The Relationship between Primary Duodenogastric Reflux and <b><i>Helicobacter pylori</i></b> Gastritis in Children

Abstract

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Most studies of the relationship between duodenogastric reflux (DGR) and &lt;i&gt;Helicobacter pylori&lt;/i&gt; have reported that the presence of DGR decreases &lt;i&gt;H. pylori&lt;/i&gt; colonization, while &lt;i&gt;H. pylori&lt;/i&gt; infection increases the frequency of DGR by impairing antroduodenal motility. The present study aimed to investigate the relationship between primary DGR and the prevalence of &lt;i&gt;H. pylori&lt;/i&gt; in children, as well as the degree of colonization and the presence and severity of gastritis. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Included in the study were 410 patients between the ages of 2 and 18 years, referred to the pediatric gastroenterology clinic with complaints of dyspepsia, abdominal pain, and nausea/vomiting, who underwent upper gastrointestinal system endoscopic examination and stomach biopsy. The study group included 60 patients with DGR, while 350 non-DGR patients formed the control group. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The mean age of patients with DGR was 15.7 ± 2.1 years, while the mean age of the control group was 14.2 ± 3.8 years (&lt;i&gt;p&lt;/i&gt; = 0.02). Of those with DGR, 50 (83.3%) were girls, while in the control group, 215 (61.4%) were girls (&lt;i&gt;p&lt;/i&gt; = 0.001). Of patients with DGR, 16 were &lt;i&gt;H. pylori&lt;/i&gt; (+) (26.7%), while in the control group, 168 were &lt;i&gt;H. pylori&lt;/i&gt; (+) (48%) (&lt;i&gt;p&lt;/i&gt; = 0.002). There was no significant difference between the 2 groups with respect to &lt;i&gt;H. pylori&lt;/i&gt; degree of colonization (&lt;i&gt;p&lt;/i&gt; = 0.08). Gastritis was present in 56 (93.3%) patients in the DGR group and 322 (92%) patients in the control group (&lt;i&gt;p&lt;/i&gt; = 0.72). A significant difference was found between the 2 groups in terms of gastritis severity (&lt;i&gt;p&lt;/i&gt; = 0.01). &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; The mean age of patients with DGR was significantly higher than that of patients without DGR, and DGR was found to be more common in girls. In patients with DGR, &lt;i&gt;H. pylori&lt;/i&gt; prevalence was significantly lower than in those without DGR; however, no significant difference was found between the 2 groups with respect to the colonization degree.

Mucosal distribution of somatostatin-secreting gastric Delta cells in children with gastrointestinal reflux diseases

“…In a previous study among a few children, the number of D-cells did not significantly differ according to symptoms and endoscopic findings; however, it was fewer in the gastric body of children with a current H. pylori infection (32). In the present study, the D-cell count was higher in the gastric body of children with DGR and was significantly lower in H. pylori-infected children, which is similar to the findings in our previous study and other groups (33). This may explain why stomach motility is decreased in DGR and why patients with H. pylori infection occasionally have motility disorders.…”

Bile reflux alters the profile of the gastric mucosa microbiota

“…Results from the current study indicate that gastric flora may be an important factor in the occurrence and development of PBRG. (Ladas et al, 1996;Arslan and Balamtekin, 2021;Wang et al, 2022) The current medical treatment of PBRG such as proton pump inhibitors, ursodeoxycholic acid, hydrotalcite and prokinetic drugs have limited effects on endoscopic appearance and histological changes, while potential influence on gastrointestinal microbiota. (Tsuda et al, 2015;McCabe and Dilly, 2018;Pearson et al, 2019) Findings suggest that probiotic treatment significantly alters the diversity, community structure, and composition of the gastric microbiota.…”

“…Some studies indicate a potential relationship between bile reflux and certain intragastric bacteria such as H. pylori (HP), but specific gastric flora have not yet been defined. (Ladas et al, 1996;Arslan and Balamtekin, 2021) The movement of alkaline bile back into the stomach may affect gastric acidity and further change the bacterial communities in this region. The current study investigates the alterations and distribution of stomach microbiota in patients with bile reflux.…”

Role of Bile Reflux in Functional Dyspepsia: Areas That Need Further Research

“…4 Reflux of duodenal contents to the stomach and then to the esophagus is a short-term physiological event rarely leading to symptoms. 5 Excessive duodenogastric reflux (DGR) occurs very commonly in adults secondary to partial gastrectomy, pyloroplasty, and cholecystectomy. 6 The role of DGR of bile in the pathogenesis of FD was investigated in a few studies.…”