[Helicobacter pylori infection in pediatrics. Present knowledge and practical problems]

Area of Science:

• Pediatrics
• Infectious Diseases
• Gastroenterology

Background:

• Helicobacter pylori (H. pylori) infection is prevalent globally, acquired in childhood, with higher rates in developing countries (70%) versus developed nations (5-15%).
• The exact transmission routes (oral-oral, fecal-oral, gastro-oral) remain undetermined.
• H. pylori infection is linked to recurrent abdominal pain in children with gastritis or ulcers.

Purpose of the Study:

• To review the epidemiology, diagnosis, and clinical manifestations of H. pylori infection in children.
• To discuss the potential long-term consequences and future eradication strategies.

Main Methods:

• Diagnosis involves invasive endoscopic tests or non-invasive methods like serum IgG antibody measurement or the 13C-urea breath test.
• Endoscopy with biopsy is standard for assessing gastritis/ulcer severity but challenging in children.
• Non-invasive tests are suitable for pediatric H. pylori diagnosis.

Main Results:

• H. pylori infection is associated with gastritis, ulcers, and potentially extraintestinal issues like anemia and growth retardation in children, though the latter are debated.
• Early childhood infection may lead to chronic atrophic gastritis and gastric cancer later in life.

Conclusions:

• Non-invasive diagnostic methods are preferred for H. pylori detection in children.
• Future strategies may involve widespread eradication and immunization programs.
• Standard eradication regimens include acid secretion inhibitors and two antibiotics for 7-10 days.