Helicobacter pylori chronic gastritis in children: to eradicate or not to eradicate?

J Pediatr. 2011 Jul;159(1):50-6. doi: 10.1016/j.jpeds.2011.01.033. Epub 2011 Mar 10.

Abstract

Objective: To evaluate the efficacy of triple eradication therapy versus symptomatic therapy in children with Helicobacter pylori-associated chronic active gastritis (H pylori-ACAG).

Study design: Symptomatic patients with H pylori-ACAG (n=31) were randomly assigned into two groups: (1) patients infected with H pylori who were treated with triple eradication therapy (n = 16); and (2) patients infected with H pylori who were treated with symptomatic therapy (n=15).

Results: After 1 year of follow-up, macroscopic appearance was significantly different in group B (P=.023), and chronic inflammation, H Pylori density, and activity were significantly higher in group B than in group A (P=.022, .007, and .002, respectively); however, we did not find a significant difference in the symptoms comparing both groups (P=.287). After 1 year of follow-up, we observed the persistence of the H pylori infection in all children who had not received eradication treatment.

Conclusions: There is no correlation between eradication of H pylori infection and improvement of dyspeptic symptoms. Self-eradication does not occur within 1 year of follow-up. A trend toward a higher rate of chronic inflammation in noneradicated children at 1 year limited the time of our study.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Aluminum Hydroxide / therapeutic use
  • Amoxicillin / therapeutic use
  • Antacids / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use*
  • Breath Tests
  • Child
  • Child, Preschool
  • Clarithromycin / therapeutic use
  • Drug Therapy, Combination
  • Endoscopy, Gastrointestinal
  • Female
  • Gastritis / drug therapy*
  • Gastritis / microbiology*
  • Helicobacter Infections / drug therapy*
  • Humans
  • Magnesium Hydroxide / therapeutic use
  • Male
  • Metronidazole / therapeutic use
  • Omeprazole / therapeutic use
  • Proton Pump Inhibitors / therapeutic use*
  • Severity of Illness Index
  • Urea

Substances

  • Antacids
  • Anti-Bacterial Agents
  • Proton Pump Inhibitors
  • Metronidazole
  • Aluminum Hydroxide
  • Amoxicillin
  • Urea
  • Clarithromycin
  • Omeprazole
  • Magnesium Hydroxide