scholarly journals The impact of bismuth adding to rabeprazole, amoxicillin and clarithromycin on eradication rate of Helicobacter pylori

2020 ◽  
Vol 9 (8) ◽  
pp. 1280
Author(s):  
Mohammad Sadrkabir ◽  
Masoud Tasouji ◽  
Afshan Sharghi ◽  
Abbas Yazdanbod
Keyword(s):  
Helicobacter Pylori ◽  
Eradication Rate ◽  
High Prevalence ◽  
Group A ◽  
Stool Antigen ◽  
The Difference ◽  
H Pylori ◽  
Group B ◽  
The Impact ◽  
Optimal Regimen

Background: High prevalence of Helicobacter pylori infection and induction of resistance as a result of consumption of antibiotics necessitates an ongoing effort for evaluation of new regimen to overcome this phenomenon.  Intensive efforts are being made to identify such an optimal regimen, but there are many obstacles hindering the achievement of this goal. This study aimed to investigate the impact of adding bismuth to rabeprazole, amoxicillin and clarithromycin on rate of H. pylori eradication.Methods: In this randomized clinical trial, 60 patients with dyspepsia and positive gastric biopsy for H. pylori in endoscopy were recruited. The first group (A) received rabiprazole for 6 weeks, amoxicillin and clarithromycin for 2 weeks either with bismuth for 2 weeks and the second group (B) received rabiprazole for 6 weeks, amoxicillin and clarithromycin for 2 weeks either without bismuth. Four weeks after the treatment, the compliance and eradication were evaluated using stool antigen of helicobacter. The patients who could complete the therapeutic regimen were assigned for analysis.Results: H. pylori eradication rates were 70% and 56.6% in two groups A and B (with and without Bismuth), respectively and the difference was significant. There is a significant relationship between the studied groups and the results of fecal antigen of H. pylori.Conclusions: The bismuth had a significant effect on the success of eradication rate of H. pylori and its impact adding to the treatment regimen containing clarithromycin was effective on eradication success rate.

scholarly journals Efficacy of dexlansoprazole-based triple therapy for Helicobacter pylori infections

2019 ◽  
Vol 12 ◽  
pp. 175628481987096
Author(s):  
Chia-Jung Kuo ◽  
Chun-Wei Chen ◽  
Puo-Hsien Le ◽  
Jun-Te Hsu ◽  
Cheng-Yu Lin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Breath Test ◽  
Eradication Rate ◽  
Urea Breath Test ◽  
Helicobacter Pylori Eradication ◽  
Treatment Regimens ◽  
Group A ◽  
H Pylori ◽  
Group B

Background: Dexlansoprazole has been shown to be efficacious for the treatment of gastroesophageal reflux disease. However, there is a paucity of data about its efficacy for Helicobacter pylori eradication. The aim of this study was to evaluate the efficacy of dexlansoprazole for H. pylori eradication as triple therapy in real-world practice. Methods: Adult patients with endoscopically proven H. pylori related peptic ulcer diseases or gastritis were recruited for this study. The eradication status was assessed based on the results of the 13C-urea breath test performed 4 weeks after treatment. According to the different treatment regimens, the patients were allocated to group A: Esomeprazole 40 mg b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days; group B: Esomeprazole 40 mg q.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days, or group C: Dexlansoprazole 60 mg q.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days. Results: A total of 215 patients (49% males) were enrolled in this study, with a mean age of 55 years. The eradication rates in group A, B, and C were 94.7% (71/75), 89.6% (69/77), and 93.7% (59/63) ( p = 0.457), respectively. The adverse events were similar between the three groups ( p = 0.068). Conclusions: This study suggests that dexlansoprazole-based triple therapy has an acceptable eradication rate for H. pylori infection.

scholarly journals Modified Sequential Therapy Regimen versus Conventional Triple Therapy forHelicobacter pyloriEradication in Duodenal Ulcer Patients in China: A Multicenter Clinical Comparative Study

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ying-Qun Zhou ◽  
Ling Xu ◽  
Bing-Fang Wang ◽  
Xiao-Ming Fan ◽  
Jian-Ye Wu ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Sequential Therapy ◽  
Burning Pain ◽  
Standard Triple Therapy ◽  
Group A ◽  
H Pylori ◽  
Group B

Objective. Antimicrobial resistance has decreased eradication rates forHelicobacter pyloriinfection worldwide. To observe the effect of eradicatingHelicobacter pylori (H. pylori)and the treatment of duodenal ulcer by 2 kinds of modified sequential therapy through comparing with that of 10-day standard triple therapy.Methods. A total of 210 patients who were confirmed in duodenal ulcer active or heal period by gastroscopy andH. pyloripositive confirmed by rapid urease test, serum anti-H. pyloriantibody (ELASE), or histological examination enrolled in the study. All the patients were randomly divided into three groups: group A (70 cases) and group B (70 cases) were provided 10-day modified sequential therapy; group C (70 cases) was provided 10-day standard triple therapy. Patients of group A received 20 mg of Esomeprazole, 500 mg of Clarithromycin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group B received 20 mg of Esomeprazole, 1000 mg of Amoxicillin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group C received 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for standard 10-day therapy. All drugs were given twice daily.H. pylorieradication rate was checked four to eight weeks after taking the medicine by using a13C urea breath test. In the first, second, third, seventh, twenty-first, thirty-fifth days respectively, the symptoms of patients such as epigastric gnawing, burning pain, and acidity were evaluated simultaneously.Results. Overall, 210 patients accomplished all therapy schemes, 9 case patients were excluded. The examination result indicated that theH. pylorieradication rate of each group was as follows: group A 92.5% (62/67), group B 86.8% (59/68), and group C 78.8% (52/66). TheH. pylorieradication rate of group A was slightly higher than group B (P<0.05) and both of them were obviously higher than group C (P<0.05). Modified sequential therapy was significantly more effective in patients with clarithromycin-resistant strains (80%/67% versus 31%;P=0.02). Symptoms improvement: all the three groups could improve the symptoms such as epigastric gnawing, burning pain, and acidity since the first day. There was no significant difference in total score descending of symptoms between each group (P>0.05).Conclusions. All the three therapy schemes could alleviate symptoms of duodenal ulcer patients in China efficiently. But as far as eradicatingH. pyloriis concerned, the modified sequential therapy was better than standard triple therapy, especially the therapy scheme used in group A.

scholarly journals Comparison of Levofloxacin-Based, 10-day Sequential Therapy with 14-day Quadruple Therapy for Helicobacter Pylori Eradication: A Randomized Clinical Trial

2018 ◽  
Vol 10 (4) ◽  
pp. 242-248 ◽  
Author(s):  
Eskandar Hajiani ◽  
Pezhman Alavinejad ◽  
Nahid Avandi ◽  
Abdol Rahim Masjedizadeh ◽  
Ali Akbar Shayesteh
Keyword(s):  
Clinical Trial ◽  
Helicobacter Pylori ◽  
Eradication Rate ◽  
Therapy Group ◽  
Sequential Therapy ◽  
Quadruple Therapy ◽  
Group A ◽  
H Pylori ◽  
Group B ◽  
To Receive

BACKGROUND Considering the importance of Helicobacter pylori (H. pylori) eradication, this clinical trial was designed to prospectively evaluate the efficacy of levofloxacin-based, sequential therapy in comparison with quadruple therapy for eradicating H. pylori. METHODS Overall 156 patients with dyspepsia and H. pylori infection were included in this study and were randomly allocated to either 10-day sequential therapy group (group A) to receive pantoprazole (40 mg twice daily), amoxicillin (1 gr twice daily), levofloxacin (500 mg twice daily), and tinidazole (500 mg twice daily) (PALT) or 14-day quadruple therapy group (group B) to receive pantoprazole, clarithromycin, bismuth subcitrate, and amoxicillin (PABC). At the end of the study the eradication rate in each group was assessed by urea breath test (UBT). RESULTS Age range of the participants was 18-65 years (average 36.9 years) and 50% of them (78 patients) were men. 78 patients were allocated to group A and 78 patients to groupe B. After antibiotic therapy, all the patients received acid suppression therapy with Proton Pump Inhibitor (PPI) for 4 weeks and then the eradication rate was confirmed by UBT (Heli FAN plus 13C, Germany). Before performing UBT, all the participants were requested to halt consumption of PPI for at least 1 week. During the treatment there was not any major complication but in group A (sequential therapy), two patients complained of minor complications including musculoskeletal pain. None of the patients in group B had any complaint or side effect. The rate of H. pylori eradication in group A was 78.2% (61 patients) while this rate in group B was 83.3% (65 patients) with no significant difference between the two groups (p = 0.42). In subgroup analysis, the rate of eradication among men in group A and B were 76.9% and 89.7%, respectively (p = 0.22) while the eradication rate among women were 79.4% and 76.9%, respectively (p = 1.00). CONCLUSION It seems that levofloxacin base sequential therapy does not have any advantage in comparison with quadruple regimen and until finding any more effective short course therapy for H. Pylori eradication; we encourage quadruple regimen to be used as the first line therapy.

scholarly journals Seroprevalence of Helicobacter pylori infection and gastric mucosal atrophy in Bhutan, a country with a high prevalence of gastric cancer

2013 ◽  
Vol 62 (10) ◽  
pp. 1571-1578 ◽  
Author(s):  
Seiji Shiota ◽  
Varocha Mahachai ◽  
Ratha-korn Vilaichone ◽  
Thawee Ratanachu-ek ◽  
Lotay Tshering ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Negative Group ◽  
Mucosal Atrophy ◽  
Gastric Mucosal Atrophy ◽  
High Prevalence ◽  
Group A ◽  
H Pylori ◽  
Group B ◽  
Group D

Gastric cancer is the second leading cause of cancer-related mortality in the world. Recently, serum Helicobacter pylori antibodies and pepsinogen (PG) have been used for gastric cancer screening. The incidence of gastric cancer in Bhutan is reported to be quite high compared with that in neighbouring countries. In this study, 381 subjects from three areas of Bhutan were assessed for gastric mucosal atrophy and serological parameters. Anti-H. pylori IgG, PG I, PG II and cytotoxin-associated gene A (CagA) antibodies were measured using ELISA. Subjects were classified into four groups according to H. pylori and PG seropositivity: Group A (H. pylori-negative/PG-negative), Group B (H. pylori-positive/PG-negative), Group C (H. pylori-positive/PG-positive) and Group D (H. pylori-negative/PG-positive). The prevalence of H. pylori in the 381 subjects was 71.1 % (271/381), with high infection rates found in rural areas. The PG I/II ratio was significantly inversely correlated with the atrophy score in the antrum and the corpus (P<0.001). Multivariate analysis showed that the PG status was significantly associated with the presence of atrophy in the corpus. The prevalence of the PG-positive status was significantly higher among H. pylori-positive subjects than among H. pylori-negative subjects (P<0.001). Based on the ABC method, Group B was the most dominant, followed by Group A, Group C and Group D. The high incidence of gastric cancer in Bhutan can be attributed to the high prevalence of H. pylori infection and gastric mucosal atrophy.

Moxifloxacin Based Triple Therapy as Alternative to Standard Therapy in Helicobacter Pylori Eradication.

2020 ◽  
Vol 18 ◽  
Author(s):  
Mohammed Hussien Ahmed ◽  
Sherief Abd-Elsalam ◽  
Aya Mohammed Mahrous
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Therapy Group ◽  
Low Cost ◽  
High Rate ◽  
Helicobacter Pylori Eradication ◽  
Treatment Regimens ◽  
Group A ◽  
H Pylori ◽  
Group B

Introduction: Helicobacter pylori eradication remains a problematic issue. We are in an urgent need for finding a treatment regimen that achieves eradication at a low cost and less side effect. Recent published results showing a high rate of resistance and with clarithromycin-based treatment regimens. The aim of the study was to compare moxifloxacin therapy and classic clarithromycin triple therapy in H. pylori eradication. Methods: This was a pilot study that enrolled 60 patients with helicobacter pylori associated gastritis. Diagnosis was done by assessment of H. pylori Ag in the stool. The patients were randomly assigned to receive either moxifloxacin based therapy (Group A), or clarithromycin based therapy (Group B) for two weeks. We stopped the treatment for another two weeks then reevaluation for cure was done. Results: 90 % of patients had negative H. pylori Ag in the stool after 2 weeks of stoppage of the treatment in group A versus 66.7 % in Group B. None of the patients in both groups had major side effects. Conclusion: Moxifloxacin-based therapy showed higher eradication power and less resistance when compared to clarithromycin triple therapy.

scholarly journals The Clinical Correlations ofHelicobacter pyloriVirulence Factors and Chronic Spontaneous Urticaria

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Yi-Chun Chiu ◽  
Wei-Chen Tai ◽  
Seng-Kee Chuah ◽  
Ping-I Hsu ◽  
Deng-Chyang Wu ◽  
...  
Keyword(s):  
Complete Remission ◽  
Virulence Factors ◽  
Eradication Rate ◽  
Eradication Therapy ◽  
Chronic Spontaneous Urticaria ◽  
Signal Region ◽  
Cytotoxin Associated Gene A ◽  
Group A ◽  
H Pylori ◽  
Group B

Background and Study Aims. The association betweenHelicobacter pylori(H. pylori) and chronic spontaneous urticaria (CSU) remains controversial. This study explored the role ofH. pyloriin CSU among different virulent genotypes patients.Patients and Methods. Patients infected byH. pyloriwere sorted into two groups as group A (with CSU) and group B (without CSU). The tissue materials were taken via endoscopy for polymerase chain reaction study to determine virulence factors.AfterH. pylorieradication therapy, the eradication rate and response of urticaria were evaluated by using C13-UBT and a three-point scale (complete remission, partial remission, or no improvement).Results. The results were comparable between patients of groups A and B in terms ofH. pyloriinfection rates and eradication rate. Longitudinal follow-up of 23.5 months showed complete remission of urticaria in 63.6% but no improvement in 36.4% of the patients afterH. pylorieradication.H. pyloriinfected patients with different virulence factors such as cytotoxin-associated gene A, vacuolating cytotoxin gene A signal region and middle region have similar remission rates for CSU.Conclusions. Current study suggests thatH. pylorimay play a role in the development and disease course of CSU but may be irrelevant to different virulent genotypes.

scholarly journals The impact of probiotics supplementation on gut microbiota after Helicobacter pylori eradication: a multicenter, open-label, randomised trial

2020 ◽  
Author(s):  
Bo Tang ◽  
Li Tang ◽  
Cheng Huang ◽  
Chuan Tian ◽  
Ling Chen ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gut Microbiota ◽  
Randomised Trial ◽  
Eradication Therapy ◽  
Open Label ◽  
Quadruple Therapy ◽  
Alpha And Beta Diversity ◽  
Group A ◽  
H Pylori ◽  
Group B

Abstract Background: Helicobacter pylori (H. pylori) eradication therapy may lead to the perturbation of gut microbiota. The role of probiotics in gut microbiota during eradication therapy is still debated. Design: This was a multicentre, open-label, randomised trial done at seven hospitals in China. 162 patients were enrolled, 79 patients were randomly divided into group A (bismuth quadruple therapy), and 83 patients were randomly subjected into group B (bismuth quadruple therapy supplemented with Medilac-S). Faecal samples were collected before treatment and 2 weeks, 4 weeks, 6 weeks, and 8 weeks after eradication therapy. Gut microbiota was analyzed by 16S rRNA high-throughput sequencing. This trial is complete and registered with Chinese Clinical Trial Registry (Chictr.org.cn, ChiCTR1900022116). Results: The eradication rates of group A and group B were 82.43% and 87.01%, respectively (P>0.05). Compared with baseline, alpha and beta diversity was significantly altered 2 weeks after eradication in both group A and group B, which was restored at week 8. There were no significant differences in alpha and beta diversity between the two groups. Bismuth quadruple therapy resulted in enrichment of some detrimental bacteria taxa such as Klebsiella and Streptococcus that were not recovered by week 8. Probiotics supplementation could rapidly restore the taxa levels of Klebsiella and Streptococcus by week 4 after eradication, and increase the beneficial taxa of Bacillus and Lactobacillales. Functional analysis revealed that lipopolysaccharide biosynthesis and polymyxin resistance pathways were significantly enriched after eradication therapy, while probiotics supplementation mainly enriched the cofactors and vitamins metabolism pathways. Several detrimental taxa were identified to be correlated with features of older age, alcohol use and high BMI, while probiotics supplementation could effectively restore the adverse impact in patients with these characteristics.Conclusion: Probiotics supplementation is beneficial for patients during H. pylori eradication, especially for patients with older age, alcohol drinking, and obesity, which might obtain the maximum benefits.

scholarly journals CLINICAL EVALUATION OF TRIPLE AND QUADRUPLE HELICOBACTER PYLORI ERADICATION THERAPY IN PEPTIC ULCER PATIENTS WITH DIFFERENT ABO BLOOD GROUP PHENOTYPES

2018 ◽  
Vol 11 (7) ◽  
pp. 460
Author(s):  
Manal Khalid Abdulridha ◽  
Rana Hussein Kutaif ◽  
Yassir Mustafa Kamal ◽  
Akram Ajeel Najeeb
Keyword(s):  
Peptic Ulcer ◽  
Triple Therapy ◽  
Blood Group ◽  
Eradication Rate ◽  
Abo Blood Group ◽  
Quadruple Therapy ◽  
Blood Group A ◽  
Group A ◽  
H Pylori ◽  
Group B

Objective: This study aimed to examine the pathological changes in gastric mucosa of Helicobacter pylori-infected peptic ulcer patients carrying different ABO phenotypes and to study the response to the 14 days’ standard triple therapy and 10 days’ quadruple therapy in peptic ulcer patients according to their ABO phenotypes.Methods: Interventional prospective randomized-controlled open-label study was performed on newly diagnosed patients with PUD. The H. pylori-positive patients were allocated into two major study groups in which they are subdivided according to ABO blood group phenotypes: Group 1 received standard H. pylori eradication triple therapy and Group 2 received standard H. pylori eradication quadruple regimen. Patients were monitored after 2 months for successful H. pylori eradication.Results: Chronic active gastritis was significantly high in patients carrying blood Group O phenotype (81.25%), while the atrophic gastritis and intestinal metaplasia were significantly high in patients carrying blood Group A phenotype (25.00% and 16.67%), respectively. 14 days’ triple therapy showed significantly lower eradication rate in H. pylori-infected peptic ulcer patients carrying blood Group O phenotype (p<0.01), meanwhile higher response was found among patients with blood Group B. 10 days’ quadruple therapy produced a significant high eradication rate in H. pylori-infected patients carrying blood Group O than those with blood Group A (p<0.01), but still both showed lower response compared to that in patients carrying blood Group B and AB phenotypes. Elderly patients showed significantly less healing efficacy than younger patients (p<0.01), and the least healing rate was noticed in female patients after both regimens.Conclusion: Lower eradication rate in H. pylori-infected was noticed in peptic ulcer patients carrying blood Group O mainly than those with other blood groups and particularly those with duodenal Ulceri. 10 days’ quadruple therapy showed significant higher eradication rate in H. pylori infection and a better ulcer healing efficacy.

scholarly journals Comparison of Clarithromycin-based Triple Therapy and Furazolidone-based Quadruple Therapy in Eradicating Helicobacter pylori Infection

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alireza Bakhshipour ◽  
Narges Mohsenpour Mohammadi ◽  
Seyed Mahdi Hashemi ◽  
Mohammad Kazem Momeni
Keyword(s):  
Helicobacter Pylori ◽  
Cross Sectional Study ◽  
Helicobacter Pylori Infection ◽  
Cross Sectional ◽  
Female Ratio ◽  
First Choice ◽  
Group A ◽  
H Pylori ◽  
Triple Regimen ◽  
Group B

Background: Helicobacter pylori infection is the most common infection of human. This organism is responsible for the majority of peptic ulcer diseases, MALToma and gastric cancer, worldwide. Several regimen therapies against H. pylori had developed and are prescribed empirically, but therapies have rarely been optimized. Objectives: In this study, we compared two regimens that are widely used in Iran, triple regimen (clarithromycin, amoxicillin, and omeprazole) and furazolidone-based quadruple regimen (furazolidone, amoxicillin, bismuth, and omeprazole) in some dyspeptic patients. Methods: In this cross-sectional study, 373 consecutive dyspeptic patients that H. pylori infection was established, randomized into one of the following groups; 188 in group A (treated with clarithromycin 500 mg, amoxicillin 1,000 mg, and omeprazole 20 mg twice daily for 10 days) and 185 in group B (furazolidone 200 mg, amoxicillin 1000 mg, bismuth subcitrate 240 mg and omeprazole 20 mg twice daily for 14 days). One month after discontinuation of the treatment, H. pylori eradication was evaluated with UBT. Results: Mean age of the patients was 35.9 ± 12.3 years, and the male to female ratio was 1: 1.6. In the per-protocol analysis, the eradication rate of H. pylori was 63.7% in comparison to 93% in group A and B, respectively (P < 0.004). Conclusions: Our study showed furazolidone-based quadruple regimen is superior to the standard triple regimen; thus, it is recommended as the first choice.

scholarly journals RECURRENT ABDOMINAL PAIN

2006 ◽  
Vol 13 (04) ◽  
pp. 563-571
Author(s):  
MUHAMMAD TARIQ NADEEM ◽  
MAZHAR ABBAS ◽  
TAQI HASSAN ◽  
Shahid Masood
Keyword(s):  
Helicobacter Pylori ◽  
Abdominal Pain ◽  
Recurrent Abdominal Pain ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Endoscopic Findings ◽  
Group A ◽  
H Pylori ◽  
Group B

Objective: To assess the association between the Helicobacter Pylori (H.pylori) infection andrecurrent abdominal pain (RAP) by documenting the frequency of Helicobacter pylori infection in children aged 5 to 15years in our setup. Design: A comparative study. Place and Duration of Study: The study was conducted in pediatricunit Military Hospital Rawalpindi over one year period from 1st Apr 200 to 31st Mar 2002. Subject and Methods: Wedivided the patients into two groups; group A or the study group and the group B or the control group. In group A, atotal of 87 Children aged 5 to 15 years presenting with RAP in which no underlying cause was found on initialassessment underwent upper gastrointestinal tract (GIT) endoscopic examination. In group B (control) we included 68children in whom upper GIT endoscopy was done for any reason other than the RAP. In both the groups thegastroduodenal biopsy samples were sent for culture and histological examination for the diagnosis of H. pyloriinfection. The signs and symptoms of these patients were analyzed in detail. Results: In group A, out of 87 patientswho were endoscoped there were 44 female and 43 male. 54(62%) were found positive and 33(38%) were foundnegative for H.pylori on histopathology and culture examination of biopsy samples. In the control group (B) thefrequency of H.pylori infection was 35% (24 of 68) which was significantly lower than the study group (p-value .001).The frequency of H.pylori increased significantly with advancement in age (p-value .003) and lowering of thesocioeconomic status (p-value.002). The commonest endoscopic finding was antral gastritis (31 of 87; 35.6%). Antralnodularity was observed in 8(26%) out of 36 cases of antral gastritis and in 23(74%) cases there was antral erythemawithout nodularity. The remaining endoscopic findings were pan-gastritis (14 of 87;16%), duodenal ulcer (10 of87;11.5%), duodenitis (4 of 87;4.6%) and gastric ulcer (2 of 87;2.3%). The less frequent findings were gastric andduodenal erosions and esophagitis (about 1% each).Their was no abnormal finding in 22(25.3%) cases. Childrenpredominantly (52%) had the symptoms characteristics of ulcer-like dyspepsia. Recurrent epigastric pain wassignificantly more common in the H.pylori positive than the H. pylori negative children (44 of 87 vs 16 of 33 [p-value.001]). There was no difference for other symptom characteristics when comparing infected with non-infected children.Conclusion: The frequency of H.pylori infection is high in children with recurrent abdominal pain and there is a high degree of association between recurrent abdominal pain, endoscopic findings (chronic gastritis, duodenitis, gastric andduodenal ulcer) and the H. pylori infection.

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