Related Experiment Videos
[Helicobacter infection in children]
H Bodánszky1, A Arató, L Szónyi
1Altalános Orvostudományi Kar, I. Gyermekklinika, Semmelweis Egyetem, Budapest.
Insights
Helicobacter pylori (H. pylori) infection in children causes chronic gastritis, rarely ulcers, and eradication heals these conditions. H. pylori gastritis alone is not linked to abdominal pain without ulcers.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Infectious Diseases
Background:
- Helicobacter pylori (H. pylori) is a common infection in children.
- H. pylori causes chronic gastritis and, less frequently, peptic ulcer disease in pediatric patients.
- The link between H. pylori gastritis and abdominal pain in children is primarily associated with the presence of ulcers.
Purpose of the Study:
- To establish consensus on the role of H. pylori infection in pediatric gastrointestinal conditions.
- To define diagnostic and treatment approaches for H. pylori in children.
- To identify areas requiring further research regarding H. pylori gastritis and symptom correlation.
Main Methods:
- Consensus meeting involving experts in pediatric gastroenterology.
- Review of existing evidence on H. pylori in children.
- Discussion on diagnostic methods including endoscopy with biopsies and non-invasive tests like the 13C-urea breath test.
Main Results:
- H. pylori infection causes chronic gastritis in children, with rare instances of gastric and duodenal ulcers.
- Eradication of H. pylori leads to the healing of gastritis and ulcer disease.
- Abdominal pain in children is not definitively linked to H. pylori gastritis unless an ulcer is present.
- Investigation for H. pylori is recommended for symptoms suggestive of organic disease, after excluding other causes.
Conclusions:
- H. pylori eradication cures gastritis in children, but symptom relief is proven only in cases of ulcer disease.
- Further research is needed to determine specific symptoms of H. pylori gastritis alone and the benefits of therapy in asymptomatic children.
- Optimal H. pylori treatment strategies in children require further study due to insufficient data.
Abstract:
Consensus was achieved on the following issues: in children H. pylori infection causes chronic gastritis, but rarely gastric and duodenal ulcer disease. Eradication of H. pylori leads to healing of these conditions. To-date, there is no evidence demonstrating a link between H. pylori gastritis and abdominal pain except in those children where a gastric or duodenal ulcer is present. Children should be investigated for H. pylori infection only if their symptoms are suggestive of organic disease rather than functional abdominal pain. Endoscopy with biopsies is the optimal method to investigate a child with upper gastrointestinal symptoms suggestive of organic disease but this should only be carried out when a diagnostic work up using non-invasive methods has excluded other causes such as lactose maldigestion, constipation, coeliac disease, liver or biliary tact disease. If H. pylori is identified through investigations carried out during endoscopy the infection should be treated. Treatment should be monitored with a reliable non-invasive test and the 13C-urea breath test is the preferred method. H. pylori eradication in such children will cure gastritis but there is no data to support a relationship between a cure of H. pylori gastritis and symptom relief except in patients with ulcer disease. Further studies are needed to establish whether there are any specific symptoms associated with H. pylori gastritis alone and whether infected children without ulcer disease benefit from anti-H. pylori therapy regarding their symptoms. This consensus meeting did not deal with the optimal therapy for H. pylori infection as there are insufficient studies concerned the best treatment in children.