[Peptic disease: comparative study between children and adolescents]
OBJECTIVES: To make a comparative analysis of clinical and endoscopic data in peptic disease in a group of children (CR) and adolescents (AD).MATERIAL AND METHODS: 30 children and 76 adolescents with peptic disease were studied between August 1992 and November 1994. In all cases the diagnosis was confirmed by endoscopic and histologic examination. Clinical data referring abdominal pain (localization, degree of intensity, chronicity and related symptons) were compared in both groups. Statistical analysis was done by the Fisher Test (significance value p< 0.05).RESULTS: Findings referring to predominance in the female sex (66% in group CR versus 70% in group AD), duration of pain between 2 and 6 months (40% CR versus 38% AD), intensive degree of pain (70% CR versus 83% AD) and presence of vomiting and nausea (42% CR versus 55% AD) were similar in both groups. Epigastric pain was predominant in AD (87%) versus CR (63%) with significant difference p=0.012. The endoscopic findings were normal in 30% of CR and 14% AD (p=0.052). Light to moderate gastritis was significantly more common in AD (72%) than CR (37%) (p=0.01). In the CR group, there was mainly antral nodular gastritis while in AD the diffuse form was more frequent. Bulbar duodenitis was present in 10% CR and 12% AD, but it was more erosive and serious in children. Peptic ulceration was found in 16% of CR (2 gastritis and 3 duodenal) and 7% AD (1 gastric and 4 duodenal) (p=0.067). H. pylori colonization was more frequent in AD (52%) than in CR (36%) (p=0.195).CONCLUSIONS: 1) epigastric pain is the main symptom in both groups; 2) endoscopic findings may be normal especially in the childreńs group; 3) antral nodular gastritis is the predominant type in children while in adolescents it is diffuse gastritis; 4) H. pylori colonization is present in 1/3 of children and 1/2 of adolescents with peptic disease; 5) in both groups ulcers are more frequent in the duodenum.
Toporovski
M S
MS
Santa Casa de São Paulo, São Paulo, SP, Brazil.
Neufeld
C B
CB
Chiara
A M
AM
Françoso
L A
LA
Beznos
G W
GW
Coates
V
V