Helicobacter pylori–positive Versus Helicobacter pylori–negative Idiopathic Peptic Ulcers in Children With Their Long‐term Outcomes

OBJECTIVES: The aim of this study is to investigate the differences in the characteristics between Helicobacter pylori-positive and H pylori-negative primary ulcers in Chinese children. PATIENTS AND METHODS: We conducted a retrospective review of children with primary peptic ulcers. Demographic data, clinical presentations, endoscopic features, histological findings, H pylori prevalence, and ulcer recurrences were studied. RESULTS: Forty-three Chinese children with primary peptic ulcers were diagnosed over 8 years and were reviewed. There were 31 boys and 12 girls (median age 12 years, range 3-16 years). Thirty children (70%) presented with acute gastrointestinal bleeding, whereas only 19 had a history of epigastric pain. Twenty-three patients (53.5%) were H pylori positive. H pylori-positive ulcers developed in older children (median age 12 vs 10 years, P<0.05) and affected more males (91.3% vs 50%, P<0.01) than the H pylori-negative group. The annual ulcer recurrence rates were estimated to be 5.2% (95% CI 4.2-6.3) and 11.4% (95% CI 9.1-13.6) for positive and negative groups, respectively (P<0.05). Multivariate logistic regression suggested H pylori-negative status and ulcer size >1cm were indepen-dent risk factors for recurrence. CONCLUSIONS: Our report suggests that H pylori-negative primary ulcers exist in children with their own distinct features. In contrast to H pylori-positive ulcers, H pylori-negative ulcers develop in younger children, affect both sexes equally, and carry a higher recurrence risk.