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Journal of Pediatric Gastroenterology & Nutrition:
ABSTRACTS: Oral Presentation Abstracts

O0017 HELICOBACTER PYLORI SHOULD BE TREATED IN CHILDREN WITH FAILURE TO THRIVE

El Guindi, Mohamed A.1; El Sayed, Mohamed M.2

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1Pediatric Hepatology, GIT and Nutrition, 2Clinical Pathology, National Liver Institute,, Menoufiya University, Egypt

Submitted by: elguindi@hotmail.com

Introduction: Helicobacter pylori (H. pylori) infects at least 50% of the world’s human population. In most children, the presence of H. pylori infection does not lead to clinically apparent disease, even when it causes chronic active gastritis(1). According to Egypt Demographic and Health Survey (2001)(2), 19% of children were stunted, 6% were severely stunted, and more than 3% were wasted. The aim of this paper is to study the effect of H. pylori infection on the growth and development of the Egyptian children.

Methods: Fifty children (5–8 yrs) suffering from failure to thrive (FTT), and 20 healthy matched children as control group, were included in the study. Either weight and/or height, or rate of weight and/or height gain of infected children were significantly below that of the control children. Complete health and dietary history (24-hr dietary recall and/or 3 days food records) and thorough examination with anthropometric measurements were applied for these children. CBC, hormonal assessment (if needed), and stool analysis were performed. H. pylori analysis including ELISA blood test, stool test for H. pylori and/or upper endoscopy with rapid urease testing were done. Children suffering from H. pylori were treated with clarithromycin, metronidazole and omeprazole for 2 weeks. The above examinations and investigations were repeated for all the children after 6 months.

Results: Out of the 50 children, 34 were suffering from H. pylori. All of them suffered from FTT in the form of wasting and/or stunting. Their dietary history showed that they all received low energy intake, low iron and zinc intakes compared to the adequate dietary intake of the control group. There were signs of anemia in the form of pallor and low hemoglobin levels (<12 gm%) in 52% of these children. After treatment, follow-up for 6 months showed that H. pylori was eradicated in 92% of the infected children. The dietary intake became adequate in 73% of the children, iron and zinc intakes became within the normal limits. They showed normal rates of weight gain, 39% of them showed signs of catch-up growth.

Conclusion: H. pylori infection can be a direct cause for inadequate dietary intake and can lead to FTT in Egyptian children. Eradication of H. pylori led in most of the children to adequate dietary intake and catch-up growth. It is recommended that H. pylori (even without symptoms) should be treated in children suffering from FTT.

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Reference(S):

1. Gold BD, Colletti RB, Abbott M, et al (2000): Helicobacter pylori Infection in Children: Recommendations for Diagnosis and Treatment. Ped Gastroent and Nutr, 31:490497.

2. El-Zanaty, F., and A. Way. (2001): Egypt Demographic and Health Survey. Ministry of Health, National Population Council and ORC Macro (Measure DHS).

© 2004 Lippincott Williams & Wilkins, Inc.

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