Peptic ulcers and erosions are common in Israeli children undergoing upper endoscopy.
BACKGROUND
Peptic ulcers and erosions (PU&E) are thought to be uncommon in children. Patients with early exposure to Helicobacter pylori may be at a higher risk for early onset PU&E. Children in Israel have a high prevalence and early acquisition of Helicobacter pylori (H. pylori) and have easy access to pediatric gastroenterologists and endoscopy. Our aim was to describe the prevalence and characteristics of PU&E in this population referred by Pediatric Gastroenterologists for an upper endoscopy.


METHODS
We conducted a retrospective study over the years January 2003-May 2006. Over these years we had information on 751 diagnostic upper endoscopies. PU&E was regarded as erosive gastritis/duodenitis or ulcer in either the stomach or duodenum. H. pylori status was assessed using rapid urease test and gastric biopsies.


RESULTS
PU&E was detected in 169 (22.5%) patients (ulcers 51 (6.8%), erosions 118 (15.7%)). One hundred twenty-four had gastric PU&E and 58 had duodenal PU&E. H. pylori was positive in 112 (66.3%). H. pylori-associated PU&E becomes common after age 10 years, with gastric PU&E presenting much earlier than duodenal disease. Most of the H. pylori-negative PU&E were idiopathic and improved symptomatically on PPI treatment. Interestingly, 43% of patients with PU&E in our cohort were either immigrants from the former Soviet Union or of Israeli Arab origin.


CONCLUSIONS
PU&E appears to be common in this selected population with a relatively high incidence of gastric PU&E. H. pylori associated PU&E becomes common after age 10 years with gastric PU&E presenting much earlier than duodenal disease. Non H. pylori PU&E in children comprises approximately a third of all PU&E, are mostly idiopathic and appear earlier than H. pylori associated PU&E.
Egbaria
Rania
R
Department of Pediatrics, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel.
Levine
Arie
A
Tamir
Ada
A
Shaoul
Ron
R
D000293:Adolescent; D000367:Age Factors; D001944:Breath Tests / Q000379:methods; D002648:Child; D004382:Duodenitis / Q000453:epidemiology*; D016099:Endoscopy, Gastrointestinal; D005006:Ethnicity; D005753:Gastric Mucosa / Q000473:pathology; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000201:enzymology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D010437:Peptic Ulcer / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D014508:Urea / Q000032:analysis; D014510:Urease / Q000378:metabolism
D014508:Urea; D014510:Urease