title: Association between Gastric pH and Helicobacter pylori Infection in Children.
abstract: OBJECTIVE
  To assess gastric pH and its relationship with urease-test positivity and histological findings in children with Helicobacter pylori infection.
  
  
  METHODS
  Fasting gastric juices and endoscopic antral biopsy specimens were collected from 562 children and subjected to the urease test and histopathological examination. The subjects were divided into 3 age groups: 0-4, 5-9, and 10-15 years. The histopathological grade was assessed using the Updated Sydney System, while the gastric juice pH was determined using a pH meter.
  
  
  RESULTS
  The median gastric juice pH did not differ significantly among the age groups (p=0.655). The proportion of individuals with gastric pH >4.0 was 1.3% in the 0-4 years group, 6.1% in the 5-9 years group, and 8.2% in 10-15 years (p=0.101). The proportions of moderate and severe chronic gastritis, active gastritis, and H. pylori infiltration increased with age (p<0.005). Urease-test positivity was higher in children with hypochlorhydria (77.8%) than in those with normal gastric pH (31.7%) (p<0.001). Chronic and active gastritis were more severe in the former than the latter (p<0.001), but the degree of H. pylori infiltration did not differ (20.9% vs. 38.9%; p=0.186).
  
  
  CONCLUSIONS
  Gastric pH while fasting is normal in most children regardless of age. Urease-test positivity may be related to hypochlorhydria in children, and hypochlorhydria is in turn related to H. pylori infection.
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Heung Keun
authors.initials: HK
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Ji Sook
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Jung Sook
authors.initials: JS
authors.lastname: Yeom
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Lim
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Chan-Hoo
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Hyang-Ok
authors.initials: HO
authors.lastname: Woo
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Hee-Shang
authors.initials: HS
authors.lastname: Youn
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Jin-Su
authors.initials: JS
authors.lastname: Jun
authors.affiliation: Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Gyung-Hyuck
authors.initials: GH
authors.lastname: Ko
authors.affiliation: Department of Microbiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Seung-Chul
authors.initials: SC
authors.lastname: Baik
authors.affiliation: Department of Microbiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Woo-Kon
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Microbiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Myung-Je
authors.initials: MJ
authors.lastname: Cho
authors.affiliation: Department of Microbiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Kwang-Ho
authors.initials: KH
authors.lastname: Rhee
keywords: Child; Gastric juice; Helicobacter pylori; Hypochlorhydria; Urease test