Helicobacter pylori infection and abdominal symptoms among Swedish school children

J Pediatr Gastroenterol Nutr. 2005 Jul;41(1):33-8. doi: 10.1097/01.mpg.0000163734.84518.9e.

Abstract

Background: The role of Helicobacter pylori infection in the etiology of abdominal symptoms remains unclear. Our aim was to investigate the association between type-specific H. pylori infection and gastrointestinal symptoms among school children in Stockholm, Sweden.

Methods: In a community-based cross-sectional study, 695 children aged 10-12 years participated with a blood sample and a questionnaire on sociodemographic characteristics and gastrointestinal symptoms, including minor abdominal pain not necessitating medical consultation, during the preceding six months. Infection was investigated by an enzyme-linked immuno-sorbent assay and confirmed by immunoblot and urea breath test.

Results: Abdominal pain was reported by 440 (63%) children and recurrent abdominal pain (RAP) by 88 (13%). Of 112 (16%) infected children, 73% had antibodies to CagA and 59% to VacA. There was no positive association between H. pylori status and the occurrence of abdominal pain; in fact, the association with any abdominal pain report was inverse (odds ratio [OR] 0,5; 95% Confidence Interval [CI] 0.3-0.8), while RAP was unrelated to the infection (OR 1.0; 95% CI 0.5-2.1) when adjusted for gender, age and family background variables. The prevalence of RAP tended to be lower among children harboring CagA+/VacA+ infections than among the uninfected (adjusted OR 0.3; 95%CI 0.1-1.1). Furthermore, CagA+/VacA+ infected children reported less acid regurgitation (adjusted OR 0.2; 95% CI 0.1-0.5).

Conclusions: Taking background factors into account, the presence of H. pylori is not accompanied by an increased occurrence of abdominal symptoms in Swedish 10-12-year-olds. However, unexpected differential associations with strain specific infections may indicate a so far overlooked complex relationship that needs to be further confirmed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / epidemiology
  • Abdominal Pain / microbiology*
  • Adolescent
  • Breath Tests
  • Child
  • Confidence Intervals
  • Cross-Sectional Studies
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / pathology*
  • Helicobacter pylori* / immunology
  • Helicobacter pylori* / isolation & purification
  • Humans
  • Immunoblotting
  • Male
  • Odds Ratio
  • Recurrence
  • Sweden / epidemiology