{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:24:42Z","timestamp":1793917482669,"version":"4.8.0"},"reference-count":55,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,3,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>Recurrent abdominal pain (RAP) and other gastrointestinal (GI) symptoms are common complaints among children. The role of Helicobacter pylori in the cause of these complaints remains controversial. Nevertheless, there is an increasing pressure on primary care clinicians to screen for H pylori infection in symptomatic children. We systematically reviewed the published evidence for an association between H pylori infection and GI symptoms in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Medline and Embase databases up to July 2009 were searched to identify studies that evaluated the association between H pylori and GI symptoms in children aged up to 18 years. When studies reported on abdominal pain without additional definition, thus not fulfilling Apley's criteria, we grouped these outcomes as unspecified abdominal pain (UAP). Methodologic quality was scored by using a standardized list of criteria, and crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and pooled.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Thirty-eight studies met our inclusion criteria: 23 case-control studies, 14 cross-sectional studies, and 1 prospective cohort study. The overall methodologic quality was low. Pooled ORs for the association between RAP and H pylori infection in children were 1.21 (95% CI: 0.82\u20131.78) in 12 case-control studies and 1.00 (95% CI: 0.76\u20131.31) in 7 cross-sectional studies. Meta-analysis of the association between UAP and H pylori infection in 6 hospital-based studies resulted in a pooled OR of 2.87 (95% CI: 1.62\u20135.09) compared with 0.99 (95% CI: 0.46\u20132.11) in 5 population-based studies. Two of 3 studies concerning epigastric pain reported a statistically significant positive association with H pylori infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>We found no association between RAP and H pylori infection in children and conflicting evidence for an association between epigastric pain and H pylori infection. We found evidence for an association between UAP but could not confirm this finding in children seen in primary care.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2010-0941","type":"journal-article","created":{"date-parts":[[2010,2,16]],"date-time":"2010-02-16T01:35:04Z","timestamp":1266284104000},"page":"e651-e669","source":"Crossref","is-referenced-by-count":100,"title":["Association Between<i>Helicobacter pylori<\/i>and Gastrointestinal Symptoms in Children"],"prefix":"10.1542","volume":"125","author":[{"given":"Leo A. A.","family":"Spee","sequence":"first","affiliation":[{"name":"Department of General Practice, Erasmus Medical Center\u2013University Medical Center, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke B.","family":"Madderom","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus Medical Center\u2013University Medical Center, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaike","family":"Pijpers","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus Medical Center\u2013University Medical Center, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus Medical Center\u2013University Medical Center, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein Y.","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus Medical Center\u2013University Medical Center, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,3,1]]},"reference":[{"issue":"7318","key":"2021120905413651300_B1","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1136\/bmj.323.7318.920","article-title":"ABC of the upper gastrointestinal tract: epidemiology and diagnosis of Helicobacter pylori infection","volume":"323","author":"Logan","year":"2001","journal-title":"BMJ"},{"issue":"9310","key":"2021120905413651300_B2","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S0140-6736(02)08025-X","article-title":"Age at acquisition of Helicobacter pylori infection: a follow-up study from infancy to adulthood","volume":"359","author":"Malaty","year":"2002","journal-title":"Lancet"},{"key":"2021120905413651300_B3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/j.1523-5378.2007.00539.x","article-title":"Helicobacter and gastric malignancies","volume":"12","author":"Moss","year":"2007","journal-title":"Helicobacter"},{"issue":"2","key":"2021120905413651300_B4","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/00005176-200002000-00020","article-title":"Helicobacter pylori infection in children: a consensus statement. European Paediatric Task Force on Helicobacter pylori","volume":"30","author":"Drumm","year":"2000","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"5","key":"2021120905413651300_B5","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/00005176-200011000-00007","article-title":"Helicobacter pylori infection in children: recommendations for diagnosis and treatment","volume":"31","author":"Gold","year":"2000","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"6","key":"2021120905413651300_B6","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1136\/gut.2006.101634","article-title":"Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report","volume":"56","author":"Malfertheiner","year":"2007","journal-title":"Gut"},{"issue":"7","key":"2021120905413651300_B7","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1155\/2005\/213608","article-title":"Noninvasive diagnostic tests for Helicobacter pylori infection in children","volume":"19","author":"Koletzko","year":"2005","journal-title":"Can J Gastroenterol"},{"issue":"9","key":"2021120905413651300_B8","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1001\/jama.1995.03520330059038","article-title":"Helicobacter pylori, gastroduodenal disease, and recurrent abdominal pain in children","volume":"273","author":"Macarthur","year":"1995","journal-title":"JAMA"},{"issue":"7","key":"2021120905413651300_B9","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1155\/1999\/286943","article-title":"Helicobacter pylori infection and childhood recurrent abdominal pain: lack of evidence for a cause and effect relationship","volume":"13","author":"Macarthur","year":"1999","journal-title":"Can J Gastroenterol"},{"issue":"7306","key":"2021120905413651300_B10","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1136\/bmj.323.7306.224","article-title":"Systematic reviews of evaluations of prognostic variables","volume":"323","author":"Altman","year":"2001","journal-title":"BMJ"},{"issue":"2","key":"2021120905413651300_B11","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2307\/2529786","article-title":"An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"issue":"5","key":"2021120905413651300_B12","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/art.10660","article-title":"Prognostic factors of progress of hip osteoarthritis: a systematic review","volume":"47","author":"Lievense","year":"2002","journal-title":"Arthritis Rheum"},{"issue":"6","key":"2021120905413651300_B13","doi-asserted-by":"crossref","first-page":"427","DOI":"10.7326\/0003-4819-144-6-200603210-00010","article-title":"Evaluation of the quality of prognosis studies in systematic reviews","volume":"144","author":"Hayden","year":"2006","journal-title":"Ann Intern Med"},{"issue":"9596","key":"2021120905413651300_B14","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet"},{"issue":"168","key":"2021120905413651300_B15","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1136\/adc.33.168.165","article-title":"Recurrent abdominal pains: a field survey of 1,000 school children","volume":"33","author":"Apley","year":"1958","journal-title":"Arch Dis Child"},{"issue":"7","key":"2021120905413651300_B16","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1111\/j.1651-2227.2007.00329.x","article-title":"Helicobacter pylori infection among children with gastrointestinal symptoms: a high prevalence of infection among patients with reflux oesophagitis","volume":"96","author":"Daugule","year":"2007","journal-title":"Acta Paediatr"},{"issue":"4","key":"2021120905413651300_B17","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/j.1523-5378.2006.00412.x","article-title":"A prospective study for the association of Helicobacter pylori infection to a multidimensional measure for recurrent abdominal pain in children","volume":"11","author":"Malaty","year":"2006","journal-title":"Helicobacter"},{"issue":"3","key":"2021120905413651300_B18","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/j.1440-1746.2005.03578.x","article-title":"Short-term recurrent abdominal pain related to Helicobacter pylori infection in children","volume":"20","author":"Yang","year":"2005","journal-title":"J Gastroenterol Hepatol"},{"issue":"10","key":"2021120905413651300_B19","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1111\/j.1572-0241.2003.07683.x","article-title":"The seroprevalence of Helicobacter pylori in a referral population of children in the United States","volume":"98","author":"Chong","year":"2003","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"2021120905413651300_B20","first-page":"866","article-title":"Immune responses to differentiated forms of Helicobacter pylori in children with epigastric pain","volume":"10","author":"Ng","year":"2003","journal-title":"Clin Diagn Lab Immunol"},{"issue":"4","key":"2021120905413651300_B21","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1046\/j.1523-5378.1999.99072.x","article-title":"Effect of cagA status on the sensitivity of enzyme immunoassay in diagnosing Helicobacter pylori-infected children","volume":"4","author":"Plebani","year":"1999","journal-title":"Helicobacter"},{"issue":"7213","key":"2021120905413651300_B22","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1136\/bmj.319.7213.822","article-title":"Helicobacter pylori and childhood recurrent abdominal pain: community based case-control study","volume":"319","author":"Macarthur","year":"1999","journal-title":"BMJ"},{"issue":"1\u20132","key":"2021120905413651300_B23","first-page":"40","article-title":"Helicobacter pylori and hypergastrinemia in children with recurrent abdominal pain","volume":"14","author":"G\u00fcnel","year":"1998","journal-title":"Pediatr Surg Int"},{"issue":"5","key":"2021120905413651300_B24","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1055\/s-2008-1043905","article-title":"Incidence of increased serum Helicobacter pylori IgG antibodies in children with and without chronic abdominal pain [in German]","volume":"210","author":"Bl\u00fcmel","year":"1998","journal-title":"Klin Padiatr"},{"issue":"4","key":"2021120905413651300_B25","first-page":"329","article-title":"Helicobacter pylori infection in recurrent abdominal pain","volume":"35","author":"Bansal","year":"1998","journal-title":"Indian Pediatr"},{"issue":"8","key":"2021120905413651300_B26","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1111\/j.1651-2227.1998.tb01546.x","article-title":"The prevalence and related symptomatology of Helicobacter pylori in children with recurrent abdominal pain","volume":"87","author":"Wewer","year":"1998","journal-title":"Acta Paediatr"},{"issue":"1","key":"2021120905413651300_B27","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/00005176-199707000-00014","article-title":"Prevalence of Helicobacter pylori infection in Nicaraguan children with persistent diarrhea, diagnosed by the 13C-urea breath test","volume":"25","author":"Kehrt","year":"1997","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"5","key":"2021120905413651300_B28","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1055\/s-2008-1066524","article-title":"Helicobacter pylori infection in symptomatic and asymptomatic children: a prospective clinical study","volume":"6","author":"Ozt\u00fcrk","year":"1996","journal-title":"Eur J Pediatr Surg"},{"issue":"3","key":"2021120905413651300_B29","first-page":"329","article-title":"Helicobacter pylori serology in childhood","volume":"38","author":"G\u00fcrakan","year":"1996","journal-title":"Turk J Pediatr"},{"issue":"2","key":"2021120905413651300_B30","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/00005176-199602000-00004","article-title":"Helicobacter pylori and recurrent abdominal pain in children","volume":"22","author":"Hardikar","year":"1996","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"2 pt 1","key":"2021120905413651300_B31","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1542\/peds.96.2.211","article-title":"Helicobacter pylori infection in recurrent abdominal pain in childhood: comparison of diagnostic tests and therapy","volume":"96","author":"Chong","year":"1995","journal-title":"Pediatrics"},{"issue":"3","key":"2021120905413651300_B32","first-page":"169","article-title":"Helicobacter pylori diagnosis in children with recurrent abdominal pain [in Spanish]","volume":"24","author":"M\u00e9ndez Nieto","year":"1994","journal-title":"Acta Gastroenterol Latinoam"},{"issue":"11","key":"2021120905413651300_B33","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1007\/BF01957927","article-title":"The prevalence of Helicobacter pylori serum antibodies in children with recurrent abdominal pain","volume":"151","author":"van der Meer","year":"1992","journal-title":"Eur J Pediatr"},{"issue":"2","key":"2021120905413651300_B34","first-page":"102","article-title":"Prevalence of Helicobacter pylori infection in children with recurrent abdominal pain","volume":"26","author":"Mukherjee","year":"2005","journal-title":"Trop Gastroenterol"},{"issue":"2","key":"2021120905413651300_B35","first-page":"102","article-title":"Helicobacter pylori infection in a group of symptomatic and asymptomatic children and adolescents in the Czech Republic [in Czech]","volume":"142","author":"Sedl\u00e1ckov\u00e1","year":"2003","journal-title":"Cas Lek Cesk"},{"issue":"4","key":"2021120905413651300_B36","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/01.mpg.0000215307.48169.7b","article-title":"Natural history and symptomatology of Helicobacter pylori in childhood and factors determining the epidemiology of infection","volume":"42","author":"Ozen","year":"2006","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"1","key":"2021120905413651300_B37","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/01.MPG.0000163734.84518.9E","article-title":"Helicobacter pylori infection and abdominal symptoms among Swedish school children","volume":"41","author":"Tindberg","year":"2005","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"3","key":"2021120905413651300_B38","first-page":"176","article-title":"A seroepidemiologic study of Helicobacter pylori and hepatitis A virus infection in primary school students in Taipei","volume":"38","author":"Lin","year":"2005","journal-title":"J Microbiol Immunol Infect"},{"issue":"4 pt 1","key":"2021120905413651300_B39","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1542\/peds.101.4.634","article-title":"Helicobacter pylori and abdominal symptoms: a population-based study among preschool children in southern Germany","volume":"101","author":"Bode","year":"1998","journal-title":"Pediatrics"},{"issue":"5","key":"2021120905413651300_B40","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1093\/tropej\/44.5.283","article-title":"Helicobacter pylori colonization in infants and young children is not necessarily associated with diarrhoea","volume":"44","author":"Rahman","year":"1998","journal-title":"J Trop Pediatr"},{"issue":"37","key":"2021120905413651300_B41","first-page":"1878","article-title":"Helicobacter pylori infection in children and juveniles: an epidemiological study on prevalence, socio-economic factors and symptoms [in German]","volume":"128","author":"Grimm","year":"2003","journal-title":"Dtsch Med Wochenschr"},{"issue":"3","key":"2021120905413651300_B42","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/0022-3468(95)90047-0","article-title":"Helicobacter pylori, hypergastrinaemia, and recurrent abdominal pain in children","volume":"30","author":"McCallion","year":"1995","journal-title":"J Pediatr Surg"},{"issue":"3","key":"2021120905413651300_B43","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1097\/01.MPG.0000154662.39488.77","article-title":"Helicobacter pylori status and symptom assessment two years after eradication in pediatric patients from a high prevalence area","volume":"40","author":"Magist\u00e0","year":"2005","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"2","key":"2021120905413651300_B44","first-page":"114","article-title":"Helicobacter pylori infection in Turkish preschool and school children: role of socioeconomic factors and breast feeding","volume":"45","author":"Ertem","year":"2003","journal-title":"Turk J Pediatr"},{"issue":"8","key":"2021120905413651300_B45","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1111\/j.1651-2227.1996.tb14194.x","article-title":"Recurrent abdominal pain and Helicobacter pylori in a community-based sample of London children","volume":"85","author":"O'Donohoe","year":"1996","journal-title":"Acta Paediatr"},{"issue":"5","key":"2021120905413651300_B46","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0022-3999(02)00459-2","article-title":"Recurrent abdominal pain in children: evidence from a population-based study that social and familial factors play a major role but not Helicobacter pylori infection","volume":"54","author":"Bode","year":"2003","journal-title":"J Psychosom Res"},{"issue":"6","key":"2021120905413651300_B47","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/S1695-4033(05)70247-2","article-title":"Helicobacter pylori infection in the child population in Spain: prevalence, related factors and influence on growth [in Spanish]","volume":"63","author":"Leandro Liberato","year":"2005","journal-title":"An Pediatr (Barc)"},{"issue":"6","key":"2021120905413651300_B48","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/j.1651-2227.1999.tb00012.x","article-title":"Clinical symptoms and social factors in a cohort of children spontaneously clearing Helicobacter pylori infection","volume":"88","author":"Tindberg","year":"1999","journal-title":"Acta Paediatr"},{"issue":"1","key":"2021120905413651300_B49","first-page":"32","article-title":"Children with recurrent abdominal pain in Manisa Region, Western Turkey: an evaluation of serological prevalence of Helicobacter pylori","volume":"5","author":"Kasirga","year":"2003","journal-title":"Int J Med"},{"issue":"4","key":"2021120905413651300_B50","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1046\/j.1523-5378.2001.00045.x","article-title":"Seroprevalence of Helicobacter pylori infection in Siberia","volume":"6","author":"Reshetnikov","year":"2001","journal-title":"Helicobacter"},{"issue":"2","key":"2021120905413651300_B51","doi-asserted-by":"crossref","first-page":"100","DOI":"10.4103\/1319-3767.45359","article-title":"Helicobacter pylori: prevalence and relationship with abdominal pain in school children in Makkah City, western Saudi Arabia","volume":"15","author":"Telmesani","year":"2009","journal-title":"Saudi J Gastroenterol"},{"issue":"11","key":"2021120905413651300_B52","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/j.gcb.2008.03.021","article-title":"Prevalence and risk factors of Helicobacter pylori infection in Tunesian children: 1055 children in Cap-Bon (northeastern Tunisia)","volume":"32","author":"Siai","year":"2008","journal-title":"Gastroenterol Clin Biol"},{"issue":"4","key":"2021120905413651300_B53","first-page":"221","article-title":"Helicobacter pylori infection in Iranian children with recurrent abdominal pain","volume":"29","author":"Masoodpoor","year":"2008","journal-title":"Trop Gastroenterol"},{"issue":"4","key":"2021120905413651300_B54","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/j.1440-1754.2008.01295.x","article-title":"Aetiology of recurrent abdominal pain in a cohort of Sri Lankan children","volume":"44","author":"Devanarayana","year":"2008","journal-title":"J Paediatr Child Health"},{"issue":"8","key":"2021120905413651300_B55","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1111\/j.1572-0241.1998.00407.x","article-title":"Validation of a serologic test for the diagnosis of Helicobacter pylori infection and the immune response to urease and CagA in children","volume":"93","author":"Camorlinga-Ponce","year":"1998","journal-title":"Am J Gastroenterol"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/125\/3\/e651\/894273\/zpe0031000e651.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/125\/3\/e651\/894273\/zpe0031000e651.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T07:35:42Z","timestamp":1685432142000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/125\/3\/e651\/72657\/Association-Between-Helicobacter-pylori-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3,1]]},"references-count":55,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2010,3,1]]},"published-print":{"date-parts":[[2010,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2010-0941","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3,1]]}}}