The incidence and clinical manifestations in pediatric gastritis

Author: Diaconu Niculina-OanaCoordinator:Reka Borka Balas

University of Medicine and Pharmacy, Pediatric Department Number One, Tg. Mures

Gastritis is an inflamatory process, acute or chronic, localized diffuze or focal in the gastric mucosa of the stomach. The positive diagnosis of the gastritis is given on Sydney’s system criteria:

endoscopic histological

From etilogic point of view there are two forms of gastritis:

The primary one

Bile reflux

Helicobacter pylori infections

Secondary one

Burns, infections, drugs, head trauma, caustic and

corrosive substances, system diseases, etc

Mecanical aggressions (insufficient mastication, tough cellulose abuse)

Physical aggresions ( ingestion of too cold or to warm food)

Chimical aggression ( nonsteroid anti-inflamatory drugs, corticosteroids, alcohol, smoking, corrosive substances, cytostatics)

Food abuses

Stress, psycho-affective lability

The risk factors

Purpose

to determinate the incidence and evaluating symptoms, methods of diagnosis in pediatric gastritis, the gravity of some risk factors not the aim of this study to evaluate risk factors

Material and method a retrospective study includes 209 patients of 2-17 years, admitted to the

Pediatric Clinic I Targu-Mures between 2009-2012.

Variables

Patients with age between :0-18Gender

ResidenceRisk factorsSymptoms

Outcome of endoscopy that confirms the gastritis

Histological changes

Results

209 patients, 61,7% were female and 38,3% were male

Girls (129)61,7%

Boys (80)38,3 %

Gender

girls boys

Age of patients and their place of living

0-4 years 5-9 years 10-14 years 15-18 years0

10

20

30

40

50

60

70

80

90

12

45

84

68

Distribution of cases based on age groups

Female Male0

10

20

30

40

50

60

70

80

90

RuralUrban

num

ber

Place of living

Helicobacter pylori infection

23%

77%

HP

10

0-4 years

5-9 years

10-14 years

15-18 years

0

10

20

30

40

50

60

70

HP 0 HP 1n

um

ber

Risk factors and seasonal evolution of the gastritis

Risk factors of gastritis

winter

springtime

summer

autumn

0 10 20 30 40 50 60 70

24,4%

32,5%

15,3%

27,8%

Seasonal evolution

Inade-quate

feeding

Fam.his. Affective disorder

Passive smoking

Alcohol

54,5%

28,7%

6,2%

38,3%

0,5%

Symptoms of gastritis and localization of abdominal pain

abdo

minal p

ain

naus

ea

inap

pete

nce

04080

120160200

Nu

mb

er

67,9%

12,4%

9,1% epigastricdiffuseperiumbil-ical

Symptoms Localization of abdominal pain

0-4 years

5-9 years

10-14 years

15-18 years

0

10

20

30

40

50

60

Without epigastric painEpigastric pain

Nu

mb

er

Distribution of cases based on age group and epigastric pain

0-4 years

5-9 years

10-14 years

14-18 years

01020304050607080

Without diffuse pain

Nu

mb

er

Distribution of cases based on age group

and diffuse pain

Correlations between age groups and abdominal pains

Age groups

Abdominal pain

Periombilical

Epigastric

Diffuse

P=0,008

P=0,079

P=0,001

0-4 years

Above 10 years

Endoscopic aspect of gastric mucosa

Erite

mat

o-ex

suda

tive

Paving

sto

ne a

ppea

ranc

e

Follicu

lare

Hemor

rhag

ic

Duode

nal c

hang

es

Esop

hagu

s ch

ange

s

No m

odifica

tion

0

40

80

120

160

Nu

mb

er

Paving stone appearance, folicullare mucosaand Helicobacter pylori infection

0 10

20406080

100120140160

Paving stone 0Paving stone 1

Helicobacter pylori

Nu

mb

er

0 10

20406080

100120140

Folicullare 0Folicullare 1

Helicobacter pylori

Nu

mb

er

Correlations between endoscopic aspect and Helicobacter pylori

Endoscopic aspect HP+

Eritemato-

exudative

Paving stone

appearance

Folliculare

Hemorrahagic

P=0,448

P=0,004

P=0,119

P=0,000

Conclusions

The incidence of gastritis nowadays, can be appreciated due to the modern techniques of investigation by gastroscopy

Gastritis is more frequent in female

The most affected group of age was 10-14 years

In 54,5% of the cases was presented the inadequate feeding and in 28,7% the heredo-collateral antecedents

We remarked a seasonal evolution of the disease in children to, with two morbidity peaks: spring time and autumn

The most common symptom was abdominal pain

The epigastric pain has been correlated with the age groups over 10 years, and the diffuse pain in age group of 0-4 years

The follicular aspect and the paving stone appearance have been correlated with the presence of Helicobacter Pylori infection

Thank you!