Association between Gastric pH and Helicobacter pylori Infection in Children

• Published in: Pediatric gastroenterology, hepatology & nutrition Vol. 18; no. 4; pp. 246 - 252
• Main Authors: Seo, Ji-Hyun, Park, Heung Keun, Park, Ji Sook, Yeom, Jung Sook, Lim, Jae-Young, Park, Chan-Hoo, Woo, Hyang-Ok, Youn, Hee-Shang, Jun, Jin-Su, Ko, Gyung-Hyuck, Baik, Seung-Chul, Lee, Woo-Kon, Cho, Myung-Je, Rhee, Kwang-Ho
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 01.12.2015; 대한소아소화기영양학회
• Subjects: Original; 소아과학; Hypochlorhydria; Urease test; Helicobacter pylori; Child; Gastric juice
• ISSN: 2234-8646; 2234-8840
• DOI: 10.5223/pghn.2015.18.4.246

To assess gastric pH and its relationship with urease-test positivity and histological findings in children with Helicobacter pylori infection. Fasting gastric juices and endoscopic antral biopsy specimens were collected from 562 children and subjected to the urease test and histopathological examination. The subjects were divided into 3 age groups: 0-4, 5-9, and 10-15 years. The histopathological grade was assessed using the Updated Sydney System, while the gastric juice pH was determined using a pH meter. The median gastric juice pH did not differ significantly among the age groups (p=0.655). The proportion of individuals with gastric pH >4.0 was 1.3% in the 0-4 years group, 6.1% in the 5-9 years group, and 8.2% in 10-15 years (p=0.101). The proportions of moderate and severe chronic gastritis, active gastritis, and H. pylori infiltration increased with age (p<0.005). Urease-test positivity was higher in children with hypochlorhydria (77.8%) than in those with normal gastric pH (31.7%) (p<0.001). Chronic and active gastritis were more severe in the former than the latter (p<0.001), but the degree of H. pylori infiltration did not differ (20.9% vs. 38.9%; p=0.186). Gastric pH while fasting is normal in most children regardless of age. Urease-test positivity may be related to hypochlorhydria in children, and hypochlorhydria is in turn related to H. pylori infection.