THE INFLUENCE OF HELICOBACTER PYLORI ERADICATION THERAPY ON THE COURSE OF GASTROESOPHAGEAL REFLUX DISEASE IN SCHOOL-AGE CHILDREN
Abstract
Introduction. Data on the role of Helicobacter pylori (Hp) in the development of gastroesophageal reflux disease (GERD) are contradictory; most researchers believe that Hp infection has a protective eff ect on the incidence of GERD. Ambiguous results have also been obtained regarding the eff ect of H. pylori eradication on the development of GERD, refl ux esophagitis and symptoms associated with refl ux. Most meta-analyses have found no signifi cant diff erences in the development of GERD after H. pylori eradication between patients with eradication and patients with persistent infection. But a number of studies have reported a signifi cant increase in the risk of GERD after successful eradication therapy. Most studies were conducted on a cohort of adult patients; data on the eff ect of H. pylori on the course of GERD in children are fragmentary. Objective. To evaluate the effect of eradication therapy on the course of gastroesophageal refl ux disease in school-age children. Materials and methods. The study included 55 children from 7 to 17 years 11 months (11.4±2.1 years) with an erosive form of gastroesophageal refl ux disease. Three observation groups were formed: fi rst — H. pylori-positive patients with eradication therapy; second — H. pylori-positive patients without eradication therapy; third — H. pylori-negative
patients. The dynamics of clinical symptoms and erosive changes in the esophagus were assessed. Results. When comparatively assessing the clinical course of GERD in the groups of H. pylori-infected and H. pylori-negative patients, no signifi cant diff erences were identifi ed. Heartburn and epigastric pain were noted with equal frequency in both groups, belching was signifi cantly more often observed in the group of H. pylori-negative patients, and vomiting, on the contrary, was slightly more common in the group of H. pylori-positive patients. The frequency of endoscopic signs of relapse of erosive esophagitis after 12–24 months was also comparable in the compared groups: 7/20 (35.0%) in the group with eradication therapy and 8/20 (40.0%) without eradication
therapy. At the same time, the lowest relapse rate of 4/14 (26.8%) was noted in the group of H. pylori-negative patients. Conclusions. Helicobacter pylori does not have a signifi cant protective or negative eff ect on the course of the erosive form of gastroesophageal refl ux disease in school-age children.
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