Dor abdominal crônica, dispepsia não ulcerosa e infecção pelo Helicobacter pylori em crianças e adolescentes

• Main Author: Silva, Renato Guilherme Silveira Corrêa [UNESP]
• Publication Date: 2014
• Format: Master thesis
• Language: por
• Source: Repositório Institucional da UNESP
• Download full: http://hdl.handle.net/11449/113874
• topic: Crianças - Doenças; Adolescentes - Doenças; Dor abdominal; Dispepsia; Helicobacter pylori; Sistema gastrointestinal; Semiologia (Medicina); Abdominal pain

Aims: To investigate if the use of refined clinical characteristics of chronic abdominal pain can identify patients for further investigation of Helicobacter pylori (H. pylori) infection. An observational study on children and adolescents with chronic non-ulcer dyspepsia was performed to investigate the potential association between specific gastrointestinal symptoms and H. pylori infection. The hypothesis was that the use of demographics and clinical data with defined criteria for chronic abdominal pain (CAP) and dyspeptic syndrome, could be of help in identifying patients with H. pylori infection. Methods: A cohort of 721 consecutive new cases of children and adolescents with CAP were investigated. Of them, 240 with clinical criteria for chronic non-ulcer dyspeptic syndrome and suggestive of organic underlying disease were enrolled into the study. Data were collected by using standardized demographic, clinical laboratory, endoscopic and histopathological protocols. Results: H. pylori infection was identified in 123 children (52%), being 76 with pangastritis (61.7%) and 47 with antral gastritis (38.3%). Symptoms duration longer than 12 months was significantly more frequent in children with pangastritis than in those with antral gastritis (p< 0.05). Dyspeptic symptoms did not differ between antral predominant and pangastritis. A significant association was observed between nausea and H. pylori infection (p<0.03). Retrosternal pain was significantly more frequent in the non-infected group (p<0.05) than in patients with H. pylori infection. No association between demographic variables and H. pylori infection was found. Conclusions: The prevalence of H. pylori infection was high among children with dyspepsia, but poorly associated with specific gastrointestinal symptoms