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Background Helicobacter pylori  infection is one of the predisposing factors for gastritis, peptic ulcer, and duodenal ulcer. Definite diagnosis of  H. pylori  infection is important in planning effective medical management. However, confirming the diagnosis through bacterial culture takes a number of days, and thus delays treatment. Objectives To examine endoscopic findings in children associated with chronic abdominal pain and  H. pylori  infection to aid in early diagnosis. We also evaluated treatment outcome of  H. pylori  infection. Methods A retrospective study was performed by reviewing the medical records of children under 15 years of age with chronic abdominal pain who underwent esophagogastroduodenoscopy (EGD) between 2011 and 2017. According to 2016 Joint ESPGHAN/NASPGHAN Guidelines,  H. pylori  infection was defined by positive tests for both histopathology test and rapid urease test (RUT). The EGD finding, RUT, histopathologic finding, and treatment outcome were recorded. Results Forty-eight children presented with chronic abdominal pain (male 47.9%, female 52.1%, mean age was 8.44 ± 2.97 years). Twelve children out of 48 had  H. pylori  infection (12/48, 25%). Eight among the 12 children had antral nodularity (8/12), wherein there was no antral nodularity in children without  H. pylori  infection (0/36). This difference was statistically significant ( P  &lt; 0.001). Sensitivity and specificity of antral nodularity finding for  H. pylori  infection were 66.7% and 100%, respectively. Eradication of  H. pylori  infection with standard regimen improved the abdominal pain within 4 weeks. Conclusion The occurrence of antral nodularity in endoscopic finding was significantly associated with  H. pylori  infection. In addition, antral nodularity finding showed a good sensitivity and high specificity for the diagnosis of  H. pylori  infection.

Endoscopic finding and treatment outcome of children with Helicobacter pylori infection in lower northern Thailand