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Helicobacter pylori: a cause of chronic abdominal pain in children
Insights
Chronic recurrent abdominal pain in children often has non-organic causes. However, Helicobacter pylori (H. pylori) infection is a potential organic cause that requires multiple drug therapy for eradication.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
Background:
- Chronic recurrent abdominal pain affects approximately 10% of children.
- Most cases are non-organic, but organic causes must be ruled out.
Observation:
- Helicobacter pylori (H. pylori) infection is a newly considered organic cause of pediatric abdominal pain.
- H. pylori are gram-negative bacilli with specific morphological characteristics.
- The natural reservoir and transmission routes of H. pylori remain unknown.
Findings:
- H. pylori infection is now part of the differential diagnosis for chronic abdominal pain in children.
- Effective eradication of H. pylori necessitates combination drug therapy.
Implications:
- Universal precautions are recommended for suspected H. pylori cases pending further epidemiological data.
- Accurate diagnosis and treatment of H. pylori can improve outcomes for children with chronic abdominal pain.
Abstract:
Approximately one in ten children are seen by a health care professional for a complaint of chronic recurrent abdominal pain. In most cases these complaints are non-organic. Organic causes of abdominal pain may include gastroesophageal reflux, peptic ulcer disease, gallbladder, pancreatic or kidney disease. In addition, infection of the gastric antrum with Helicobacter pylori is now included in the differential diagnosis of chronic abdominal pain in children. H. pylori are "S" or "C" shaped, gram negative bacilli with a smooth outer coat and two to four unipolar flagella. There is no known natural reservoir for H. pylori in the environment. The mode of transmission is also unknown. Multiple drug therapy is necessary to maintain long-term eradication of the organism. Until epidemiologic data are determined, universal precautions should be employed in cases of suspected H. pylori infection.