Helicobacter pylori infection in Saudi children; clinical, endoscopic and pathological findings

Abstract 

Background and study aims

Helicobacter pylori (H. pylori) infection is common in the Saudi paediatric population. The aim of this study was to describe the clinical presentation, endoscopic abnormalities and associated histopathological changes in a group of Saudi children with H. pylori infection.

Patients and methods

This is a chart review of all Saudi children diagnosed at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia, between September 2001 and July 2005 with H. pylori infection.

Results

A total of 230 children were identified. One hundred and thiry six (55%) were females. The mean age was 11±3.9 years (range, 2–17). Thirty-two (14%) were underweight and 12 (5%) were stunted. The main symptom was epigastric pain in 128 (56%). Nodular gastritis was the most frequent endoscopic finding in 94 patients (40%). The histopathological findings in the antrum showed moderate chronic inflammatory activity in 65%, mild glandular atrophy in 14% and intestinal metaplasia in 2%. In the corpus, moderate chronic inflammatory activity was found in more than 50%, glandular atrophy in 7%, and no cases with intestinal metaplasia. The density of H. pylori in the antrum was mild in 67% and moderate in 26% of cases. In the corpus, it was mild in 49% and moderate in 21% of patients.The mean gastritis score was 4.2±1.3 in the antrum and 3.4±1.3 in the corpus. Nodular gastritis was associated with the highest mean gastritis score of 4.9±1.2 in the antrum (ANOVA<0.001). The severity of gastritis in the antrum and the corpus was associated with higher density of H. pylori (ANOVA<0.001).

Conclusion

Saudi children with H. pylori infection were commonly found to have abnormal endoscopic findings which were associated with significant gastric mucosal inflammation.

Keywords: Helicobacter pylori, Nodular gastritis, Gastritis, Children, Saudi Arabia