Dyspeptic syndrome and infection by Helicobacter pylori exhibit histopathologic correlation when observed in adolescents

Abstract

Objective: Chronic gastritis is a histological entity and is primarily associated with Helicobacter pylori infection. The main reason for controversy is the lack of correlation between dyspeptic symptoms and histopathologic changes. The purpose of this study was to compare histological findings with dyspeptic symptoms in adolescents. Methods: Adolescents aged 10 to 19 years old with dyspeptic symptoms were referred to upper endoscopy. A protocol was systematically submitted to all patients prior to endoscopy. Histopathologic examination was performed on biopsy specimens. H. pylori infection was detected by rapid urease test and histology. Results: A total of 162 consecutive outpatients with dyspeptic complaints and indication for endoscopy were entered in the database of this study. The mean age of the sample was 16 years old; There were 120 females (74%) and 42 males (26%). Helicobacter pylori were present in 123 patients (75.9%) with a Pearson's coefficient of 0.7 (infection versus symptoms). The frequency of gastritis in the antrum and incisura angularis was significantly higher in subjects who had epigastric pain (p=0,004). Superficial gastritis was 2 times more frequent among subjects who had epigastric pain than those who do not presented (p=0,012). Severe gastritis was significantly more frequent among those who had epigastric pain (p=0,016). There was no correlation between gastritis and other dyspeptic symptoms. Conclusion: This study shows that there is a correlation between epigastric pain and superficial gastritis of greater intensity and infection by H. pylori. There is no correlation between epigastric pain and intestinal metaplasia in adolescents. Gastritis of the antrum and incisura angularis showed a correlation to regurgitation. Gastritis was not associated to other dyspeptic symptoms.