Helicobacter pylori infection in recurrent abdominal pain.
BACKGROUND
Helicobacter pylori is associated with chronic gastritis and peptic ulcer in adults and in children. The purpose of the present study was to analyze the association of recurrent abdominal pain and H. pylori infection in children and to evaluate the efficacy of antimicrobial treatment in patients with evidence of infection.


METHODS
The clinical and histopathologic findings in children who underwent diagnostic upper endoscopy for recurrent abdominal pain were analyzed retrospectively. Patients with evidence of infection with H. pylori were treated with a combination of omeprazole, amoxicillin, and clarithromycin. Efficacy of treatment was assessed using the 13C-urea-breath test.


RESULTS
H. pylori was found in histopathologic sections of 29 (40%) of 73 patients undergoing diagnostic endoscopy for recurrent abdominal pain. Five children (17%) were of Swiss ethnic origin, and 24 (83%) were non-Swiss. All the infected patients had chronic gastritis and 4 (14%) had ulcerations in the duodenum. Treatment with omeprazole, amoxicillin, and clarithromycin resulted in eradication of the infection in all and in resolution of the clinical symptoms in 15 (80%) of 19 patients who had a follow-up examination.


CONCLUSIONS
The presented data suggest that gastritis induced by H. pylori may be associated with recurrent abdominal pain and that in Switzerland infections with H. pylori primarily involve persons who are non-Swiss. A combined therapy results in eradication of the bacterium and in improvement of the clinical symptoms in a significant majority of the patients.
Frank
F
F
Department of Pediatric Gastroenterology and Nutrition, University Children's Hospital, Zürich, Switzerland.
Stricker
T
T
Stallmach
T
T
Braegger
C P
CP
D015746:Abdominal Pain / Q000188:drug therapy* / Q000208:ethnology; D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000208:ethnology / Q000382:microbiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005756:Gastritis / Q000188:drug therapy / Q000208:ethnology / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000208:ethnology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D013270:Stomach / Q000382:microbiology; D013557:Switzerland / Q000453:epidemiology
D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole