Frequency and risk factors of gastric and duodenal ulcers or erosions in children: a prospective 1-month European multicenter study

Abstract

Although limited by the short-time duration and the heterogeneity of the patients included throughout the 19 centers, our study shows a frequency of 8.1% of ulcers and/or erosions in children, occurring mainly in the second decade of life. H. pylori infection and gastrotoxic medications were less frequently implicated than expected.

Helicobacter pylori—Associated Dyspepsia in Paediatrics

“…In Canada, however, the approximate incidence of peptic ulcer was 1 case per 2,500 hospital admissions [92]. In a recent large European multicenter study, including 1233 symptomatic children with H. pylori infection, peptic ulcer disease was diagnosed in less than 5% of children younger than 12 years of age and in ≈10% of teenagers [8]. Interestingly, other studies indicate a higher association of H. pylori with peptic ulcer in adolescents than in younger children [100,101].…”

“…[95]. Despite changing prevalence trends, H. pylori-induced gastritis causing mucosal ulceration either in the stomach (gastric ulcer) or the proximal duodenum (duodenal ulcer) is a relatively uncommon event in children, compared with adults [4][5][6][7][8]. In fact, during childhood, H. pylori is associated with predominant antral gastritis or with pangastritis [96].…”

“…In fact, during childhood, H. pylori is associated with predominant antral gastritis or with pangastritis [96]. In children, few studies have yet investigated the actual trend of H. pylori prevalence in peptic ulcer disease [5][6][7][8] and the available data are more difficult to interpret, considering that the rates of peptic ulcer diagnosis depend also on the clinical setting (endoscopy versus outpatient clinic or hospital admissions) [97,98]. For example, in Italy the detection rate of ulcer disease was 7.8% out of an average of 180 paediatric gastrointestinal endoscopies performed each year [99].…”

“…Nevertheless, H. pylori-associated peptic ulcer disease may also occur shortly after infection in childhood [4][5][6][7][8]. This rare event may be due to more virulent strains [9][10][11][12][13][14][15][16], and/or more predisposed subjects [17][18][19].…”

“…If often asymptomatic, the H. pylori-associated non-ulcer dyspepsia is clearly the strongest aetiological factor for severe gastric diseases that will develop late in adult life in a minority of infected patients, i.e., peptic ulcer disease, both gastric and duodenal ulcers, and gastric cancer, namely, adenocarcinoma and mucosa associated lymphoid tissue (MALT) lymphoma (reviewed in [3]). Peptic ulcer disease rarely occurs soon after H. pylori infection [4][5][6][7][8] that generally starts in childhood; this presumably reflects marked differences in the virulence [9][10][11][12][13][14][15][16] and/or in the susceptibility of young patients [17][18][19].…”