The Association between Helicobacter Pylori Infection and Recurrent Abdominal Pain in Children Aged 2-10 Years

Background: Helicobacter pylori (H. Pylori) is a common infection in children, especially in the developing countries. The infection is usually asymptomatic but it may cause gastrointestinal diseases. In children, the symptoms include abdominal pain, vomiting and anemia. Recurrent abdominal pain (RAP) is a common cause of children's referral. But, whether H. Pylori causes RAP in children has to be scrutinized to prevent further complications by proper diagnosis and treatment. However, there is still controversy in the literature regarding this issue. Therefore, we aimed to assess the association between H. Pylori and RAP in children. Materials and Methods: In this case-control study, the children with RAP aged 2-10 years who referred to a private pediatric clinic in Marvdasht, Iran, were compared to other children without RAP, during 2015. The sample size was calculated to be 70 for each case and the control group. The patients were visited by a gastro-enterologist who recorded the demographic data of all the patients and the findings of stool test for H. Pylori. To assess the association of RAP with H. Pylori, the odds ratio was calculated. The statistical analysis was performed using SPSS 20.0 software. The P-values less than 0.05 were considered as statistically significant. Results: The mean age of the participants was 7.35 +/- 3.11 (with a range of 2-10). In the case group, 41/70 and 69/70 of the control group were girls. H. Pylori was found positive in 37 cases (52.9%) of the case group and 11 (15.7%) in the control group (P<0.001, OR=6.01, 95% CI=2.71-13.34). Logistic regression with adjustment for age indicated that there was a positive association between positive H. Pylori and abdominal pain (OR=16.69, 95% CI=4.71-59.18). This model also showed that by adjusting the H. Pylori test result, age was also positively associated with abdominal pain (OR=0.27, 95% CI=0.18-0.45). A T-test also indicated that the mean titer of H. Pylori was significantly higher in case group (1.42 +/- 1.29) than the control group (0.86 +/- 1.52) (P=0.020). Conclusion: There was a statistically significant correlation between H. Pylori and RAP.