Document Type : original article
Department of Pediatrics, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
Assistant Professor of Biostatistics, Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Background: The effectiveness of eradicating Helicobacter pylori infection in improving the symptoms of chronic gastritis has been examined; however, the results of the studies have been contradictory, especially in childhood. This study aimed to compare the clinical effectiveness of sequential Helicobacter pylori eradication treatment and proton pump inhibitor alone in children with chronic Helicobacter pylori-positive gastritis.
Methods: This randomized double-blinded clinical trial was conducted on 84 children aged 5 to 15 years suffering from Helicobacter pylori-associated active chronic gastritis. The patients in the experimental group received sequential therapy including omeprazole, amoxicillin, clarithromycin, and metronidazole; and those in the control group only received omeprazole. Before the intervention, and 2 and 4 months after it, the severity of clinical symptoms was assessed.
Results: After therapeutic regimens, the intervention group was found to have a significantly higher decrease in the severity grades of some symptoms including heartburn, gastroesophageal reflux, and abdominal pain in the epigastric area as compared to the control group (P<0.05). The assessment of the frequency of clinical symptoms in the intervention and control groups also indicated a greater reduction in epigastric pain in the group treated with Helicobacter pylori eradication as compared to the control group (P<0.05).
Conclusion: Prescribing a sequential Helicobacter pylori eradication regimen can lead to reducing the severity of clinical symptoms in children suffering from chronic gastritis.
- Yang L, Liu X, Zhu J, Zhang X, Li Y, Chen J, Liu H. Progress in traditional Chinese medicine against chronic gastritis: From chronic non-atrophic gastritis to gastric precancerous lesions. Heliyon. 2023; 9(6):e16764.
- Gomez-Ramirez U, Valencia-Mayoral P, Mendoza-Elizalde S, Murillo-Eliosa JR, Solórzano Santos F, Contreras-Rodríguez A, Zúñiga G, Aguilar-Rodea P, Jiménez-Rojas VL, Vigueras Galindo JC, Salazar-García M, Velázquez-Guadarrama N. Role of Helicobacter pylori and Other Environmental Factors in the Development of Gastric Dysbiosis. Pathogens. 2021; 10(9).
- Pennelli G, Grillo F, Galuppini F, Ingravallo G, Pilozzi E, Rugge M, Fiocca R, Fassan M, Mastracci L. Gastritis: update on etiological features and histological practical approach. Pathologica. 2020; 112(3):153-65.
- Domșa AT, Lupușoru R, Gheban D, Șerban R, Borzan CM. Helicobacter pylori Gastritis in Children-The Link between Endoscopy and Histology. J Clin Med. 2020; 9(3).
- Rossi RE, Elvevi A, Sciola V, Mandarino FV, Danese S, Invernizzi P, Massironi S. Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis: Insights into mechanisms, pathophysiology, and treatment options. World J Gastroenterol. 2023; 29(23):3733-47.
- Al-Sinani S, Al-Mulaabed SW, Al-Naamani K, Al-Sharji H. Helicobacter Pylori infection in Omani children. Helicobacter. 2017; 22(2).
- Carlos ABM, Costa VE, Kobayasi R, Rodrigues MAM. Prevalence of Helicobacter pylori infection among asymptomatic children in southeastern Brazil: a cross-sectional study. Sao Paulo Med J. 2022; 140(5):719-22.
- Yorulmaz A, Emiroğlu HH, Gümüş MD, Emiroğlu M. The relationship between helicobacter pylori infection and nodular antral gastritis in pediatric patients. J Natl Med Assoc. 2022; 114(4):440-50.
- Al Kirdy F, Rajab M, El-Rifai N. Helicobacter pylori Infection: Clinical, Endoscopic, and Histological Findings in Lebanese Pediatric Patients. Int J Pediatr. 2020; 2020:4648167.
- Anbari K, Amiri MM, Heidari-Soureshjani S, Sherwin MTC, Kasiri K. A Systematic Review and Meta-analysis on the Role of Statins in the Prevention of Mortality Following Pancreatic Cancer. Anticancer Agents Med Chem. 2023; 23:1-.
- Darvishi M, Soureshjan-Heidari S, Bidares M. Systematic Review and Meta-analysis of the Relationship between Proton Pump Inhibitors and Esophageal Adenocarcinoma. Curr Drug Res Rev. 2023; 15(3):262-71.
- Domșa AT, Lupușoru R, Gheban D, Buruiană-Simic A, Gheban BA, Lazăr C, Borzan CM. Helicobacter pylori Infection and the Patterns of Gastric Mucin Expression in Children. J Clin Med. 2020; 9(12).
- Xu S, Wan X, Zheng X, Zhou Y, Song Z, Cheng M, Du Y, Hou X. Symptom improvement after helicobacter pylori eradication in patients with functional dyspepsia-A multicenter, randomized, prospective cohort study. Int J Clin Exp Med. 2013; 6(9):747-56.
- Assa A, Borrelli O, Broekaert I, Saccomani MD, Dolinsek J, Martin-de-Carpi J, Mas E, Miele E, Sila S, Thomson M, Tzivinikos C, Benninga MA; Gastrointestinal Committee of ESPGHAN. Helicobacter pylori-negative Chronic Gastritis in Children: A Systematic Review. J Pediatr Gastroenterol Nutr. 2022; 74(5):956-67.
- Uc A, Chong SK. Treatment of Helicobacter pylori gastritis improves dyspeptic symptoms in children. J Pediatr Gastroenterol Nutr. 2002; 34(3):281-5.
- Ozgenc F, Akman SA, Arikan Ç, Alkanat MB, Aydogdu S, Yagci RV. Treatment of Helicobacter pylori gastritis improves dyspeptic symptoms in Turkish children. J Pediatr Gastroenterol Nutr. 2003; 36(4):507.
- Ünlüsoy Aksu A, Yılmaz G, Eğritaş Gürkan Ö, Sarı S, Dalgıç B. The effect of Helicobacter pylori eradication on functional dyspepsia in Turkish children. Helicobacter. 2018; 23(4):e12497.
- Ganga-Zandzou PS, Michaud L, Vincent P, Husson MO, Wizla-Derambure N, Delassalle EM, Turck D, Gottrand F. Natural outcome of Helicobacter pylori infection in asymptomatic children: a two-year follow-up study. Pediatrics. 1999; 104(2 Pt 1):216-21.