BACKGROUND: Helicobacter pylori may be found during upper gastrointestinal endoscopy (UGE) performed to diagnose celiac disease (CeD), inflammatory bowel disease (IBD), and eosinophilic esophagitis (EoE). We aimed to describe the frequency of H. pylori in children undergoing UGE for CeD, IBD, and EoE and the number of children receiving eradication treatment. MATERIALS AND METHODS: A retrospective multicenter study from 14 countries included pediatric patients diagnosed with CeD, IBD, and EoE between January 2019 and December 2021. DATA COLLECTED: age, gender, hematologic parameters, endoscopic, histologic, and H. pylori culture results, and information on eradication treatment. RESULTS: H. pylori was identified in 349/3890 (9%) children [167 (48%) male, median 12 years (interquartile range 8.1-14.6)]. H. pylori was present in 10% (173/1733) CeD, 8.5% (110/1292) IBD and 7.6% (66/865) EoE patients (p = NS). The prevalence differed significantly between Europe (Eastern 5.2% (28/536), Southern 3.8% (78/2032), Western 5.6% (28/513)) and the Middle East 26.6% (215/809) [odds ratio (OR) 7.96 95% confidence interval (CI) (6.31-10.1) p < 0.0001]. Eradication treatment was prescribed in 131/349 (37.5%) patients, 34.6% CeD, 35.8% IBD, and 56.1% EoE. Predictors for recommending treatment included erosions/ulcers [OR 6.45 95% CI 3.62-11.47, p < 0.0001] and nodular gastritis [OR 2.25 95% CI 1.33-3.81, p 0.003]. Treatment rates were higher in centers with a low H. pylori prevalence (<20%) [OR 3.36 95% CI 1.47-7.66 p 0.004]. CONCLUSIONS: Identifying H. pylori incidentally during UGE performed for the most common gastrointestinal diseases varies significantly among regions but not among diseases. The indications for recommending treatment are not well defined, and less than 40% of children received treatment.

Arabkir Institute of Child and Adolescent Health Yerevan Armenia

Clinic of Children's Diseases of Vilnius University Faculty of Medicine Vilnius Lithuania

Department of Translational Medical Science Section of Paediatrics University of Naples Federico 2 Naples Italy

Division of Gastroenterology and Hepatology 1st Pediatrics Department University of Athens Agia Sofia Children's Hospital Athens Greece

Division of Paediatric Gastroenterology and Hepatology Mitera Children's Hospital Athens Greece

Division of Pediatric Gastroenterology Gaziantep Islam Science and Technology University Medical Faculty Gaziantep Turkey

Emma Children's Hospital Amsterdam UMC University of Amsterdam Paediatric Gastroenterology Amsterdam The Netherlands

Faculty of Medical sciences Department of Pediatrics University of Kragujevac Kragujevac Serbia

Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel

Faculty of Medicine in Pilsen Charles University Prague Prague Czech Republic

Faculty of Medicine Tel Aviv University Tel Aviv Israel

Paediatric Division Kaplan Medical Centre Rehovot Israel

Paediatric Gastroenterology and Cystic Fibrosis Unit Department of Human Pathology University of Messina Messina Italy

Paediatric Gastroenterology Kaplan Medical Centre Rehovot Israel

Paediatric Gastroenterology Unit Hospital 12 de Octubre Madrid Spain

Paediatric Gastroenterology Unit The Edmond and Lily Safra Children's Hospital Sheba Medical Center Ramat Gan Israel

Pediatric Gastroenterology Division Wolfson Medical Center Holon Israel

Pediatric Gastroenterology Unit Centro Materno Infantil do Norte Centro Hospitalar e Universitário de Santo António Porto Portugal

Pediatric Gastroenterology Unit Puerta de Hierro Majadahonda Hospital Madrid Spain

Referral Centre for Paediatric Gastroenterology and Nutrition Children's Hospital Zagreb University of Zagreb School of Medicine Zagreb Croatia

Saint Antoine Paediatric Clinic Saint Vincent de Paul Hospital Groupement des Hôpitaux de l'Institut Catholique de Lille Catholic University Lille France

Université Libre de Bruxelles Hôpital Universitaire de Bruxelles Hôpital Universitaire des Enfants Reine Fabiola Brussels Belgium

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