Prevalence of Functional Defecation Disorders in Children: A Systematic Review and Meta-Analysis.

OBJECTIVE\nTo assess the evidence for a cause-and-effect relationship between Helicobacter pylori infection and antral gastritis, peptic ulcer disease, and recurrent abdominal pain in children.\n\n\nDATA SOURCES\nA MEDLINE search from January 1983 through July 1994 was used to identify pertinent English-language publications. Current Contents and selected specialty journals were searched manually. Editorials, reviews, case reports, abstracts, and letters to the editor were excluded.\n\n\nSTUDY SELECTION\nAll studies in children (ie, 0 to 18 years) were included.\n\n\nDATA EXTRACTION\nHill's criteria for causal inference were used to determine the strength of the evidence for a causal relationship.\n\n\nDATA SYNTHESIS\nIn total, 45 studies (case series, cross-sectional surveys, and treatment trials) were retrieved. The rate ratio of antral gastritis in children with H pylori infection (compared with uninfected children) ranged from 1.9 to 71.0 (median, 4.6). The prevalence of H pylori infection in children with duodenal ulcer was high (range, 33% to 100%; median, 92%) compared with children with gastric ulcer (range, 11% to 75%; median, 25%). Prevalence rates of infection in children with recurrent abdominal pain were inconsistent (range, 0% to 81%; median, 22%), with lower rates in children meeting Apley's criteria (range, 0% to 9%; median, 6%).\n\n\nCONCLUSIONS\nThere is strong evidence for an association between H pylori infection and antral gastritis and duodenal ulcer disease in children; however, data from randomized, double-blind, placebo-controlled treatment trials are required. There is weak evidence for an association with gastric ulcer and weak or no evidence for an association with recurrent abdominal pain.

Helicobacter pylori, gastroduodenal disease, and recurrent abdominal pain in children

Helicobacter pylori is usually acquired during childhood. The reports from the last two decades pointed out a decrease in H. pylori prevalence across geographical areas worldwide compared to previously reported data. Most of the studies performed in America found an overall H. pylori infection prevalence of approximately 50%. The most important risk factors in America include being male, poor adherence or difficult access to treatment, and the lack of in-home water service. Despite the descending trend in prevalence worldwide, the overall prevalence in Africa remains very high (70%). Nevertheless, the prevalence of H. pylori in children without gastrointestinal who underwent screening was reported to be only 14.2%. The main risk factors in Africa are having a traditional pit or no toilet, poverty, birth order, source of drinking water, or being a farmer. Asia seems to have the widest variations in terms of H. pylori prevalence. Several risk factors were reported in Asia to be associated with this infection, such as lower income and educational level, house crowding, rural residence, ethnicity, the use of tanks as water supplies, alcohol drinking, active smoking, eating spicy food or raw uncooked vegetables, poor living conditions and sanitation. The overall prevalence of H. pylori infection in European children is almost 25%. Portugal has the highest prevalence of all European countries at 66.2% in children 13 years of age. The risk factors in European individuals consist of living in rural areas, eating unwashed fruits and vegetables, not washing hands after school, low parental education and unemployment, and short education duration. Further studies are required to identify the precise mechanisms involved in the discrepancies of H. pylori prevalence worldwide.

/pdf/worldwide-prevalence-and-risk-factors-of-helicobacter-pylori-290s14hm.pdf

Worldwide Prevalence and Risk Factors of Helicobacter pylori Infection in Children

Non-alcoholic fatty liver disease (NAFLD) is a common liver disease. Previous studies on the association between Helicobacter pylori (HP) infection and NAFLD are inconsistent. Our study was aimed to find out the relationship between HP infection and NAFLD. We performed a large cross-sectional study in northern Chinese adults in 2015. 13C-urea breath tests were used to determine HP infection status. Abdominal ultrasonography was performed to diagnose NAFLD. Multivariable logistic regression was conducted to identify the association between HP infection and NAFLD. A total of 4081 individuals were included in this study; 2137 (52.36%) participants were HP-positive, and 1022 (47.82%) were diagnosed with NAFLD in HP-positive individuals. The odds ratios (OR) and 95% confidence intervals (CI) of participants with HP infection for NAFLD were 1.20 (1.06-1.36) in crude model and 1.27 (1.07-1.50) in fully adjusted model. When stratified by sex and dyslipidemia, the fully adjusted OR and 95% CI for NAFLD were 1.22 (1.10-1.80) in females and 1.44 (1.18-1.75) in subjects with dyslipidemia. There were not significant increased OR for NAFLD when stratified by age. The study indicate that HP infection is associated with NAFLD, particularly in females and patients with dyslipidemia, suggesting that HP eradication might be an alternative method for the prevention or treatment of NAFLD treatment.

/pdf/association-between-helicobacter-pylori-infection-and-non-3c48k2i74o.pdf

Association between Helicobacter pylori infection and non-alcoholic fatty liver disease in North Chinese: a cross-sectional study.

Interactions between H. pylori and the Gastric Microbiome: Impact on Gastric Homeostasis and Disease.

BACKGROUND Most studies on functional gastrointestinal disorders (FGIDs) in children are based on data from the northern hemisphere. Scientific reports are arising in South American population, but little is still known about children from low socio-economic status (SES), where Helicobacter pylori infection is endemic. Our objective was to evaluate the prevalence of FGIDs in school children from low SES and its relationship with H. pylori infection. METHODS Children from 3 public schools of low SES from Santiago de Chile were included. Students completed the Rome III Questionnaire and a survey about other symptoms. Also, the 13 C urea breath test determined the presence of H. pylori infection. RESULTS Five hundred six children were included, where 48% were male, with a median age of 15.7 years (range 7.1-19.6). Forty-two percent had some FGID, aerophagia and functional constipation being the most frequent. Females (adjusted OR 1.5, 95% CI [1.1, 2.2]), those children with parents within the lowest level of education (adjusted OR 1.6, 95% CI: 1.1-2.4), and family history of gastric cancer (adjusted OR 1.9, 95% CI: 1.2-3.1) were related to FGIDs. The prevalence of H. pylori infection was 55.9% (95% CI [50.7, 60.9]). In multivariable analysis, the presence of abdominal pain (OR 1.55, 95% CI [1.02, 2.36]), but not FGIDs, was related to H. pylori infection. CONCLUSIONS FGIDs are common in low SES students. A low educational level of the household head, family history of gastric cancer. and being female are related to the development of FGIDs. In this study, no relationship between the presence of H. pylori and FGIDs was found.

Functional gastrointestinal disorders in children from low socio-economic status and Helicobacter pylori infection.

Introduction: H. pylori  infection is acquired early in childhood. However, there is little information available regarding the role of breastfeeding and neonatal acquisition of the infection. Objective:  To evaluate factors affecting the acquisition of  H. pylori  in newborns and infants from infected mothers. Patients and Method:  Consecutive mothers and their newborns were recruited into the study from the maternity unit, immediately after delivery. After signing informed consent, one stool sample from the mother was obtained before hospital discharge. Three stool samples of the newborns were then collected at home at 15, 60, and 90 days of life, for the detection of  H. pylori  antigen (Monoclonal HpSAg, sensitivity 94% and specificity 97%). The socio-epidemiological and biomedical variables were also analysed using a questionnaire. Results:  A total of 32 mother-child pairs (64 subjects) were enrolled. The mean maternal age was 30.1 ± 5.1 years, with 53% vaginal delivery, and 85% exclusively breastfed. There were 13 (40%) infected mothers. No  H. pylori  infection was detected in newborns and infants up to 3 months of follow-up. No significant differences were found in socioeconomic level between infected versus non-infected mothers (both groups mostly in the very high socioeconomic category: 28% and 32%, respectively,  P  = .15) and in the number of family members between infected versus non-infected mothers (3.8 ± 0.8 vs 4.2 ± 1.8 persons,  P  = .18). Conclusion: Despite having a significant percentage of  H. pylori- infected mothers, no newborn was infected at the third month of life. The protective role of breastfeeding cannot be ruled out.

/pdf/la-infeccion-materna-por-helicobacter-pylori-no-aumenta-el-1kbvbm14ro.pdf

La infección materna por Helicobacter pylori no aumenta el riesgo de contraer la bacteria en el primer trimestre de vida de sus lactantes

Helicobacter pylori colonization may affect the mucosal immune system through modification of microbiota composition and their interactions with the host. We hypothesized that maternal H. pylori status affects the maternal intestinal microbiota of both mother and newborn. In this study, we determine the structure of the fecal microbiota in mothers and neonates according to maternal H. pylori status and delivery mode. We included 22 mothers and H. pylori infection was determined by fecal antigen test. Eleven mothers (50%) were H. pylori-positive (7 delivering vaginally and 4 by C-section), and 11 were negative (6 delivering vaginally and 5 by C-section). Stool samples were obtained from mothers and infants and the fecal DNA was sequenced. The fecal microbiota from mothers and their babies differed by the maternal H. pylori status, only in vaginal birth, not in C-section delivery. All 22 infants tested negative for fecal H. pylori at 15 days of age, but those born vaginally –and not those by C-section- showed differences in the infant microbiota by maternal H. pylori status (PERMANOVA, p = 0.01), with higher abundance of Enterobacteriaceae and Veillonella, in those born to H. pylori-positive mothers. In conclusion, the structure of the infant fecal microbiota is affected by the maternal H. pylori status only in infants born vaginally, suggesting that the effect could be mediated by labor and birth exposures.

/pdf/maternal-h-pylori-is-associated-with-differential-fecal-3p6t1nexl5.pdf

Maternal H. Pylori Is Associated With Differential Fecal Microbiota in Infants Born by Vaginal Delivery

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Functional gastrointestinal disorders in children from low socio-economic status and Helicobacter pylori infection.

La infección materna por Helicobacter pylori no aumenta el riesgo de contraer la bacteria en el primer trimestre de vida de sus lactantes

Maternal H. Pylori Is Associated With Differential Fecal Microbiota in Infants Born by Vaginal Delivery