Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains

Rutigliano, Vincenzo; Ierardi, Enzo; Francavilla, Ruggiero; Castellaneta, Stefania; Margiotta, M.; Amoruso, A.; Marrazza, Elisa; Traversa, A; Panella, C.; Rigillo, N; Francavilla, A.

doi:10.1097/00005176-199903000-00015

Cited by 30 publications

(32 citation statements)

References 28 publications

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“…In only 6/53 children, the H. pylori was also detected in the gastric body [9 0] . Clinical evaluation showed a significant difference in favor of subjects positive for H. pylori only for epigastric burning and/or pain [90] . Clinical symptoms associated with H. pylori infection have been reported in patients with human immunodeficiency virus ( HIV )-1 [91,92] .…”

Section: Symptomsmentioning

confidence: 92%

“…A standardized and simplified C-13 breath test was recently described in children [122] . The high sensitivity and specificity of the 13 C-breath test in the detection of H. pylori infection in children has been unequivocally demonstrated [90,123,124] . The best cut off value is obtained after 30 minutes [120] .…”

Section: Diagnostic and Screening Toolsmentioning

confidence: 97%

“…In Finland, 4% of children under the age of 7 years have a positive serology [89] . Approximately 30% of 53 children ( 16/53 ) with dyspepsia were infected with H. pylori in the antrum, and about half of them a cytotoxic train was present (anti-Cag A antibodies in 64% and antivacA antibodies in 43%) [90] . In only 6/53 children, the H. pylori was also detected in the gastric body [9 0] .…”

Section: Symptomsmentioning

confidence: 99%

“…Immunoblot has become the reference method used to confirm doubtful results [118] . Specific serologies for cytoxic strains may be helpful in selecting patients for treatment [90] . Carbon-13 and C-14 breath tests are based on the fact that urease from H. pylori will hydrolyze the ingested labeled urea into ammonia and labeled bicarbonate, which is exhaled as labeled carbon dioxide [18] .…”

Section: Diagnostic and Screening Toolsmentioning

confidence: 99%

“…Although the dose required for one test is not greater than the natural background radiation, the use of 14C is considered unethical in pregnant women, adolescents and children because of its extremely long half-life, since 14C may be incorporated into the bicarbonate pool [128] . The urea breath test is in general accepted to be the most reliable noninvasive diagnostic method [90,129] . The urea breath test detects only current infection and can be used to screen for H. pylori infection and as the sole method for assessing eradication, and to evaluate treatment efficacy [129] .…”

Section: Diagnostic and Screening Toolsmentioning

confidence: 99%

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Helicobacter pyloriinfection

Vandenplas¹

2000

WJG

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Section: Symptomsmentioning

confidence: 92%

Section: Diagnostic and Screening Toolsmentioning

confidence: 97%

Section: Symptomsmentioning

confidence: 99%

Section: Diagnostic and Screening Toolsmentioning

confidence: 99%

Section: Diagnostic and Screening Toolsmentioning

confidence: 99%

See 3 more Smart Citations

Helicobacter pyloriinfection

Vandenplas¹

2000

WJG

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Gastric Emptying of Solids in Children with H. pylori‐Positive and H. pylori‐Negative Non‐Ulcer Dyspepsia

Sýkora,

Malán,

Záhlava

et al. 2004

J. pediatr. gastroenterol. nutr.

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Objective:There is currently no data available in children on possible relationships among Helicobacter pylori, gastric motility and gastric inflammation. This is a prospective study of gastric emptying (GE) in symptomatic children with and without H. pylori who met symptom‐based criteria for non‐ulcer dyspepsia (NUD).Methods:47 consecutive dyspeptic patients (23 males; age range, 7 to 18 years) were enrolled. All patients had extensive negative diagnostic investigations. Scintigraphic solid‐phase gastric emptying was assessed.Results:21 H. pylori‐positive and 26 H. pylori‐negative patients were identified with non‐ulcer dyspepsia. The groups were not different in clinical symptoms except that pain related to feeding was more frequent in infected children (P < 0.03). Nodular antral gastritis was found more frequently in the H. pylori positive group (P < 0.0001). The gastritis score was more severe in H. pylori infected than H. pylori negative patients in both fundic and body mucosa (P < 0.001). Within the H. pylori‐positive NUD group, the mean half‐time GE of a solid meal was significantly accelerated compared to the non‐infected group (P < 0.05). There was no difference in the intragastric food distribution and curves of gastric emptying of both groups. A significant relationship was found between the degree of gastric body inflammation gastric emptying, but not antral inflammation. Gastric emptying rate did not differ by sex or age of the subjects in either group.Conclusions:In dyspeptic children with H. pylori, gastric emptying of a solid was significantly accelerated compared with symptomatic H. pylori uninfected patients. This suggests that H. pylori is able to induce gastric emptying acceleration. Our findings add more information on H. pylori infection and gastroduodenal disease.

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Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009

et al. 2009

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The array of tests that can be used for diagnosis of Helicobacter pylori infection is large, and it can be confusing to define which test to use particularly in children where results may not be comparable to those obtained in adult patients. Using PubMed, we reviewed the English literature from January 1999 to May 2009 to identify articles that determined sensitivity and specificity of H. pylori invasive and non-invasive diagnostic tests in children. We excluded articles that presented a review of the literature, abstracts, case reports, or series where children's results could not be separated from adult populations. Of the tissue based methods, rapid urease tests have better sensitivity than histology to detect presence of H. pylori; however, histology can detect the pathology associated with disease including gastritis, intestinal metaplasia, and other conditions that could be the cause of the child's symptoms. Culture of gastric tissues or stool has 100% specificity but sensitivity is low. Of the serologic tests, immunoblot has the best sensitivity. The urea breath tests have >75% sensitivity for detection of H. pylori before and after treatment. Immunoassays in stool using monoclonal antibodies have >95% sensitivity for detection of H. pylori before and after treatment. PCR testing can be performed in tissue and stool samples and can detect genes associated to antibiotic resistance. In summary, the current commercial non-invasive tests have adequate sensitivity and specificity for detecting the presence of H. pylori; however, endoscopy with histopathology is the only method that can detect H. pylori and lesions associated with the infection.

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Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains

Cited by 30 publications

References 28 publications

Helicobacter pyloriinfection

Helicobacter pyloriinfection

Gastric Emptying of Solids in Children with H. pylori‐Positive and H. pylori‐Negative Non‐Ulcer Dyspepsia

Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009

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