Frequency and risk factors of gastric and duodenal ulcers or erosions in children: A prospective 1-month European multicenter study

Nicolas Kalach, Patrick Bontems, Sibylle Koletzko, Petronella Mourad-Baars, Peter Shcherbakov, Danuta Celinska-Cedro, Barbara Iwanczak, Frederic Gottrand, Maria Jose Martinez-Gomez, Ender Pehlivanoglu, Giuseppina Oderda, Pedro Urruzuno, Thomas Casswall, Thierry Lamireau, Josef Sykora, Elefteria Roma-Giannikou, Gabor Veres, Vibeke Wewer, Sonny Chong, Marie Laure CharkalukFrancis Mégraud, Samy Cadranel

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Abstract

There are no solid figures of the frequency of ulcer disease during childhood in Europe. We assessed its frequency and analyzed known risk factors. PATIENTS AND Methods: Ulcers, erosions, indications, and risk factors were recorded in all children undergoing an upper gastrointestinal endoscopy in a prospective study carried out during 1-month simultaneously in 19 centers among 14 European countries. Results: Ulcers and/or erosions were observed in 56 out of 694 children. Children with ulcers/erosions were significantly older than those without lesions (10.3±5.5 vs. 8.1±5.7 years, P=0.002). Helicobacter pylori infection was present in 15 of 56 children (27%) where NSAIDs were used in eight, steroids in five, immune-suppressive drugs in five, antibiotics in six, antacids in one, H2-blockers in six and proton pump inhibitors in eight children (more than one risk factor was detected in 32 of 56 children). No risk factors were observed in 24 of 56 children (43%). The main indications for endoscopy were epigastric or abdominal pain (24%) and suspicion of gastroesophageal reflux disease (15%). Similarly, epigastric tenderness, hematemesis, melena, and weight stagnation were significantly associated with ulcers/erosions, whereas sex, H. pylori infection, socioeconomic and lifestyle factors were equally distributed. Conxlusion: Although limited by the short-time duration and the heterogeneity of the patients included throughout the 19 centers, our study shows a frequency of 8.1% of ulcers and/or erosions in children, occurring mainly in the second decade of life. H. pylori infection and gastrotoxic medications were less frequently implicated than expected.

Original languageEnglish
Pages (from-to)1174-1181
Number of pages8
JournalEuropean Journal of Gastroenterology and Hepatology
Volume22
Issue number10
DOIs
Publication statusPublished - Oct 1 2010

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Keywords

  • Helicobacter pylori
  • child
  • erosion
  • ulcer

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Kalach, N., Bontems, P., Koletzko, S., Mourad-Baars, P., Shcherbakov, P., Celinska-Cedro, D., Iwanczak, B., Gottrand, F., Martinez-Gomez, M. J., Pehlivanoglu, E., Oderda, G., Urruzuno, P., Casswall, T., Lamireau, T., Sykora, J., Roma-Giannikou, E., Veres, G., Wewer, V., Chong, S., ... Cadranel, S. (2010). Frequency and risk factors of gastric and duodenal ulcers or erosions in children: A prospective 1-month European multicenter study. European Journal of Gastroenterology and Hepatology, 22(10), 1174-1181. https://doi.org/10.1097/MEG.0b013e32833d36de