Appropriate strategies for testing and treating Helicobacter pylori in children: When and how?

Publication date: 6 September 2004 Source:The American Journal of Medicine Supplements, Volume 117, Issue 5, Supplement 1 Author(s): Philip M. Sherman Helicobacter pylori infection is acquired primarily during childhood and carries a significant lifetime risk for morbidity. In developing countries, approximately 70% of children are infected with the bacterium by their 15th birthday. In the United States, the rate of H pylori infection among children varies widely—approximately 10% of all 10-year-olds are infected; however, this figure is substantially higher among populations of immigrant children and children born of recent immigrants to the United States. H pylori transmission is primarily “person-to-person” via fecal-oral, gastric-oral, or oral-oral routes, with evidence suggesting contaminated water as a potential source of infection. Risk factors for infection in childhood include an infected family member, having ≥2 siblings, crowded living conditions, lower socioeconomic means, and attendance at a daycare facility. The natural history of H pylori infection includes an increased lifetime risk for peptic ulcer and gastric adenocarcinoma or lymphoma. In children and adults who develop H pylori–related peptic ulcer, cure of the infection is associated with a <5% rate of ulcer recurrence. The ideal mode of H pylori detection among children is unclear—currently available serology and whole blood tests are unreliable, while the urea breath test and st...
Source: The American Journal of Medicine Supplements - Category: Drugs & Pharmacology Source Type: research