Helicobacter pylori Infection in Children with Upper Gastrointestinal Bleeding at Tanta University Hospital, Egypt

Background: In children, upper gastrointestinal bleeding (UGIB) is a potentially dangerous and fatal clinical disease. The fact that the majority of risk factors for infection are strongly associated with substandard living circumstances provides evidence in favour of the oral-oral or fecal-oral pathways of H. pylori transmission. The purpose of this study was to determine the prevalence of H. pylori infection in kids who had been diagnosed with UGIB and to compare the results of the endoscopy with the infection.

Methods: This prospective, case-control cross- sectional study was carried out on 70 children aged <18 years old, both sexes, with upper gastrointestinal tract (GIT) bleeding in the form of hematemesis, melena, or both and 30 healthy children as control. Gastrointestinal endoscopy was performed on each patient, and stool samples were tested for the H. pylori antigen.
Results: Patients with H. pylori infection were positively correlated with age, and older patients had a considerably higher presentation rate of H. pylori infection.

Low socio-economic standard level, large family members, family history and epigastric abdominal pain were significantly high in h. pylori positive group. The history of umbilical catheterization, percentage of splenomegaly and hepatosplenomegaly was significantly higher in variceal group. Mean hemoglobin level, total serum protein and serum albumin was significantly lower in variceal group.

Conclusions: 26 (37%) cases with upper GI bleeding had H. pylori infection. H. pylori-infected patients were older, had larger family size, family history of H. pylori infection and lower standard of living than H. pylori-negative patients. They had lower serum hemoglobin level and presenting with abdominal pain(epigastric). H. pylori infected patients had endoscopic findings mostly gastritis (56%) and peptic ulcer (53%).