The Relationship between Primary Duodenogastric Reflux and <b><i>Helicobacter pylori</i></b> Gastritis in Children
Melike Arslan, Necati Balamtekın
Abstract
<b><i>Background:</i></b> Most studies of the relationship between duodenogastric reflux (DGR) and <i>Helicobacter pylori</i> have reported that the presence of DGR decreases <i>H. pylori</i> colonization, while <i>H. pylori</i> infection increases the frequency of DGR by impairing antroduodenal motility. The present study aimed to investigate the relationship between primary DGR and the prevalence of <i>H. pylori</i> in children, as well as the degree of colonization and the presence and severity of gastritis. <b><i>Methods:</i></b> Included in the study were 410 patients between the ages of 2 and 18 years, referred to the pediatric gastroenterology clinic with complaints of dyspepsia, abdominal pain, and nausea/vomiting, who underwent upper gastrointestinal system endoscopic examination and stomach biopsy. The study group included 60 patients with DGR, while 350 non-DGR patients formed the control group. <b><i>Results:</i></b> The mean age of patients with DGR was 15.7 ± 2.1 years, while the mean age of the control group was 14.2 ± 3.8 years (<i>p</i> = 0.02). Of those with DGR, 50 (83.3%) were girls, while in the control group, 215 (61.4%) were girls (<i>p</i> = 0.001). Of patients with DGR, 16 were <i>H. pylori</i> (+) (26.7%), while in the control group, 168 were <i>H. pylori</i> (+) (48%) (<i>p</i> = 0.002). There was no significant difference between the 2 groups with respect to <i>H. pylori</i> degree of colonization (<i>p</i> = 0.08). Gastritis was present in 56 (93.3%) patients in the DGR group and 322 (92%) patients in the control group (<i>p</i> = 0.72). A significant difference was found between the 2 groups in terms of gastritis severity (<i>p</i> = 0.01). <b><i>Conclusions:</i></b> The mean age of patients with DGR was significantly higher than that of patients without DGR, and DGR was found to be more common in girls. In patients with DGR, <i>H. pylori</i> prevalence was significantly lower than in those without DGR; however, no significant difference was found between the 2 groups with respect to the colonization degree.