. However, the basic causal mechanisms of H pylori colonization on the gastric mucosa are still unclear. The authors evaluated the prevalence of H pylori colonization in 266 children who underwent upper gastrointestinal endoscopy during a 12-month period. The indications for endoscopy were follow-up of esophagitis related to gastroesophageal reflux (n = 17), suspicion of gastroesophageal reflux (n = 51), abdominal pain (n = 28), vomiting (n = 30), follow-up of esophageal atresia (n = 46) and duodenal atresia (n = 28), inflammatory bowel disease (n = 28), and miscellaneous (n = 38). The methods used to detect H pylori colonization were histology and the rapid urease test. H pylori colonization was demonstrated in 31 (11.6%) of the 266 patients. In two patient groups, a high prevalence of colonization was identified. In patients with an operated duodenal atresia, 36% (10 of 28) had H pylori on the gastric mucosa. The organism was demonstrated on the gastric mucosa in 47% (8 of 17) of the patients with gastroesophageal reflux-related esophagitis; five of the eight patients had neurological impairment. In the other patient groups, the prevalence of H pylori infection ranged from 2% to 14%. The present study suggests that, in children, the disturbed esophagogastroduodenal motility, which is commonly associated with gastroesophageal reflux and duodenal atresia, predisposes to H pylori infection.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital, University of Helsinki, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Rintala
authors.forename: M L
authors.initials: ML
authors.lastname: Kokkonen
authors.forename: H
authors.initials: H
authors.lastname: Lindahl
authors.forename: H
authors.initials: H
authors.lastname: Sariola
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005753:Gastric Mucosa / Q000382:microbiology*; D005756:Gastritis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology*; D005769:Gastrointestinal Motility; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies