Frequency of Helicobacter Pylori Infection (Detected by Gastric Biopsy Culture and Histopathology) in Children Presenting with Recurrent Abdominal Pain (RAP)

Abstract

OBJECTIVE: To determine the frequency of Helicobacter pylori infection (detected by Gastric Biopsy culture and histopathology) in children presenting with recurrent abdominal pain. DURATION: Six months from June 2014 to November 2014. SETTING: Department of Pediatric unit II, Civil Hospital Karachi, DUHS. STUDY DESIGN: Descriptive study, Case series METHODOLOGY: Children 2-15 years of age with either sex, presenting with history of recurrent abdominal pain as per defined criteria were included in the study. Children were excluded from the study if having history of intake of Steroids, antibiotic, NSAIDs, H2 receptor blockers, proton pump inhibitors or bismuth subsalicylate preceding 4 weeks prior to endoscopy, already diagnosed as having H. pylori infection, inflammatory bowel disease, chronic liver disease, acute appendicitis and renal disease. Recurrent abdominal pain (RAP) was diagnosed on the basis of history of recurrent severe abdominal pain occurring at-least once in a month for 3 consequent months. Prior to upper GI endoscopy and biopsy, other causes of recurrent abdominal pain were ruled out by performing appropriate tests that includes complete blood picture, urine detailed examination, stool detailed examination, stool culture and sensitivity, liver function tests, renal function tests, abdominal and pelvic ultra-sonograms. Upper Gastrointestinal endoscopy was performed in all patients RESULTS: Out of 60 cases of RAP 61.7% were males and 38.3% were females. Male to female ratio was 1.60. Mean age of children was 7.71 ± 2.68 years. Mean duration of RAP was 5.55± 1.83 months. Frequency of RAP episodes per month ranged from 3-11 episodes (mean 5.97 ± 2.09). On culture of total 60 biopsy cases H Pylori was positive in 36.7% while it was negative in 63.3% cases. Out of 22children having H. Pylori infection14 were males and 8were females. Mean age of children with H. pylori positive was 8.09 ± 2.18 years. Mean duration of RAP in positive case was 5.77 ±1.88 months. Conclusion: H pylori infection is a major cause of RAP in children and therefore should always be considered in differential diagnosis. Large scale studies are warranted to build national database.