Helicobacter pylori Chronic Gastritis in Children: To Eradicate or Not to Eradicate?

Objective To evaluate the efficacy of triple eradication therapy versus symptomatic therapy in children with Helicobacter pylori-associated chronic active gastritis (H pylori-ACAG). Study design Symptomatic patients with H pylori-ACAG (n = 31) were randomly assigned into two groups: (1) patients infected with H pylori who were treated with triple eradication therapy (n = 16); and (2) patients infected with H pylori who were treated with symptomatic therapy (n = 15). Results After 1 year of follow-up, macroscopic appearance was significantly different in group B (P = .023), and chronic inflammation, H Pylori density, and activity were significantly higher in group B than in group A (P = .022, .007, and .002, respectively); however, we did not find a significant difference in the symptoms comparing both groups (P = .287). After 1 year of follow-up, we observed the persistence of the H pylori infection in all children who had not received eradication treatment. Conclusions There is no correlation between eradication of H pylori infection and improvement of dyspeptic symptoms. Self-eradication does not occur within 1 year of follow-up. A trend toward a higher rate of chronic inflammation in noneradicated children at 1 year limited the time of our study. (J Pediatr 2011;159:50-6).