Does Helicobacter pylori infection influence the incidence of acid gastroesophageal reflux in children and teenagers?

Introduction: The role of Helicobacter pylori infection in pathogenesis and gastroesophageal reflux disease (GERD) incidence still remains unexplained. Helicobacter pylori influences the incidence of acid gastroesophageal reflux depending on the region of inflammation, concomitant inflammatory lesions of the stomach cardia and the oesophagus, bacterial virulence and motor disturbances of the gastrointestinal tract.
Aim: The aim of the study is to attempt to answer the question whether H. pylori infection influences acid GERD incidence in children and teenagers and also whether these dependences are connected with mucosal inflammation of the stomach cardia and the oesophagus.
Material and methods: Two hundred fourteen patients, older than 3 years of age, with dyspeptic symptoms, were included in the study. All children underwent both endoscopic examination of the upper part of the gastrointestinal tract and pH-metry. Helicobacter pylori infection was diagnosed on the basis of presence of the bacteria in a biopsy specimen of the mucosa and/or abnormal result of urease test and urea respiratory test.
Results: Helicobacter pylori infection was diagnosed in 101 patients [group I (n = 101)]. pH-metry result was abnormal in 50 patients in this group [group Ia (n = 50)], but in 51 persons the reflux index was below 4% [group Ib (n = 51)]. One hundred and thirteen patients were qualified into group II (n = 113) with excluded H. pylori infection. Gastroesophageal reflux was diagnosed in 56 patients from this group [group IIa (n = 56)], but was excluded in 57 cases [group IIb (n = 57)]. There was no difference concerning GERD incidence (%) in compared groups (p = 0.99, ns). Macroscopic inflammatory lesions of the oesophageal mucosa were found in 13 patients in the group of patients with H. pylori infection (group I) 13/101 (12.8%) and in 11 patients without infection (group II) 11/113 (9.7%). The difference was not statistically significant (p = 0.47, ns). Only 3 patients presented inflammation of the cardia mucosa.
Conclusions:
1. Helicobacter pylori infection did not influence GERD incidence in children and teenagers.
2. Occurrence of inflammatory changes of the oesophageal mucosa was not dependent on H. pylori infection and GERD prevalence.