Helicobacter pylori-positive versus Helicobacter pylori-negative idiopathic peptic ulcers in children with their long-term outcomes.
OBJECTIVE
The aim of this study is to investigate the differences in the characteristics between Helicobacter pylori-positive and H pylori-negative primary ulcers in Chinese children.


METHODS
We conducted a retrospective review of children with primary peptic ulcers. Demographic data, clinical presentations, endoscopic features, histological findings, H pylori prevalence, and ulcer recurrences were studied.


RESULTS
Forty-three Chinese children with primary peptic ulcers were diagnosed over 8 years and were reviewed. There were 31 boys and 12 girls (median age 12 years, range 3-16 years). Thirty children (70%) presented with acute gastrointestinal bleeding, whereas only 19 had a history of epigastric pain. Twenty-three patients (53.5%) were H pylori positive. H pylori-positive ulcers developed in older children (median age 12 vs 10 years, P<0.05) and affected more males (91.3% vs 50%, P<0.01) than the H pylori-negative group. The annual ulcer recurrence rates were estimated to be 5.2% (95% CI 4.2-6.3) and 11.4% (95% CI 9.1-13.6) for positive and negative groups, respectively (P<0.05). Multivariate logistic regression suggested H pylori-negative status and ulcer size >1cm were indepen-dent risk factors for recurrence.


CONCLUSIONS
Our report suggests that H pylori-negative primary ulcers exist in children with their own distinct features. In contrast to H pylori-positive ulcers, H pylori-negative ulcers develop in younger children, affect both sexes equally, and carry a higher recurrence risk.
Tam
Yuk Him
YH
Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. pyhtam@hotmail.com
Lee
Kim Hung
KH
To
Ka Fai
KF
Chan
Kin Wai
KW
Cheung
Sing Tak
ST
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D016896:Treatment Outcome
D054328:Proton Pump Inhibitors