Abstract
Background
Helicobacter pylori (H. pylori) has been recognized as one of the most common chronic bacterial infections in the world. Most children are colonized in early childhood, and the infection will last a lifetime unless the child is treated with appropriate antibiotics.
Aim
To evaluate whether H. pylori infection has an influence on growth and whether the severity of endoscopic findings relates to the growth impairment.
Methods
We formed four groups based on the presence or absence of H. pylori infection and gastrointestinal complaints as follows: group I: RAP +/H. pylori+; group II: RAP +/H. pylori−; group III: RAP −/H. pylori+; group IV: RAP −/H. pylori−. The relationship between endoscopic appearances, histological severity of gastritis, and antral H. pylori density with growth parameters was evaluated.
Results
The BMI standard derivation scores of groups I and II were significantly lower than those of asymptomatic controls independent of their H. pylori status. A significant difference in height for age standard derivation scores was observed only between groups I and IV. When we compared the BMI and height for age standard derivation scores of group III and group IV combined with that of the endoscopically normal children in the recurrent abdominal pain group, there was no significant difference between the two groups.
Conclusion
Recurrent abdominal pain associated with gastric mucosal injury plays a role in a decrease in BMI independent of H. pylori infection. However, if recurrent abdominal pain originates from H. pylori infection, it appears that linear growth is also affected.
Similar content being viewed by others
References
Blaser MJ, Chyou PH, Nomura A. Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer, and duodenal ulcer risk. Cancer Res. 1995;55:562–565.
Drumm B, Sherman P, Cutz E, et al. Association of Campylobacter pylori on the gastric mucosa with antral gastritis in children. N Engl J Med. 1987;316:1557–1561.
Macarthur C, Saunders N, Feldman W, et al. Helicobacter pylori and childhood recurrent abdominal pain: community based case-control study. BMJ. 1999;319:822–823.
O’Donohoe JM, Sullivan PB, Scott R, et al. Recurrent abdominal pain and Helicobacter pylori in a community-based sample of London children. Acta Paediatr. 1996;85:961–964.
Rowland M, Imrie C, Bourke B, et al. How should Helicobacter pylori infected children be managed. Gut. 1999;45:S136–S139.
Drumm B, Rhoads JM, Stringer DA, et al. Peptic ulcer disease in children: etiology, clinical findings, and clinical course. Pediatrics. 1988;82:410–414.
Korzon M, Sikorska-Wisniewska G, Jankowski Z, et al. Clinical and pathological importance of cagA-positive Helicobacter pylori strains in children with abdominal complaints. Helicobacter. 1999;4:238–242.
Bravo E, Mera R, Reina J, et al. Impact of Helicobacter pylori infection on growth of children: a prospective cohort study. J Pediatr Gastr Nutr. 2003;37:614–619.
Mera RM, Correa P, Fontham EE, et al. Effects of a new Helicobacter pylori infection on height and weight in Colombian children. Ann Epidemiol. 2006;16(5):347–351.
Thomas JE, Dale A, Bunn JE, et al. Early Helicobacter pylori colonisation: the association with growth faltering in The Gambia. Arch Dis Child. 2004;89(12):1149–1154.
Perri F, Pastore M, Leandro G, et al. Helicobacter pylori infection and growth delay in older children. Arch Dis Child. 1997;77:46–49.
Dale A, Thomas JE, Darboe MK, et al. Helicobacter pylori infection, gastric acid secretion and infant growth. J Pediatr Gastroenterol Nutr. 1998;26:393–397.
Richter T, List S, Muller DM, et al. Five- to 7-year-old children with Helicobacter pylori infection are smaller than Helicobacter-negative children: a cross-sectional population-based study of 3,315 children. J Pediatr Gastroenterol Nutr. 2001;33(4):472–475.
Chimonas MA, Baggett HC, Parkinson AJ, et al. Asymptomatic Helicobacter pylori infection and iron deficiency are not associated with decreased growth among Alaska Native children aged 7–11 years. Helicobacter. 2006;11(3):159–167.
Ozcay F, Demir H, Ozen H, et al. Normal growth in young children with Helicobacter pylori infection. J Pediatr Gastr Nutr. 2002;35:102.
Apley J, Naish N. Recurrent abdominal pains: a field survey of 1,000 school children. Arch Dis Child. 1958;33:165–170.
Koh Hong, Noh Tae-Woong, Back Seoung-Yon, et al. Noduler gastritis and pathologic findings in children and young adult with Helicobacter pyloripylori. Infection Yonsei Med J. 2007;48:240–246.
Hassal E, Dimmick JE. Unique features of Helicobacter pylori disease in children. Dig Dis Sci. 1991;36:417–423.
Dixon MF, Gento RM, Yardley JH. Classification and grading of gastritis: The updated Sydney System. Am J Surg Pathol. 1996;20:1161–1181.
Mégraud F. European Paediatric Task Force on Helicobacter pylori. Comparison of non-invasive tests to detect Helicobacter pylori infection in children and adolescents: results of a multicenter European study. J Pediatr. 2005;146(2):198–203.
Ozen A, Ertem D, Pehlivanoglu E. Natural history and symptomatology of Helicobacter pylori in childhood and factors determining the epidemiology of infection. J Pediatr Gastroenterol Nutr. 2006;42(4):398–404.
Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbooks of Pediatrics. 18th ed. Philadelphia, PA: Saunders Publishers; 2007.
Choe YH, Kim SK, Hong YC. Helicobacter pylori infection with iron deficiency anaemia and subnormal growth at puberty. Arch Dis Child. 2000;82:136–140.
Cacciari E, Menegatti M, Salardi S, Ali A, et al. Helicobacter pylori infection and cytotoxic antigen associated gene “A” status in short children. J Pediatr Endocrinol Metab. 1999;12:197–201.
Passaro DJ, Taylor DN, Gilman RH, et al. Growth slowing after acute Helicobacter pylori infection is age-dependent. J Pediatr Gastroenterol Nutr. 2002;35:522–526.
Patel P, Mendall MA, Khulusi S, et al. Helicobacter-pylori infection in Patel P, Mendall MA, Khulusi S, et al. Helicobacter-pylori infection in childhood—risk-factors and effect on growth. BMJ. 1994;309:1119–1123.
Soylu OB, Ozturk Y. Helicobacter pylori infection: effect on malnutrition and growth failure in dyspeptic children. Eur J Pediatr. 2008;167(5):557–562.
Bandu R, Shankar N, Tandon O. The effect of iron on growth in iron deficient anemic school going children. Indian J Physio Pharmacol. 2003;47:59–66.
Burman D. Iron deficiency in infancy and childhood. Clin Haematol. 1982;11:339–351.
Lantham M, Stephenson M, Kinoti S, et al. Improvements in growth following iron supplementation in young Kenyan school children. Nutrition. 1990;6:159–165.
Baysoy G, Ertem D, Ademoglu E, et al. Gastric histopathology, iron status and iron deficiency anemia in children with Helicobacter pylori infection. J Pediatr Gastroenterol Nutr. 2004;38:146–151.
Ashorn M. Acid and iron-disturbances related to Helicobacter pylori infection. J Pediatr Gastroenterol Nutr. 2004;38:137–139.
Acknowledgments
This study was financially supported by Yeditepe University Hospital.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gulcan, M., Ozen, A., Karatepe, H.O. et al. Impact of H. Pylori on Growth: Is the Infection or Mucosal Disease Related to Growth Impairment?. Dig Dis Sci 55, 2878–2886 (2010). https://doi.org/10.1007/s10620-009-1091-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10620-009-1091-y