[Helicobacter pylori. Part II. Epidemiology, diagnosis, and treatment]

In recent years, the diagnosis of Helicobacter Pylori (HP)-mediated infection has become increasingly important not only in adults but also in children. Factors such as residence in a country with low social and economic standards and the presence of HP-positive family members underscore the widely-acknowledged fact that the incidence of HP infection tends to increase with age both in children (where the increase is roughly 1% per year) and in adults, where it reaches values of 50% in the industrialized nations and 80% in developing countries. This has led to research aimed at developing more accurate and less invasive diagnostic techniques that can be used in children as well. Also, the development of simple, cost-effective diagnosis is all the more important given the widespread occurrence of HP infection, particularly in the developing countries. The techniques employed range from the classical histological and culture examination, which involves esophagogastroduodenoscopy (a rather invasive technique), to serology and the Urea Breath Test with 13C. Also, the feasibility of tracing HP antigens in the faeces, a non-invasive and simple technique, is under investigation. As for therapy, there is as yet no unanimous agreement about when to start treatment, about which antibiotics (beta-lactams, macrolides and nitro-imidazoles) to use in association, about their effect on the gastric mucosa, nor, indeed, about the treatment routines to be followed in adults and children.