Helicobacter pylori in children: an Indian perspective
Related Experiment Video
Updated: Jul 10, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Ujjal Poddar1, Surender Kumar Yachha
1Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. ujjal@sgpgi.ac.in
Insights
Helicobacter pylori infection is common in Indian children, often asymptomatic. Treatment is recommended for H. pylori-related diseases like peptic ulcers, not just infection, using a triple-drug regimen.
Area of Science:
- Pediatrics
- Gastroenterology
- Infectious Diseases
Background:
- Helicobacter pylori infection is a significant global health concern, linked to peptic ulcer disease and gastric cancer.
- In India, H. pylori infection is highly prevalent, with most individuals infected by age 10, yet disease manifestations typically appear in adulthood.
Purpose of the Study:
- To review the epidemiology, diagnosis, and management of Helicobacter pylori infection in children, with a focus on Indian studies.
- To clarify the association between H. pylori and recurrent abdominal pain in children.
Main Methods:
- A comprehensive literature search of PubMed was conducted, focusing on randomized controlled trials, clinical trials, meta-analyses, and practice guidelines concerning H. pylori in pediatric populations.
- Emphasis was placed on including relevant Indian research to reflect regional epidemiology.
Main Results:
- H. pylori infection is highly prevalent in Indian children, particularly those from lower socioeconomic backgrounds, but remains largely asymptomatic during childhood.
- Approximately 15% of infected individuals develop peptic ulcer disease in young adulthood, and 1% develop gastric cancer later in life.
- No association was found between H. pylori infection and recurrent abdominal pain in children.
Conclusions:
- Endoscopy is the preferred diagnostic tool for children presenting with upper gastrointestinal symptoms indicative of organic disease.
- Treatment with a two-week triple-drug regimen (proton pump inhibitor and two antibiotics) is indicated for H. pylori-related diseases, not for asymptomatic infection.
Abstract:
Helicobacter pylori is causally associated with peptic ulcer disease and gastric carcinoma. Typically children get infected with this organism during the first decade of life but diseases, associated with H. pylori, are seen mainly in adults. In India, almost 80% of population is infected with H. pylori and most of them by 10 years of age. Hence, it is important for a pediatrician to know when to suspect this infection, how to investigate and how to treat it. Extensive electronic (PubMed) literature search was done for this review and literature (randomized controlled trials, clinical trials, meta-analysis, practice guidelines) related to H. pylori in children were reviewed. Special emphasis was given to Indian studies. From this review we can conclude that H. pylori infection is very common in Indian children especially in the low socioeconomic status but most infected children remain asymptomatic through out their childhood and about 15% develop peptic ulcer disease as young adults and 1% develop gastric cancer in older age. There is no association, what so ever, of H. pylori infection and recurrent abdominal pain (RAP). Endoscopy is the preferred method of investigation in children with upper digestive symptoms suggestive of organic disease. Children with H. pylori related disease (peptic ulcer, primary gastric B-cell lymphoma and atrophic gastritis with intestinal metaplasia) but not mere H. pylori infection should be treated with the triple drug regimen comprising of proton pump inhibitor (PPI) and two antibiotics for two weeks.
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