Helicobacter pylori Chronic Gastritis in Children and Adolescents was not Associated with Anaemia
Authors: Carvalho Mary de Assis , De Oliveira Julia Ferreira , Silva Renato Guilherme Correa , Penatti Debora Avellaneda , Tedesco Juliana Tedesco Dias , Machado Nilton Carlos 
Published: July 2022

Background: Helicobacter pylori (H. pylori) colonizes the gastric mucosa, leading to chronic inflammation. Epidemiological studies have demonstrated that H. pylori infection is high in areas with a high prevalence of anaemia. Consequently, patients infected with H. pylori are at a higher risk of anaemia. However, the relationship between H. pylori and anaemia remains controversial. Therefore, a study conducted among children with chronic abdominal pain with organic dyspepsia (chronic gastritis due to H. pylori and (or?) Esophagitis), and a functional disorder (Irritable Bowel Syndrome), will be appropriate.
Objective: Compare the prevalence of Anaemia in children and adolescents with chronic abdominal pain, divided into: 1) Non-ulcer dyspepsia associated with H. pylori gastritis., 2) Dyspepsia associated with chronic Esophagitis, and Irritable Bowel Syndrome.
Methods: The study was a single-centre, observational retrospective cohort. Inclusion and Exclusion Criteria. All children must be well categorized with signs and symptoms consistent with chronic abdominal pain and aged between 5-and 18 years. Exclusion criteria: genetic, metabolic, immune, cardiac, hepatic or renal diseases, neurodevelopmental delay, and previous surgery. Laboratory tests were performed for all patients: complete blood cell count, Erythrocyte Sedimentation Rate, urinalysis, stool for ova & parasites, and H. pylori serology. Another diagnostic test was decided at the discretion of the gastroenterology team. The chronic dyspeptic syndrome with non-ulcer dyspepsia associated with H. pylori if they presented both results: the rapid urease test positive and the histological examination of the gastric mucosa confirming the presence of the bacterium. Dyspepsia associated with chronic Esophagitis was based on clinical symptoms/signs and endoscopic and histologic evaluation. Patients with IBS were diagnosed according to Rome Criteria.
Results: Three hundred and seven children/adolescents: H. pylori gastritis (154, 50%), Esophagitis (41, 14%), and IBS (112, 36%) were included. There was a non-statistically significant difference in the baseline characteristics (sex, first-born child, age of mothers, age of fathers, crowding index, duration of pain symptoms, headache and limb pain, overweight/obesity and malnutrition) between the three groups. Clinical characteristics demonstrated: H. pylori and Esophagitis have epigastric pain and IBS periumbilical pain. There was a non-statistically significant difference in haemoglobin values and red cell parameters between the three groups in laboratory investigation. The prevalence of anaemia was very low, with no difference between the groups. Urinalysis and stool for ova & parasites were negative in all children.
Conclusion: Anaemia was not present in children with chronic abdominal pain, both organic and functional disorders. Age, good nutritional status, good sanitation and hygiene may have contributed to the results in this study.