Influence of Helicobacter pylori eradication on gastroesophageal reflux symptoms and epigastric pain in children and adolescents.
OBJECTIVE
Conflicting reports have noted a possible association linking eradication of Helicobacter pylori with aggravation of gastroesophageal reflux (GER) disease. We prospectively evaluated the effect of eradication of H pylori on GER symptoms and epigastric pain and the association among these 3 parameters in a pediatric cohort.


METHODS
Patients who were referred for gastroscopy were evaluated for frequency, severity, and nocturnal presence of symptoms related to GER as well as epigastric pain. Patients who were positive for H pylori received triple antibiotic therapy. The patients were followed for at least 6 months after therapy. Patients with successful eradication had symptoms compared with their pre-eradication state and were compared with a cohort of patients without H pylori or those with persistent H pylori.


RESULTS
Of 119 children and adolescents who were recruited, 95 patients completed the study, with a mean follow-up of 11.2 months. The distribution of outcomes for each GER symptom (better, worse, unchanged) was similar before and after eradication and did not depend on prior H pylori status. Among patients with GER and epigastric pain, improvement in epigastric pain was significantly correlated with the improvement in GER symptoms but not with eradication of H pylori.


CONCLUSIONS
Eradication of H pylori is not associated with increased symptoms of GER in children and adolescents. Improvement in epigastric pain in children is significantly correlated with the improvement in GER symptoms but not with eradication of H pylori.
Levine
Arie
A
Pediatric Gastroenterology Unit, Edith Wolfson Medical Center, Holon, Israel. a-levine@inter.net.il
Milo
Tamir
T
Broide
Efrat
E
Wine
Eitan
E
Dalal
Ilan
I
Boaz
Mona
M
Avni
Yona
Y
Shirin
Haim
H
D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002648:Child; D004942:Esophagitis, Peptic / Q000209:etiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology*; D006356:Heartburn / Q000209:etiology; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011795:Surveys and Questionnaires