H pylori a usual finding during endoscopy for other paediatric GI diseases

A common incidental discovery during upper endoscopy for the diagnosis of common paediatric gastrointestinal (GI) diseases is Helicobacter pylori (H pylori) gastritis, a recent study has revealed. However, indications for treatment are not clear and warrant further research.

In this retrospective, single-centre study, the authors reviewed the endoscopy reports of paediatric patients diagnosed with celiac disease (CeD), inflammatory bowel disease (IBD), and eosinophilic esophagitis (EoE) between January 2017 and December 2021. They then obtained the following patient data: age; gender; haematologic parameters; endoscopic, histologic, and H pylori culture results; and information on eradication treatment.

A total of 558 children (mean age 10.6 years, 60 percent female) were identified, of whom 120 (21.5 percent) were diagnosed with H pylori gastritis during gastroscopy, which was performed for the diagnosis of other GI diseases. Specifically, H pylori was found in 87 of 404 (21.5 percent) CeD, 27 of 113 (23.9 percent) IBD, and six of 41 (14.6 percent) EoE patients (p=0.46).

The main indication for treatment was the presence of ulcers in four of 120 (3.3 percent) and erosions in 17 of 120 (14.2 percent) patients. Eradication treatment was then recommended in 22 of 120 (18.3 percent) patients, eight of 87 (9.2 percent) CeD, 10 of 27 (37 percent) IBD, and four of six (66.7 percent) EoE patients (p<0.001).

The authors found four independent positive treatment predictors, namely age >10 years (odds ratio [OR], 10.57, 95 percent confidence interval [CI], 1.88‒59.36; p=0.007), presence of nodular gastritis (OR, 5.03, 95 percent CI, 1.09‒23.15; p=0.38), erosions (OR, 49.21, 95 percent CI, 8.19‒295.83; p<0.000), and ulcers (OR, 22.69, 95 percent CI, 1.25‒410.22; p=0.035).

Notably, CeD was found to be a strong negative predictor for treatment (OR, 0.23, 95 percent CI, 0.002‒0.241; p=0.002).