Complaints, Endoscopic and Histopathological Findings in Patients with Helicobacter Pylori Infection and their Correlation with Each Other

Objectives and study:There is no significant clinical state indicating H.pylori infection in pediatric population.In this study, most common complaints,endoscopic and histopathological findings in children with H.pylori infection were evaluated and their correlation with each other was explicated.

Methods:Patients between 3-18 years,applied to the hospital with dyspepsia,epigastric pain,reflux symptoms,anemia and suspected gastrointestinal(GI)bleeding and underwent upper GI endoscopy were enrolled in this study.Gastric antrum and corpus biopsies were performed in all patients during endoscopy for rapid urease test and histopathological examination.Sydney classification was used to evaluate H.pylori intensity,activity of gastritis,chronic inflammation,atrophy and intestinal metaplasia.Demographical properties, complaints,endoscopic findings and Sydney scores of the patients were recorded.

Results: A total of 339 patients(183 female)were enrolled in the study.The most common complaints were dyspepsia and epigastric pain.90% of the patients had antral pathology, 78% of which was nodularity.Relation between dyspepsia, epigastric pain and antral nodularity is found to be statistically significant.In histopathological examination, intensity score of H.pylori is found to be increasing with the age.Rapid urease test was positive in 90.2% patients.Relation between rapid urease test and the intensity of H.pylori was statically significant.Relations between detected morphological changes in the antrum and the intensity of H.pylori,activity and chronic inflammation scores were statistically significant.Intestinal metaplasia(IM)and gastric atrophy(GA)was present in 7.1% and 6.2% of the patients respectively.No relation was found between IM or GA with the intensity of H.pylori, endoscopic findings and complaints.

Conclusion: The most common complaints of children with H.pylori infection were epigastric pain and dyspepsia.There were significant relations with this complaints,antral morphological changes and with the intensity of H.pylori,and the intensity of H.pylori,increases with age.Since these complaints were related with antral morphological changes and these changes were related with activity of gastritis,chronic inflammation and increased intensity of H.pylori, early eradication can be recommended in these children in order to prevent from long term complications.