Gastric pathology in celiac children and adults: the role of Helicobacter pylori.

Background: Celiac disease (CD) is an immune-mediated enteropathy that occurs in genetically susceptible individuals and is caused by an abnormal immune response to gluten. A possible relationship between Helicobacter pylori (Hp) infection and CD is not fully understood. Objectives: The aim of our study was to compare the prevalence of Hp infection and gastric findings in CD children as compared to CD adults. Methods: In our retrospective study 61 children (38 Females; age range 1-16.8 years; median age: 7.1 years) and 60 adults (43 Females; age range 18-74 years; median age: 35.5 years) with CD were evaluated. 65 children and 74 adults were chosen as control group age and sex matched. Diagnosis of Hp infection was based on positivity to histology and rapid urea test. Results: All celiac enrolled were positive for EMA and/or tTG antibodies. Hp infection was diagnosed in two children and ten adults (3.3% vs. 17.5%; p<0.02). Hp infection was less frequent in celiac patients compared to the control groups, in both children and adults (p=0.005 and p=0.4, respectively). The gastric involvement in celiac patients without Hp infection was more frequent both in children (66.1% vs 11.8%; p<0.0001) and in adults (22.5% vs 16%, p= 0.3) with respect to Hp-negative controls. Discussion and Conclusion: In conclusion, in our study we confirmed that the stomach can be involved in celiac disease both in children and adults. Sometimes, Hp infection coexists with CD diagnosis, particularly in celiac adults that can present some specific clinical findings.