Helicobacter pylori in children

Abstract

Helicobacter pylori infection in early childhood may differ in many aspects compared to infection in adulthood: the immune response in the gut, the type and prevalence of complications within and outside the stomach, and the impact on long-term health. In high prevalence countries, transient infections seem to be common in infants and toddlers, and the consequences of this phenomenon on the short- and long-term immune response are still unclear. Other controversial issues are related to the question of which H. pylori-infected children benefit from treatment and which is the best regimen to eradicate the infection in the presence of a worldwide increasing antibiotic resistance. The first large-scale randomized placebo-controlled vaccination trial in schoolchildren indicates that prevention of the infection may be possible.

No association between Helicobacter pylori infection and gastrointestinal complaints in a large cohort of symptomatic children

“…Our results were in line with other studies from different counties. They also support the latest 2017 guidelines about Helicobacter pylori diagnosis and treatment in children, which were developed by both the European and the North‐American Society of Paediatric Gastroenterology, Hepatology and Nutrition . The lack of an association between symptoms and Helicobacter pylori positivity, along with the evidence for decreasing the prevalence of Helicobacter pylori , confirm that the regional and national situation in Poland is similar to most high‐income countries.…”

“…There was no difference in age between Helicobacter pylori positive and negative children or between the prevalence of the infection among three‐ to five‐year‐olds and six‐ to 18‐year‐olds. However, this difference has been reported by various authors . It should be pointed out that most of these studies were based on serological testing and the increasing prevalence with age may have been a consequence of the methods that were applied .…”

“…Other causes, such as functional abdominal pain disorders, are more common . Nevertheless, abdominal pain can sometimes be caused by peptic ulcer disease, erosive gastritis or duodenitis, which can develop as a consequence of the Helicobacter pylori infection . This Gram‐negative bacterium has been classified by the Agency for Research for Cancer as a first‐class carcinogen since 1994 .…”

“…Even though infections without macroscopic inflammatory changes of the gastric mucosa are predominantly asymptomatic , caregivers, as well as physicians, frequently insist upon a diagnostic test for the Helicobacter pylori infection. This fact may partially result from the different prevalence of Helicobacter pylori, as well as the considerably broader indications for eradication in the adult population.…”

“…Most importantly, complications such as peptic ulcer disease only develop occasionally in children, compared to the adult population, and it is extremely rare for children to develop Helicobacter pylori ‐related gastric cancer . The majority of children are asymptomatic even when they are infected with Helicobacter pylori , and the disease does not play a role in functional abdominal disorders . Moreover, scientific data have suggested that having this infection in early childhood might be immunologically beneficial in later life .…”