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Helicobacter pylori infection: effect on malnutrition and growth failure in dyspeptic children

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There are conflicting reports regarding the association of Helicobacter pylori (H. pylori) infection with growth failure. We evaluated the role of H. pylori infection on malnutrition and growth failure in dyspeptic children. The study cases included 108 dyspeptic children and were evaluated by endoscopic gastric biopsy, while 50 healthy children constituted the control group. The study cases were grouped as H. pylori [+] (n = 57) and H. pylori [−] (n = 51) by the presence or absence of microorganism in gastric tissue, respectively. Age, gender, height for age (H/A), weight for height (W/H), body mass index (BMI), weight and height z scores and the daily calorie intake of the children were recorded. Malnutrition and growth failure were evaluated by the Waterlow criteria and height z score, respectively. Then, the H. pylori [+], H. pylori [−] and control groups were compared in relation to the variables defined above. All groups were similar with respect to gender and age. The daily calorie intake was lower in dyspeptic children. Although anthropometric variables were similar in the H. pylori [+] and [−] groups, the control cases had higher W/H compared to both H. pylori [+] (p = 0.030) and H. pylori [−] (p = 0.000) cases, and higher BMI (p = 0.001) and weight z scores (p = 0.014) than those in the H. pylori [−] group. The malnutrition rate was similar in the H. pylori [+] and [−] groups. However, mild acute (p = 0.033) and general malnutrition rates (p = 0.000) were lower in the control cases compared to the study cases. The short stature rate was not different significantly in all three groups. In conclusion, the results of this study do not support the data that H. pylori infection plays an extra role in malnutrition and growth failure in children presenting with dyspeptic complaints. However, as a major cause of dyspepsia, H. pylori infection might be considered to cause malnutrition secondary to decreased calorie intake associated with dyspepsia.

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H. pylori :

Helicobacter pylori


Weight for height


Height for age


Body mass index


  1. 1.

    Altuğlu I, Sayiner AA, Ozacar T, Egemen A, Bilgiç A (2001) Seroprevalence of Helicobacter pylori in a pediatric population. Turk J Pediatr 43:125–127

  2. 2.

    Bourke B, Ceponis P, Chiba N, Czinn S, Ferraro R, Fischbach L, Gold B, Hyunh H, Jacobson K, Jones NL, Koletzko S, Lebel S, Moayyedi P, Ridell R, Sherman P, van Zanten S, Beck I, Best L, Boland M, Bursey F, Chaun H, Cooper G, Craig B, Creuzenet C, Critch J, Govender K, Hassall E, Kaplan A, Keelan M, Noad G, Robertson M, Smith L, Stein M, Taylor D, Walters T, Persaud R, Whitaker S, Woodland R; Canadian Helicobacter Study Group (2005) Canadian Helicobacter Study Group Consensus Conference: update on the approach to Helicobacter pylori infection in children and adolescents—an evidence-based evaluation. Can J Gastroenterol 19:399–408

  3. 3.

    Bravo LE, Mera R, Reina JC, Pradilla A, Alzate A, Fontham E, Correa P (2003) Impact of Helicobacter pylori infection on growth of children: a prospective cohort study. J Pediatr Gastroenterol Nutr 37:614–619

  4. 4.

    Cacciari E, Menegatti M, Salardi S, Ali A, Stella FA, Figura N, Landi F, Holton J, Farinelli S, Cuccaro V, Miglioli M, Vaira D (1999) Helicobacter pylori infection and cytotoxic antigen associated gene "A" status in short children. J Pediatr Endocrinol Metab 12:197–201

  5. 5.

    Chimonas MA, Baggett HC, Parkinson AJ, Muth PT, Dunaway E, Gessner BD (2006) Asymptomatic Helicobacter pylori infection and iron deficiency are not associated with decreased growth among Alaska Native children aged 7–11 years. Helicobacter 11:159–167

  6. 6.

    Choe YH, Kim SK, Hong YC (2000) Helicobacter pylori infection with iron deficiency anaemia and subnormal growth at puberty. Arch Dis Child 82:136–140

  7. 7.

    Dale A, Thomas JE, Darboe MK, Coward WA, Harding M, Weaver LT (1998) Helicobacter pylori infection, gastric acid secretion, and infant growth. J Pediatr Gastroenterol Nutr 26:393–397

  8. 8.

    Dixon MF, Genta RM, Yardley JH, Correa P (1996) Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 20:1161–1181

  9. 9.

    Drumm B, Koletzko S, Oderda G (2000) Helicobacter pylori infection in children: a consensus statement. European Paediatric Task Force on Helicobacter pylori. J Pediatr Gastroenterol Nutr 30:207–213

  10. 10.

    Ertem D, Harmanci H, Pehlivanoglu E (2003) Helicobacter pylori infection in Turkish preschool and school children: role of socioeconomic factors and breast feeding. Turk J Pediatr 45:114–122

  11. 11.

    Gold BD, Colletti RB, Abbott M, Czinn SJ, Elitsur Y, Hassall E, Macarthur C, Snyder J, Sherman PM; North American Society for Pediatric Gastroenterology and Nutrition (2000) Helicobacter pylori infection in children: recommendations for diagnosis and treatment. J Pediatr Gastroenterol Nutr 31:490–497

  12. 12.

    Graham DY, Genta R, Evans DG, Reddy R, Clarridge JE, Olson CA, Edmonds AL, Siepman N (1996) Helicobacter pylori does not migrate from the antrum to the corpus in response to omeprazole. Am J Gastroenterol 91:2120–2124

  13. 13.

    Kivi M, Tindberg Y (2006) Helicobacter pylori occurrence and transmission: a family affair? Scand J Infect Dis 38:407–417

  14. 14.

    Logan RP, Walker MM, Misiewicz JJ, Gummett PA, Karim QN, Baron JH (1995) Changes in the intragastric distribution of Helicobacter pylori during treatment with omeprazole. Gut 36:12–16

  15. 15.

    Malfertheiner P, Megraud F, O’morain C, Bazzoli F, El-Omar E, Graham D, Hunt R, Rokkas T, Vakil N, Kuipers EJ (2007) Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut 56:772–781

  16. 16.

    Mera RM, Correa P, Fontham EE, Reina JC, Pradilla A, Alzate A, Bravo LE (2006) Effects of a new Helicobacter pylori infection on height and weight in Colombian children. Ann Epidemiol 16:347–351

  17. 17.

    Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F (2006) Growth references for Turkish children aged 6 to 18 years. Acta Paediatr 95:1635–1641

  18. 18.

    Novak J, Szekanecz Z, Sebesi J, Takats A, Demeter P, Bene L, Sipka S, Csiki Z (2003) Elevated levels of anti-Helicobacter pylori antibodies in Henoch-Schönlein purpura. Autoimmunity 36:307–311

  19. 19.

    Oderda G, Palli D, Saieva C, Chiorboli E, Bona G (1998) Short stature and Helicobacter pylori infection in Italian children: prospective multicentre hospital based case-control study. The Italian Study Group on Short Stature and H pylori. BMJ 317:514–515

  20. 20.

    Oguz A, Gökalp AS, Gültekin A (1990) Incidence of malnutrition in children aged 0–6 years in Sivas, an eastern province of Turkey. Indian Pediatr 27:257–262

  21. 21.

    Oner N, Vatansever U, Sari A, Ekuklu E, Güzel A, Karasalihoglu S, Boris NW (2004) Prevalence of underweight, overweight and obesity in Turkish adolescents. Swiss Med Wkly 134:529–533

  22. 22.

    Ozçay F, Demir H, Ozen H, Gürakan F, Saltik IN, Yüce A, Koçak N (2002) Normal growth in young children with Helicobacter pylori infection. J Pediatr Gastroenterol Nutr 35:102

  23. 23.

    Ozen A, Ertem D, Pehlivanoğlu E (2006) Natural history and symptomatology of Helicobacter pylori in childhood and factors determining the epidemiology of infection. J Pediatr Gastroenterol Nutr 42:398–404

  24. 24.

    Patel P, Mendall MA, Khulusi S, Northfield TC, Strachan DP (1994) Helicobacter pylori infection in childhood: risk factors and effect on growth. BMJ 309:1119–1123

  25. 25.

    Perri F, Pastore M, Leandro G, Clemente R, Ghoos Y, Peeters M, Annese V, Quitadamo M, Latiano A, Rutgeerts P, Andriulli A (1997) Helicobacter pylori infection and growth delay in older children. Arch Dis Child 77:46–49

  26. 26.

    Richter T, Richter T, List S, Muller DM, Deutscher J, Uhlig HH, Krumbiegel P, Herbarth O, Gutsmuths FJ, Kiess W (2001) Five- to 7-year-old children with Helicobacter pylori infection are smaller than Helicobacter-negative children: a cross-sectional population-based study of 3,315 children. J Pediatr Gastroenterol Nutr 33:472–475

  27. 27.

    Sauvé-Martin H, Kalach N, Raymond J, Senouci L, Benhamou PH, Martin JC, Briet F, Maurel M, Flourié B, Dupont C (1999) The rate of Helicobacter pylori infection in children with growth retardation. J Pediatr Gastronetrol Nutr 28:354–355

  28. 28.

    Sherman P, Czinn S, Drumm B, Gottrand F, Kawakami E, Madrazo A, Oderda G, Seo JK, Sullivan P, Toyoda S, Weaver L, Wu TC (2002) Helicobacter pylori infection in children and adolescents: Working group report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 35(Suppl 2):S128–S133

  29. 29.

    Sood MR, Joshi S, Akobeng AK, Mitchell J, Thomas AG (2005) Growth in children with Helicobacter pylori infection and dyspepsia. Arch Dis Child 90:1025–1028

  30. 30.

    Takahashi M, Kimura H, Watanabe K (2002) Helicobacter pylori infection in patients with idiopathic short stature. Pediatr Int 44:277–280

  31. 31.

    Tasar A, Kıbrıslı E, Dallar Y (2006) Seroprevalence of Helicobacter pylori in children with constitutional height retardation. Turk J Gastroentrol 17:7–12

  32. 32.

    Thomas JE, Dale A, Bunn JEG, Harding M, Coward WA, Cole TJ, Weaver LT (2004) Early Helicobacter pylori colonisation: the association with growth faltering in the Gambia. Arch Dis Child 89:1149–1154

  33. 33.

    Tunçbilek E, Ünalan T, Coşkun T (1996) Indicators of nutritional status in Turkish preschool children: results of Turkish Demographic and Health Survey 1993. J Trop Pediatr 42:78–84

  34. 34.

    Tytgat GN (1991) The Sydney System: Endoscopic division. Endoscopic appearances in gastritis/duodenitis. J Gastroenterol Hepatol 6:223–234

  35. 35.

    Vaira D, Menegatti M, Salardi S, Ali A, Altomare Stella F, Figura N, Landi F, Holton J, Farinelli S, Cuccaro V, Miglioli M, Cacciari E (1998) Helicobacter pylori and diminished growth in children: is it simply a marker of deprivation? Ital J Gastroenterol Hepatol 30:129–133

  36. 36.

    Vandenplas Y (2001) The role of Helicobacter pylori in paediatrics. Curr Opin Infect Dis 14:315–321

  37. 37.

    Waterlow JC (1972) Classification and definition of protein-calorie malnutrition. BMJ 3:566–569

  38. 38.

    Yang Y-J, Sheu B-S, Lee S-C, Yang H-B, Wu J-J (2005) Children of Helicobacter pylori-infected dyspeptic mothers are predisposed to H. pylori acquisition with subsequent iron deficiency and growth retardation. Helicobacter 10:249–255

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Correspondence to Özlem Bekem Soylu.

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Soylu, Ö.B., Ozturk, Y. Helicobacter pylori infection: effect on malnutrition and growth failure in dyspeptic children. Eur J Pediatr 167, 557–562 (2008). https://doi.org/10.1007/s00431-007-0552-6

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  • Helicobacter pylori
  • Malnutrition
  • Growth failure