Pediatr Gastroenterol Hepatol Nutr.  2015 Dec;18(4):246-252. 10.5223/pghn.2015.18.4.246.

Association between Gastric pH and Helicobacter pylori Infection in Children

Affiliations
  • 1Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea. hsyoun@gnu.ac.kr
  • 2Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 3Department of Microbiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.

Abstract

PURPOSE
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).
CONCLUSION
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.

Keyword

Urease test; Helicobacter pylori; Child; Gastric juice; Hypochlorhydria

MeSH Terms

Achlorhydria
Biopsy
Child*
Fasting
Gastric Juice
Gastritis
Helicobacter pylori*
Helicobacter*
Humans
Hydrogen-Ion Concentration*
Urease
Urease
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