Pangastritis and oesophageal reflux disease in children and teenagers

Introduction: The role of Helicobacter pylori infection in pathogenesis and GERD incidence still persists unexplained. Helicobacter pylori influence on incidence of acid gastroesophageal reflux depends on the region of inflammation, bacteria virulence and motoric disturbances of the gastrointestinal tract. The pathomechanism of these dependences is still not entirely known.

Aim: The aim of the study is to evaluate the influence of
H. pylori infection, affecting the entire stomach (pangastritis), and its treatment upon the frequency of oesophageal reflux disease in children and teenagers.

Material and methods: 101 patients aged 5-18 with dyspeptic symptoms were treated with endoscopic examination of the upper segment of the digestive tract and it affirmed the infection of the stomach and/or duodenum mucous membrane. The H. pylori infection was also proved in histopathological examination and/or in urease test and urea breathing test. The pH-metric examination of the oesophagus was done before and after the infection treatment.

Results: Among the examined patients there were 101 people who had H. pylori infection (group I). In 62 cases the H. pylori infection included only the prepyloric part of the stomach 62/101 (61.4%) – group Ia; in 6 cases it included only the corpus part of the stomach (0.06%) – group Ib; 33 patients had pangastritis, which occurred when infection was found in the prepyloric part and corpus part of the stomach 33/101 (32.7%) – group Ic. A difference in frequency of GERD was not demonstrated between the group of patients with pangastritis and the group with prepyloric (p=1.09 ns) or corpus infection of the stomach (p=–0.10 ns). No difference was found in frequency of GERD occurrence after H. pylori eradication between the group of patients with pangastritis and the group which was still infected (p=0.10 ns).

Conclusions:

1. H. pylori infection which includes the entire stomach does not influence the frequency of GERD in children and teenagers.
2. Eradicative treatment probably does not influence the frequency of GERD after treatment.