Helicobacter pylori gastritis in Jordanian children: persistence versus resolution

Introduction
Helicobacter pylori (H. pylori) is the most common cause of infectious gastritis. Helicobacter pylori is an infection that is typically acquired during childhood.

Aim
This study aims to describe children with H. pylori infection and compare the clinicopathological features of children with resolved and persistent infection.

Material and methods
This is a retrospective review of all children with biopsy-proven H. pylori infection over a 6-year period. Hospital electronic files, endoscopic database, and histopathology database were reviewed. Patients who underwent follow-up endoscopy were identified, and their data was compared.

Results
A total of 176 patients were identified, of whom 100 (56.2%) were females. The average age at presentation was 10.2 years (range: 2.5–17 years). Children older than 10 years were the most affected age group. The most commonly presenting symptom was recurrent abdominal pain (92 (51.69%)), followed by epigastric pain/dyspepsia and vomiting (44 (24.72%) and 18 (10.11%), respectively). The most common macroscopic feature was antral nodularity (76 (42.70%)). The most prevalent microscopic findings were moderate inflammation of moderate chronicity. None of the patients developed gastric atrophy. Forty-four (23.5%) patients had comorbid diseases. On follow-up, upper endoscopy was available for 42 (23.59%) patients. The resolution of H. pylori based on histological examination was observed in only 10 (23.81%) patients. Children whose infections resolved were older.

Conclusions
A significant number of children with biopsy-proven H. pylori infection presented with abdominal pain. Female gender, older age, and less severe macroscopic and microscopic findings may be associated with a higher chance of infection resolution.