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Assessment of the influence of smoking on the incidence of Helicobacter pylori infection in children and adolescents

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Author(s): Monika Parzęcka | Anna Szaflarska-Popławska | Ewa Pufal | Karol Śliwka | Mieczysława Czerwionka-Szaflarska

Journal: Polish Gastroenterology
ISSN 1232-9886

Volume: 19;
Issue: 4;
Start page: 157;
Date: 2012;
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Keywords: cotinine | Helicobacter pylori | smoking | children

ABSTRACT
Introduction: Helicobacter pylori (Hp) infection of the stomach mucous membrane initiates chronic inflammatory lesions and sometimes leads to peptic ulcers. Exposure to tobacco smoke can be an additional factor influencing the incidence of Hp infections in pediatric populations. Aim of the study was to assess the influence of passive smoking, by children and adolescents, on the incidence of Hp infection in this age group. Material and methods: Three hundred and thirty five patients qualified for the study. Their age was 4-18 years, they showed symptoms of dyspepsia and they underwent endoscopic examination of the upper gastrointestinal tract with histopathological assessment of specimens of the stomach and/or duodenum mucous membrane. Hp infection was diagnosed based on the presence of bacteria confirmed by histopathological examination of the collected specimens. At the same time, a survey was carried out among the parents about smoking by household members. In order to verify the survey, the presence of cotinine was determined in urine of the studied patients. Results: The average age of the studied children was 13.02 years (±0.5). No exposure to passive smoking was declared (in the survey) by 155 patients (group A) 155/335 (46.27%); active smoking at home was declared by 180 parents (group B) 180/335 (53.73%). In group A, 18.06% of children and adolescents were diagnosed with Hp infection; in group B, 28.33% (18.06% vs. 28.33%). The infection was significantly more frequent in children coming from smoking families. No difference was observed in the intensity of Hp infection in both groups. No urine cotinine was found in 228 patients (group A1) 228/335 (68.06%). Cotinine was found in urine of 107 patients (group B1) 107/335 (31.94%). Hp infection was diagnosed in 58 patients in group A1 58/228 (25.44%) and 20 in group B1 20/107 (18.69%). No differences were observed in the incidence of Hp infection according to the presence of urine cotinine. In group A, urine cotinine was found most frequently in preschool children, in 4-year-olds. Whereas in school children, it was found most frequently in 8-year-olds and in adolescents aged 15 and 16 years, in group A. In group B, urine cotinine was found more frequently in older than in younger children. Conclusions: Passive and/or active smoking can influence the frequency of Hp infection. Cotinine can be a good marker of active and/or passive smoking in children and adolescents. School children are more exposed to passive smoking. In this age group, also undeclared active smoking should be taken into consideration.

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