Upper GI endoscopy in children with Helicobacter pylori Infection: Insights from a six-year retrospective review

Helicobacter pylori ( H. pylori ) is a prevalent bacterial infection acquired primarily during childhood, particularly in regions with poor sanitation and overcrowding. In Bangladesh, limited data exists on pediatric H. pylori infections and their endoscopic findings. This study aimed to evaluate the clinical presentations, endoscopic features, and histopathological findings of children with H. pylori infection in a tertiary care center. This retrospective study was conducted at Bangladesh Shishu Hospital & Institute between July 2018 and September 2024. A total of 1,145 upper gastrointestinal (GI) endoscopies were performed, with 241 children included based on positive Rapid Urease Test (RUT) or Campylobacter-like Organism (CLO) test results. Demographic data, clinical symptoms, and endoscopic findings in the esophagus, stomach, and duodenum were recorded. Biopsies were taken for histopathological examination. Data analysis was descriptive, with results presented as frequencies. Among the 241 patients, 58% were male, with a mean age of 8.6 years. The common presenting symptom was recurrent abdominal pain (62%), followed by vomiting (15%) and hematemesis/melena (12%). Endoscopic findings revealed multiple erythematous lesions in the stomach in 88% of cases, with nodular lesions present in 7% of duodenal cases. Histopathological examination confirmed chronic gastritis in 82% of patients and chronic gastritis with duodenitis in 15%. Recurrent abdominal pain and erythematous gastric lesions were the predominant clinical and endoscopic findings in children with H. pylori infection. Chronic gastritis was the most common histopathological diagnosis. Early diagnosis through upper GI endoscopy is crucial in managing pediatric H. pylori infections to prevent complications. To further refine management strategies and enhance generalizability, future studies should incorporate multicenter cohorts, include H. pylori -negative controls, and assess antibiotic resistance patterns.