Helicobacter pylori colonization occurs in early childhood, and correlates with socioeconomic parameters.
H. pylori infection is highly prevalent in many countries. It can cause chronic gastritis and peptic ulcer in both adults and children.
Gastritis induced by H. pylori may be associated with recurrent abdominal pain in children. The eradication of the bacterium may improve the clinical symptoms.
In this study, researchers from Israel characterized pediatric patients according to referral patterns and the results of 13C-urea breath tests (13C -UBT).
They also evaluated treatment combinations for H. pylori eradication.
|History of peptic disease was the main indication for the test.|
|Journal of Clinical Gastroenterology|
The team performed the 13C-UBT using 75mg urea labeled with 13C in 200ml orange juice.
They collected breath samples at 0 and 30 minutes. They expressed the results as the change in the 13C/12C ratio at time 30 minutes minus time 0 minutes.
The cutoff for H. pylori eradication was 3.5.
The team collected data on demographics, indication for the test, and type of combination eradication therapy.
They evaluated 1655 children, aged 1 to 18 years. The sample included 60% boys, and subjects were from all parts of the country.
The researchers found that the 13C-UBT was positive in 46%.
They also found that the prevalence of positive results was directly correlated with age.
History of peptic disease was the main indication for the test, in 81% of cases.
The team gained information on eradication therapy for 435 children. Of these, 43% had a positive 13C-UBT, indicating a successful eradication rate of 58%.
When compared with children of Israeli and American-European origin, Asian-African children had a higher rate of referrals for reason of validation of successful H. pylori eradication, greater long-term PPI use, and a higher rate of 13C-UBT positivity.
The team did not find any significant differences between the triple therapy regimens used.
Dr Yaron Niv's team concluded, "13C-UBT may be performed in children of all age groups".
"The main indication is a history of peptic ulcer disease".
"The prevalence of H. pylori infection increased with age and the only factor associated with increased H. pylori infection was Asian-African origin".
"The most frequent eradication therapy used in children is a combination of omeprazole, amoxicillin, and clarithromycin".