Gastritis in Saudi Arab children

OBJECTIVE: Information on childhood gastritis in developing countries is rare; hence, the objective of this study is to report the pattern of this condition in Saudi Arab children.

METHODS: Data analysis were carried out in all children <18 years of age who were referred for endoscopy at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from 1993 to 2002. Only children with histology-proven gastritis were included.

RESULTS: One hundred and seventy-five patients out of 851, referred for the investigation of gastrointestinal symptoms, had histology-proven gastritis; whereas only 110/851 (13%) had endoscopic features of gastritis. Most of the children (96%) were Saudi nationals, the age ranged between 4 days to 18 years, and the male to female ratio was 0.4:1. The most common presentation of gastritis was abdominal pain in 42%, followed by combination of abdominal pain and vomiting in 20% and vomiting alone in 18% of the children. Rare but important presentations included refractory anemia, melena and halitosis. The prevalence of gastritis increased with age from 9% in children <5 years of age to 42% in adolescents 16-18 years of age. Likewise, the prevalence of Helicobacter pylori (H. pylori) gastritis increased from 47% in children <5, to 62% in the 6-15 year age group, and 69% in the 16-18 years old adolescents. Endoscopy was normal in 74/175 (42%) of histologic gastritis and the prevalence of H. pylori gastritis was the highest in cases of endoscopic nodularity (92%)

CONCLUSION: Compared to findings from various parts of the world, this report document a similar clinical pattern, but high prevalence of H. pylori gastritis in Saudi Arab children.