This investigation examined the correlation between Helicobacter pylori (HP) infection, as reflected in immunoglobulin G serum antibodies, and the risk of gastric cancer. Serum samples were obtained from populations with contrasting gastric cancer risks. The highest prevalence of HP infection, 93%, was observed in the adult population at highest gastric cancer risk, the residents of Pasto, Colombia. In the lower risk Colombian city of Cali, a 63% overall prevalence rate was found. Both children and adults were sampled in New Orleans, Louisiana, where gastric cancer rates are high for blacks but not for whites. The prevalence of HP infection was significantly higher in black than in white adults, 70% versus 43%, P = 0.0001. A higher prevalence was also detected in black compared with white children, 49% versus 32%, P = 0.01; however, an even greater disparity was noted when comparing children from two hospitals, regardless of race, which serve different socioeconomic groups. A prevalence rate of 54% was found at Charity Hospital compared with 24% (P = 0.0001) at Children's Hospital. Our findings indicate that socioeconomic conditions, known to influence gastric cancer risk, are also important determinants of HP infection.

We report the case of a 9-year-old boy who presented with chronic rectal bleeding. On proctosigmoidoscopy, a polypoid elevation in the rectal ampulla measuring 5 x 3 cm was found. Biopsies were reported to show gastric mucosa. The Giemsa stain showed Helicobacter pylori-like organisms. Including our patient, there are now 30 similar cases reported in the medical literature. The usual manifestations of this rare entity are chronic bleeding and rectal pain. In one-half of cases there is chronic rectal ulceration. The recommended treatment is transanal surgical resection unless there is rectal peptic ulceration. H2 receptor blockers are then advised. Surgical excision is carried out after healing has taken place.

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