Risk Factors for Gastric Disease in Pediatric Helicobacter Pylori (H. Pylori)
Helicobacter Infections, Gastritis, Peptic Ulcer
About this trial
This is an observational trial for Helicobacter Infections focused on measuring gastric disease, H. pylori, children, Helicobacter pylori, child, epidemiology
Eligibility Criteria
Inclusion Criteria: Using the power determinations for age, gender and demographic characteristics, the investigators will screen all patients undergoing diagnostic upper endoscopy at: Children's Healthcare of Atlanta (Egleston and Scottish Rite Children's Hospitals), Atlanta, GA Rainbow Babies and Children's Hospital, Cleveland, OH Miami Children's Hospital, Miami, FL. Patients will be enrolled over the first 3 years of the study, and then based on interim univariate analysis. The investigators also will perform follow-up evaluations (i.e., clinically-indicated) on the two novel cohorts identified during the first 5 years of funding: the atrophic gastritis Hp-infected cohort the esophagitis/gastritis cohort, in order to assess the natural history of gastroduodenal inflammation in the Hp-infected child. Exclusion Criteria: Patients who have taken antibiotics within one month of endoscopy will be excluded, as preceding antibiotic therapy will confound ability to determine Hp infection status. In the previous five years, the investigators initially eliminated children taking proton pump inhibitors (PPIs) (e.g., omeprazole); Na+/H+ ATPase channel inhibitors. PPIs have a minimum inhibitory concentration (MIC) against Hp in vitro, and therefore may reduce the overall bacterial load, diminishing the ability to detect infection, and resolve gastroduodenal mucosal inflammation, confounding characterization of cellular host response to Hp infection. However, due to the pervasive use of PPIs in the pediatric population, and the exclusion of potential cases, the investigators improved their culture sensitivity techniques and are able to successfully detect the organism in the setting of a child on a PPI. This will be taken into account when characterizing the gastric mucosal inflammatory phenotype and comparative analyses are performed.
Sites / Locations
- Miami Children's Hospital; Division of Pediatric Gastroenterology
- Emory University School of Medicine; Emory Children's Center
- Case Western Reserve University; Rainbow Babies and Children's Hospital