Primary antral gastritis in young American children. Low prevalence of Helicobacter pylori infections.

Although Helicobacter pylori (H. pylori) is considered by many to be the major cause of primary antral gastritis (PAG), several important questions concerning its pathogenetic role remain unanswered. The most basic unresolved issue relates to the low prevalence of H. pylori in children in developed countries. If H. pylori is the cause of PAG, the prevalence of PAG should also be low, but previous studies have not provided data on this issue. To answer this question, we prospectively studied 408 children who underwent esophagogastroduodenoscopy and biopsy from January 1, 1988, to December 31, 1990, for symptoms consistent with peptic disease or immunocompromise. Although the prevalence of PAG was similar (about 20%) in the four age groups of patients studied (< 5, 5-9, 10-14, and 15-20 years), the prevalence of H. pylori infections was significantly greater in the oldest age group (67%, P < 0.0001). Only four of 39 children < 10 years old with PAG had evidence of H. pylori. H. pylori is an uncommon finding in our population of young American children with PAG, indicating that it does not play an important role in the pathogenesis of this disorder in this age group.