Abstract:OBJECTIVE: Chronic gastritis and peptic ulcer are considered to be the major causes of childhood recurrent abdominal pain (RAP). It is known that Helicobacter pylori (H. Pylori) is related to chronic gastritis and pediatric peptic ulcer. However,the association between H. Pylori infection and RAP still needs to be investigated. Now there is not a safe, simple, reliable, and non-invasive method for clinical diagnosis of H. Pylori infection in pediatric practice. So the purpose was of this study to investigate the relationship between RAP and H. Pylori infection and the value of H. Pylori stool antigen (HpSA ) in the etiological diagnosis of childhood RAP. METHODS: One hundred and eighty-two children with RAP received both 13C-urea breath test( 13C -UBT )and HpSA test for the determination of H. Pylori infection. An anti-H. Pylori therapy was administered in RAP children with H. Pylori infection. The clinical symptom (abdominal pain) was observed after anti-H. Pylori treatment. RESULTS: Of the 182 children with RAP, 75(41.2%) were found to be H. Pylori-positive according to the 13C-UBT results, without gender difference in H. Pylori infection incidence. Sixty-eight RAP patients presented H. Pylori-positive in both 13C -UBT and HpSA test. After anti-H. Pylori treatment abdominal pain was alleviated in 93.4% of children whose H. Pylori eradication was successful,but only in 28.6% of those whose eradication was unsuccessful (P<0.05).When 13C-UBT served as a "gold standard", the sensitivity, specificity, accuracy, false-positive and false-negative rates, and positive predictive and negative predictive values of HpSA test were 90.7%, 97.2%, 2.8%, 9.3%, 94.5%, 95.8% and 93.7%, respectively. The concordance between HpSA test and 13C-UBT was expressed in Kappa=0.886, U=25.237, and P=0. CONCLUSIONS: H. Pylori infection is associated with RAP in children.The HpSA test is a simple, cost-effective and reliable method for the detection of H.Pylori infection and may be used in the etiological diagnosis of childhood RAP.
