Presence of Stool H. Pylori Antigen among Children with Abdominal Symptoms: A Sudanese Hospital Based Study

Background. pylori infection is one of the most common infections in the world. It is usually acquired during childhood and without antibiotic therapy, it generally persists for life. A causal relationship between H. pylori infection and abdominal symptoms of childhood is still not proven. In addition, there seems to be a relationship between ulcer disease and abdominal symptoms but it is still not confirmed. The aim of this study is to evaluate the association between abdominal symptoms and positivity of H pylori in their stool Methodology: This is hospital based study done in pediatric gastroenterology clinic in Sudan, A total of 50 children were selected according to specific criteria, any child presented with abdominal symptoms were included according to certain inclusion and exclusion criteria, The age of the study group was between one month and 15 yrs. The stool antigen test for H. pylori was performed, data was analyzed using SPSS. Results: Out of Fifty selected patients, 20 (40 %) had only recurrent abdominal pain, 15 (30 %) presented with concomitant abdominal pain and diarrhea, and 3 (6 %) had both abdominal pain and vomiting, while 4 (8 %) had tripled symptoms of abdominal pain, diarrhea, and vomiting, just 6 (12 %) presented with isolated diarrhea, also 2 (4 %) presented with isolated vomiting. Positivity of H. pylori antigen was 29 (58 %) of the whole group, 20 (70 %) of those had positive H. pylori were under five years, furthermore 7 (63.6 %) of those had family history of similar condition were harboring the H. pylori antigen in their stool, in addition 27 (93 %) of those had positive stool test lived in very poor or poor socioeconomic conditions, indicating existence of strong and significant correlation between detection of antigen and their living condition. More analysis showed 25 out of 29 of those positive for the H. pylori stool test were presented with isolated recurrent abdominal pain, or in association with vomiting/diarrhea or both, while just 4 cases out of 29 who had the antigen were presented with isolated one symptom (diarrhea or vomiting) and this showed statistically significance correlation between abdominal pain+/- other symptoms and the presence of the stool H pylori. Conclusion: The authors concluded that the most common GI presentation associated with fecal antigen for H. pylori was abdominal pain whether alone or in association with other symptom, while isolated diarrhea or vomiting has no significant association, moreover concluded that presence of H. pylori fecal antigen in children less than five is more than those who are above than five year old.