title: Frequency and risk factors of gastric and duodenal ulcers or erosions in children: a prospective 1-month European multicenter study.
abstract: There are no solid figures of the frequency of ulcer disease during childhood in Europe. We assessed its frequency and analyzed known risk factors.
  
  
  METHODS
  Ulcers, erosions, indications, and risk factors were recorded in all children undergoing an upper gastrointestinal endoscopy in a prospective study carried out during 1-month simultaneously in 19 centers among 14 European countries.
  
  
  RESULTS
  Ulcers and/or erosions were observed in 56 out of 694 children. Children with ulcers/erosions were significantly older than those without lesions (10.3+/-5.5 vs. 8.1+/-5.7 years, P=0.002). Helicobacter pylori infection was present in 15 of 56 children (27%) where NSAIDs were used in eight, steroids in five, immune-suppressive drugs in five, antibiotics in six, antacids in one, H2-blockers in six and proton pump inhibitors in eight children (more than one risk factor was detected in 32 of 56 children). No risk factors were observed in 24 of 56 children (43%). The main indications for endoscopy were epigastric or abdominal pain (24%) and suspicion of gastroesophageal reflux disease (15%). Similarly, epigastric tenderness, hematemesis, melena, and weight stagnation were significantly associated with ulcers/erosions, whereas sex, H. pylori infection, socioeconomic and lifestyle factors were equally distributed.
  
  
  CONCLUSIONS
  Although limited by the short-time duration and the heterogeneity of the patients included throughout the 19 centers, our study shows a frequency of 8.1% of ulcers and/or erosions in children, occurring mainly in the second decade of life. H. pylori infection and gastrotoxic medications were less frequently implicated than expected.
authors.affiliation: Saint Vincent de Paul Hospital, Clinic of Pediatrics St Antoine, Catholic University, Lille, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Kalach
authors.forename: Patrick
authors.initials: P
authors.lastname: Bontems
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
authors.forename: Petronella
authors.initials: P
authors.lastname: Mourad-Baars
authors.forename: Peter
authors.initials: P
authors.lastname: Shcherbakov
authors.forename: Danuta
authors.initials: D
authors.lastname: Celinska-Cedro
authors.forename: Barbara
authors.initials: B
authors.lastname: Iwanczak
authors.forename: Frederic
authors.initials: F
authors.lastname: Gottrand
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Martinez-Gomez
authors.forename: Ender
authors.initials: E
authors.lastname: Pehlivanoglu
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Oderda
authors.forename: Pedro
authors.initials: P
authors.lastname: Urruzuno
authors.forename: Thomas
authors.initials: T
authors.lastname: Casswall
authors.forename: Thierry
authors.initials: T
authors.lastname: Lamireau
authors.forename: Josef
authors.initials: J
authors.lastname: Sykora
authors.forename: Elefteria
authors.initials: E
authors.lastname: Roma-Giannikou
authors.forename: Gabor
authors.initials: G
authors.lastname: Veres
authors.forename: Vibeke
authors.initials: V
authors.lastname: Wewer
authors.forename: Sonny
authors.initials: S
authors.lastname: Chong
authors.forename: Marie Laure
authors.initials: ML
authors.lastname: Charkaluk
authors.forename: Francis
authors.initials: F
authors.lastname: Mégraud
authors.forename: Samy
authors.initials: S
authors.lastname: Cadranel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004381:Duodenal Ulcer / Q000453:epidemiology* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005060:Europe / Q000453:epidemiology; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000453:epidemiology* / Q000473:pathology