Main Article Content
Background. There are recent publications about the possible impact of Helicobacter pylori (H.pylori) on the mucous membrane of the stomach or duodenum, as well as the pancreas. This relation is theoretically possible considering the close connection of stomach, duodenum and pancreas. The purpose of the study was the determination of the incidence and characteristics of combined lesions of the pancreas and the upper gastrointestinal tract associated with H.pylori infection in children. Material and methods. A retrospective analysis of medical records of 684 children, who were hospitalized in the gastroenterology department of the Chernivtsi regional children’s hospital during the period from 2010 to 2016. A comprehensive examination included ultrasound diagnostics of the abdomen, esophagogastroduodenoscopy, determination of the activity of serum α-amylase, urine diastase, coprogram assessment. A test system HELIC-test “AMA” (Russia, St. Petersburg) and histological methods (bioptates were taken from the fundal and antral gastric mucosa, after Giemsa stain of histological sections, the visualization of H.pylori was performed by means of light microscopy) were used for the H.pylori diagnosis. The descriptive statistics methods with parametric distribution estimating the mean and standard deviation (M ± SD) were applied. Statistical significance of differences was assessed by Student’s t-test for independent samples. Results. Of the 684 children, who completed a survey, 310 were boys (45.3 %) and 374 — girls (54.7 %) aged 6 to 18 years. The diagnosis of chronic gastroduodenitis was the most frequently registered among examined children (420 out of 684 patients examined, 61.4 %). A rather high number of children had erosive and ulcerative lesions of the stomach and duodenum (157 of 684 patients, 22.9 %). H.pylori infection in a group of the children surveyed was detected in 64.5 % cases. The highest incidence of H.pylori was in children with ulcerative-erosive lesions of the upper gastrointestinal tract — 121 of 157 analyzed, 77.1 %. In more than half of patients (352 of 684 patients, 51.5 %) with gastroduodenal pathology, the pancreas was also involved in the pathological process. In 56.8 % of those with combined lesions, a test for H.pylori was positive. H.pylori was most frequently detected in patients with erosive and ulcerative lesions of the upper gastrointestinal tract and lesions of the pancreas (92 of 119 examined patients, 77.9 %). Patients with H.pylori positive test had 5.1 ± 1.2 points of pain syndrome intensity, whereas those with H.pylori negative test — 2.8 ± 1.0 points (p < 0.05). The manifestations of the neurasthenic syndrome (dizziness, fatigue, drowsiness, sleep disturbances, reduced work capacity and weakness) prevailed in children with H.pylori positive test. Increasing of the pancreatic size was seen in one-third of patients, altered echogenicity — in 28.8 % of cases, blurred contours of gland — in 23.6 %. Increased activity of serum α-amylase was found in 44.8 %. Changed levels of urine diastase were observed in 90 (45.4 %) infected patients and in 36 (23.3 %) — uninfected (p < 0.01) with H.pylori. Changes in the coprological test were seen in 130 of 352 children (36.9 %), namely, steatorrhea was observed in 27.4 % of cases, creatorrhea — in 22.6 %, starch in large quantities — in 12.9 %, mucus — in 9.6 %, iodophilic and fungal flora were found in 16.1 and 18.5 % of children, respectively. Conclusion. More than a half of children with gastroduodenal pathology, according to the data of retrospective analysis, have impaired exocrine pancreatic function, which is diagnosed by means of generally accepted clinical laboratory and instrumental methods. Such violations are more often recorded in H.pylori-associated pathologies of the upper digestive tract, the pain and cerebro-asthenic syndromes prevailed in clinical picture, especially in case of erosive and ulcerative lesions of the mucous membrane of the gastroduodenal region. This necessitates an in-depth study of pancreatic function in children with H.pylori-associated gastroduodenal pathology.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.
Schwarzenberg SJ, Bellin M, Husain SZ, Ahuja M, Barth B, Davis H, Durie PR. Pediatric chronic pancreatitis is associated with genetic risk factors and substantial disease burden. J Pediatr. 2015 Apr;166(4):890-6.e1. doi: 10.1016/j.jpeds.2014.11.019.
Manes G, Dominguez-Muñoz JE, Hackelsberger A, Leodolter A, Rössner A, Malfertheiner P. Prevalence of Helicobacter pylori infection and gastric mucosal abnormalities in chronic pancreatitis. Am J Gastroenterol. 1998 Jul;93(7):1097-100. doi:10.1111/j.1572-0241.1998.336_b.x.
Jowiya W, Brunner K, Abouelhadid A, Nai SP, Sadiq S, et al. Pancreatic amylase is an environmental signal for regulation of biofilm formation and host intera ction in Campylobacter jejuni. Infect Immun. 2015 Dec;83(12):4884-95. doi: 10.1128/IAI.01064-15. Epub 2015 Oct 5.
Rabelo-Gonçalves EM, Roesler BM, Zeitune JM. Extragastric manifestations of Helicobacter pylori infection: Possible role of bacterium in liver and pancreas diseases. World J Hepatol. 2015 Dec 28;7(30):2968-79. doi: 10.4254/wjh.v7.i30.2968.
Polyzos SA, Kountouras J, Zavos C, Deretzi G. The association between Helicobacter pylori infection and insulin resistance: a systematic review. Helicobacter. 2011;16:79–88. doi: 10.1111/j.1523-5378.2011.00822.x.