Comparative Evaluation of Clinical, Endoscopic and Histopathological Findings of Helicobacter Pylori-Associated Gastroduodenitis in Children

Chronic colonization with Helicobacter pylori (Hp) has been shown to significantly increase the risk of gastric ulcer and duodenum as well as chronic gastritis in children and adults. Due to the importance of early detection and treatment of HP infection especially in children, this study aimed to compare the clinical, endoscopic and histopathological findings in children with HP gastroduodenitis and control group.

In this cross-sectional study, all children referred to the gastroenterology clinic of children´s hospital, Qazvin, Iran, between 2016 and 2018, with a history of gastrointestinal complaints underwent upper gastrointestinal endoscopy if necessary, then tissue samples were taken, and rapid urease test was performed; subsequently the patients were divided into two equal groups of 200: HP positive (patient group), and Hp negative (control group).

The mean age in the Hp positive group and in the control group was 8.11±3.68 and7.22±2.96 years, respectively (p <0.05). The most common clinical manifestation in the Hp positive group was chronic abdominal pain (n=66, p <0.001). Endoscopic examinations revealed that the evidence of mucosal erythema, erosions and nodular mass of the corpus, antrum and bulb were significantly higher in Hp positive group. Histopathologic studies also showed more evidence of corpus, antrum and bulb inflammation in the Hp positive group compared to the control group.

Overall, based on the results of this study, it seems that endoscopic evidence of mucosal appearance of erythema, obvious nodularity and mucosal erosion in the corpus and antrum as well as bulb of duodenum in children with HP gastroduodenitis has a diagnostic value.