Treatment of Helicobacter pylori in children with recurrent abdominal pain.
BACKGROUND
The role of Helicobacter pylori remains unclear in children with recurrent abdominal pain (RAP). In this study children with RAP were included in a double blind treatment study to elucidate whether symptoms disappear in children with a H. pylori infection and RAP, if the bacteria are eradicated.


METHODS
Thirty-seven H. pylori-infected children aged 4.9-14.5 years (median 9.8 years) with RAP were included. H. pylori was identified by histology and culture. The children were treated with amoxicillin and metronidazole for 14 days. A re-endoscopy including biopsies for histology and culture was done at least one month after the end of treatment. Simple questions for symptoms were asked and blood for serology was repeated 3 and 6 months after the end of treatment. During the observation period the results of the re-endoscopy and the serology 3 and 6 months after the re-endoscopy were blinded for 23 patients and opened to 14 of the patients according to the choice of the families.


RESULTS
The eradication rates were 81% (30/37) in the total group and 74% (17/23) in the blinded group. The IgG antibodies to H. pylori decreased significantly 3 (p =.03) as well as 6 months after end of treatment (p <.001) in children with successful eradication. The number of children with RAP decreased after examination and treatment and the well-being improved after 6 months in almost 95% of the children. However, no correlation was seen between eradication of H. pylori and disappearance of RAP, neither after 3 nor after 6 months' observation in the total group of patients (p =.94 and p =.90) or in the blinded group (p =.42 and p =.65).


CONCLUSIONS
These results do not provide evidence for a causal relationship between RAP and H. pylori.
Wewer
V
V
Department of Pediatrics H, Odense University Hospital, Odense, Denmark.
Andersen
L P
LP
Paerregaard
A
A
Gernow
A
A
Hansen
J P
JP
Matzen
P
P
Krasilnikoff
P A
PA
D015746:Abdominal Pain / Q000188:drug therapy / Q000382:microbiology*; D000293:Adolescent; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004724:Endoscopy; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D010406:Penicillins / Q000627:therapeutic use; D012008:Recurrence
D000900:Anti-Bacterial Agents; D010406:Penicillins; D008795:Metronidazole; D000658:Amoxicillin