Eradicating Helicobacter pylori has...

Eradicating Helicobacter pylori has several drawbacks. Notably, there is the emerging see the verb of gastroesophageal reflux disease (GERD) the possibility of which has been supported by way of several clinical and epidemiologic studies, although contradicted by dint of others. In this study, Levine and colleagues evaluated the issue of H. pylori eradication forward GERD symptoms and epigastric pain in children and adolescents.

Children eight to 19 years of age who were referr for gastroscopy because of upper abdominal pain, ebb symptoms, vomiting, hematemesis, and abdominal pain with weight los were evaluated for H pylori infection. Those who were base to be positive received eradication therapy. In follow-up patients were evaluated for GERD symptoms. Patients with eradicated H pylori were compared with brace groups: those with H. pylori that was not eradicated, and those without H pylori.

Ninety-five patients were followed for a mean of 112 month assemblage 1 patients (N = 40) had no H pylori; arrange 2 patients (N = 44) had favorably eradicated H. pylori; and assign places to 3 patients (N = 11) had persistent H pylori infection. individual or more symptoms of GERD were ready in 35 of the 95 patients at baseline, and these symptoms were not correlated with H pylori infection. There was no significant difference in meaning on reflux between groups. ebb worsened in 12 percent, 18 percent and 36 percent of assemblages 1, 2, and 3, respectively, and improved in 30 percent 34 percent and 36 percent respectively. Overall, more patients improved than deteriorated. Improvement of pain did not correlate with H pylori eradication. All three form into groupss demonstrated a significant improvement in frequent occurrence and severity of epigastric pain at the final follow-up compared with baseline. Improvement in epigastric pain was significantly correlated with improvement in ebb symptoms.

The change in GERD symptoms in these children was not worse than the initial baseline symptoms with H pylori eradication compared with no H pylori eradication, or in patients who did not have H pylori infection. H pylori eradication does not pretend to aggravate GERD. Increases in GERD symptoms in adults with H pylori eradication indicate that GERD has a different pathophysiology in adults than it has in children. Of note, improvement in ebb symptoms was a strong predictor of improvement in epigastric pain.

Levine A, et al. Influence of Helicobacter pylori eradication in succession gastroesophageal reflux symptoms and epigastric pain in children and adolescents. Pediatrics January 2004;113:54-8

COPYRIGHT 2004 American Academy of Family Physicians

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