The aim of this study was to evaluate observed changes in the prevalence of biopsy-proven Helicobacter pylori infection in Korean children with functional recurrent abdominal pain during the past 18 years.

Between July 1991 and December 2008, 1,194 children with functional recurrent abdominal pain (499 males and 695 females) 9.2±3.1 years of age were included. Upper gastrointestinal endoscopies were performed in all patients. H. pylori infection was assessed by the CLO test. Changes in the prevalence of the endoscopic diagnosis of H. pylori infection during 18 years were analyzed.

The prevalence of H. pylori infection between 1991 and 1993, 1994 and 1996, 1997 and 1999, 2000 and 2002, 2003 and 2005, and 2006 and 2008 were 25.1% (56/223), 23.1% (45/195), 19.3% (28/145), 16.1% (39/242), 11.3% (24/213), and 10.8% (19/176), respectively; these serial decreases in the prevalence over 18 years were statistically significant (p<0.001). Regardless of gender and age, the prevalence of H. pylori infection decreased. This decrease was inversely related to socioeconomic improvement as represented by the per capita gross national income growth of Korea.

The prevalence of H. pylori infection has decreased significantly for the past 18 years in Korean children. This decrease might be caused by an improvement in socioeconomic status.