The prevalence of Helicobacter pylori gastritis in newly diagnosed children with inflammatory bowel disease.
BACKGROUND
Recent studies have shown that patients with inflammatory bowel disease (IBD) are less likely to be infected with Helicobacter pylori compared with non-IBD patients. We aimed to study the prevalence of H. pylori-positive and H. pylori-negative gastritis in newly diagnosed children with IBD in comparison to those with non-IBD in Greece.


METHODS
All children who underwent first esophagogastroduodenal endoscopy between 2002 and 2011 were retrospectively included. Four groups were studied: patients with Crohn's disease (CD), ulcerative colitis (UC), IBD unclassified (IBDU), and non-IBD individuals (non-IBD). Helicobacter pylori infection was defined by positive culture or by positive histology and CLO test. Those children with negative or not available culture and only one positive test (histology or CLO) were further evaluated by urea breath test, and the positives were also included in the infected group.


RESULTS
We studied 159 patients with IBD (66 CD, 34 UC, and 59 IBDU) and 1209 patients in non-IBD individuals. Helicobacter pylori gastritis was less frequent in the IBD group (3.8% vs 13.2% in the control group, p < .001), whereas IBD patients were significantly older than non-IBD children (p < .001). Children with H. pylori-negative gastritis were 3.3 times more likely to belong in the IBD group compared with H. pylori-positive patients (p = .006).


CONCLUSIONS
Occurrence of H. pylori gastritis is less frequent in children with IBD compared with controls. Our study confirms an inverse association between H. pylori and IBD. Future studies are needed to distinguish between a true protective role of H. pylori and a confounding effect due to previous antibiotic use in children with IBD.
1st Department of Paediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.
Kleoniki
K
Roka
Aikaterini
A
Roubani
Kalliopi
K
Stefanaki
Ioanna
I
Panayotou
Eleftheria
E
Roma
Giorgos
G
Chouliaras
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications / Q000453:epidemiology; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology; D016145:Endoscopy, Digestive System; D005260:Female; D005756:Gastritis / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D006115:Greece / Q000453:epidemiology; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies
Crohn's disease; Helicobacter pylori; inflammatory bowel disease; inflammatory bowel disease unclassified; pediatrics; ulcerative colitis