Influence of the location and intensity of Helicobacter pylori infection and gastritis on the incidence of gastroesophageal reflux in children and adolescents

Introduction: The influence of Helicobacter pylori (H. pylori) infection on the incidence of acidic gastroesophageal reflux (GER) depends probably on the location and intensity of gastritis. However, the mechanism of those mutual dependencies remains unclear. Aim of the study was to answer the question, whether the location and intensity of infection and the location and intensity of gastritis, that coexists with H. pylori infection, influence the incidence of gastroesophageal reflux (GER) in children and adolescents. Materials and methods: A hundred and one patients were enrolled in the study. They were over 3-year-old and had a diagnosed H. pylori infection. The patients were divided into the following groups: I – patients with GER (n=50); II – patients without GER (n=51). H. pylori infection was diagnosed based on abnormal results of urease test and/or abnormal results of urea breath test, and the determined presence of bacteria in the specimens of stomach/duodenum mucous membrane. The intensity of H. pylori infection and gastritis was assessed according to the Sydney scale. All the patients were subjected to esophageal pH test. The presence of GER was recognized if the total time during which pH was below 4 (so called reflux index) exceeded 4%. The results were statistically analyzed. Results: The analysis of the relation between GER incidence and the location and degree of infection of stomach mucous membrane by H. pylori, and the location and intensity of gastritis showed that the weakest (insignificant) influence on the development of GER has the infection of the stomach body. Based on the conducted statistical analysis, it can be concluded that the infection and gastritis in the prepyloric part have almost the same influence on the probability of GER development. Conclusion: The patients with H. pylori infection in the prepyloric part of the stomach suffered more frequently from acidic gastroesophageal reflux, the intensity of which was directly proportional to the intensity of inflammation and infection of stomach mucous membrane in that part of the stomach.