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Current controversies associated with Helicobacter pylori infection in the pediatric population
1Research Institute, Division of Gastroenterology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Canada. sherman@sickkids.ca
Insights
Helicobacter pylori (H. pylori) infection is a likely cause of unexplained iron deficiency anemia in children. However, more evidence is needed to link H. pylori to other childhood conditions.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Helicobacter pylori is a known human gastric pathogen.
- Reports suggest H. pylori may cause extra-intestinal issues in children.
- Koch's postulates are fulfilled for H. pylori causing ulceration.
Purpose of the Study:
- To review the English literature on H. pylori's role in childhood conditions.
- To assess the evidence linking H. pylori to extra-intestinal manifestations in children.
Main Methods:
- Systematic review of the English language literature.
- Analysis of studies investigating H. pylori and pediatric health outcomes.
Main Results:
- Evidence suggests H. pylori is a likely cause of unexplained iron deficiency (sideropenic) anemia in children.
- This association exists even without gastrointestinal bleeding.
- Evidence is insufficient to link H. pylori to recurrent abdominal pain, short stature, diarrhea, or SIDS in children.
Conclusions:
- H. pylori is strongly implicated in pediatric iron deficiency anemia.
- Further research is necessary to establish H. pylori as a cause for other pediatric conditions.
Abstract:
Helicobacter pylori is a human bacterial gastric pathogen, fulfilling each of Koch's postulates for causal inference for ulceration in children and adults. In addition many reports purport to show that the organism causes a variety of extra-intestinal manifestations in children. This review of the English language literature provides evidence that H. pylori is likely a cause of unexplained iron deficiency (sideropenic) anemia in children, even in the absence of gastrointestinal bleeding. Much stronger evidence is required however, before H. pylori infection can be considered as an etiologic agent in recurrent abdominal pain of childhood, unexplained short stature, protracted diarrhea in pre-schoolers and sudden infant death syndrome.