Helicobacter pylori infection and abdominal pain in children

Seo, Jeong Kee

Abstract

The relationship between H. pylori(Hp) infection and recurrent abdominal pain(RAP) in children is not clear. Current data in the literature regarding a causal relationship between Hp infection and childhood RAP are conflicting. However, meta-analysis and most of the recently published studies have not supported an association between Hp infection and an increased prevalence of abdominal pain. Most published studies have some problems and have been criticized on methodological grounds. Most of the existing studies have not been designed to include double-blind placebo controls. And, because of the low incidence of Hp infection in children, they have a problem of obtaining sufficient numbers of the Hp infected children. There is also a concern about the heterogeneity of testing methodology in the studies and diagnostic accuracy problems of the non-invasive tests such as low sensitivity of the serology tests and false positive results of the UBT in children. And conflicting results may be explained, in part, by the poor definition of RAP or dyspepsia for the study subjects. To date, no consensus exists for the treatment of Hp-infected children with RAP. Some authors suggest the clinical efficacy of Hp. But others suggest that eradication of Hp is not associated with improvement of RAP. The problem of the most treatment studies is that they had usually no control groups and the number of the subjects was small. In order to make reasonable decisions about treatment of Hp infection in children with RAP, long-term, randomized, double blind, well controlled studies in large numbers of children will be required.