ABSTRACT

Objective: To examine the relationship between Helicobacter pylori (H. pylori) infection and gastrointestinal symptoms, and the efficacy of eradication treatment.

Methods: A retrospective chart review was carried for children (5–18 years old), who underwent a 14C-urea breath test (14C-UBT) for H. pylori infection. Pre- and post treatment 14C-UBT results, gastrointestinal symptoms, H. pylori eradication protocol and treatment consistency were noted.

Results: At presentation, out of 537 patients (65.2% girls), 43.9% had 14C-UBT positivity. The frequency of heartburn, acid regurgitation and halitosis (p = 0.001, p = 0.006 and p = 0.03, respectively) were significantly high in the 14C-UBT (+) patients; the frequency of epigastric pain (p < 0.0001) was significantly high in the 14C-UBT (–) patients at presentation. The 14C-UBT (+) patients were treated with amoxicillin + lansoprazole + clarithromycin (66.1%)/ metranidazole (33.9%). After the eradication treatment, control 14C-UBT was negative in 62.5% of patients treated with metranidazole compared with 47.4% of patients treated with clarithromycin protocol (p = 0.03). After the eradication treatment, the frequency of gastrointestinal symptoms (except the feeling of hunger) were significantly decreased regardless of treatment success (p < 0.0001). The frequency of total gastrointestinal symptoms (p < 0.0001), epigastric pain (p < 0.0001), epigastric burning (p = 0.003), heartburn (p = 0.002), acid regurgitation (p = 0.006), nausea (p = 0.001), halitosis (p = 0.02) and early satiety (p = 0.02) were significantly reduced in patients with control 14C-UBT (–).

Conclusion: H. pylori eradication, or the attempt to eliminate H. pylori, reduces gastrointestinal symptoms in H. pylori-infected children.