Helicobacter pylori infection in children: update

Despite its worldwide distribution, the pathogenesis of Helicobacter pylori associated gastroduodenal disease remains poorly understood. What is clear is that H. pylori infection rarely resolves spontaneously and that the chronic gastritis that accompanies infection is typically maintained for the duration of infection. Ultimately, if untreated, this chronic inflammation predisposes a subset of individuals to develop gastric or duodenal ulcers and even gastric cancer. Chronic long-lasting H. pylori infection, particularly when acquired early in childhood, can predispose an individual to a significantly increased risk of developing gastric cancer. These studies were so compelling that the World Health Organization has recently classified H. pylori as a type 1 human carcinogen. Since the discovery of H. pylori less than 20 years ago, this infection has continued to generate considerable interest in the medical and scientific community. As we enter the new millenium, there are now a number of effective treatments for children in whom H. pylori-associated peptic ulcer disease is diagnosed. Although there is now overwhelming evidence to confirm that H. pylori plays an etiologic role in the development of peptic ulcer disease, only a small number of these children develop H. pylori disease. In this review, we highlight some of the recently published pediatric studies addressing the role H. pylori plays in the development of gastroduodenal disease in children.