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Helicobacter pylori Gastritis and Peptic Ulcer Disease

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Textbook of Pediatric Gastroenterology, Hepatology and Nutrition

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Abstract

The majority of the Helicobacter (H.) pylori-infected population remains asymptomatic, but some individuals may develop chronic gastritis, peptic ulcer, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or even carcinoma. Factors determining the subset of infected individuals who will develop the disease compared to asymptomatic carriers remain unclear and include interplay between H. pylori virulence factors and host immunity. H. pylori infection differs between pediatric and adult patients in many aspects including prevalence of the infection, the complication rate, and the near-absence of gastric malignancies. Testing for H. pylori in children should be performed in properly selected patients. Current recommendations for children do not approve “test and treat” approach recommended for adults. Diagnostic procedures should aim to determine underlying disease and not to detect H. pylori. Although noninvasive tests yield high sensitivity and specificity, endoscopy with histopathology remains the only method that can detect lesions associated with the infection, and also other possible causes of the patient’s symptoms. If properly diagnosed, first-line eradication therapy has three different regimens which include triple therapy with a proton pump inhibitors (PPI) and amoxicillin and imidazole or clarithromycin, bismuth salts with amoxicillin and imidazole, or sequential therapy. Assessment of eradication should be performed with noninvasive test at least 4–8 weeks following completion of therapy.

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Abbreviations

13C-UBT:

13C-urea breath test

BabA:

Blood antigen-binding adhesin

CagA:

Cytotoxin-associated gene A

COX-1:

Cyclooxygenase-1

ELISA:

Enzyme-linked immunosorbent assay

ESPGHAN:

European Society of Pediatric Gastroenterology, Hepatology, and Nutrition

FISH:

Fluorescence in situ hybridization

H. pylori :

Helicobacter pylori

MALT:

Mucosa-associated lymphoid tissue

NASPGHAN:

North American Society for Pediatric Gastroenterology Hepatology, and Nutrition

NSAIDs:

Nonsteroidal anti-inflammatory drugs

PAMPs:

Pathogen-associated molecular patterns

PPI:

Proton pump inhibitors

PRRs:

Pattern recognition receptors

VacA:

Vacuolating cytotoxin A

WB:

Western blot

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Authors and Affiliations

  1. Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, University of Zagreb School of Medicine, Klaićeva 16, 10000, Zagreb, Croatia

    Iva Hojsak

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  1. Iva Hojsak
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Correspondence to Iva Hojsak .

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Editors and Affiliations

  1. Department of Pediatrics, University of Chicago, Chicago, Illinois, USA

    Stefano Guandalini

  2. Clinical Director Child Health King’s College Hospital, Professor and Director Pediatric Liver, GI and Nutrition Center, London, United Kingdom

    Anil Dhawan

  3. Department of Pediatrics, Hebrew University Hadassah Hospital, Jerusalem, Israel

    David Branski

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Hojsak, I. (2016). Helicobacter pylori Gastritis and Peptic Ulcer Disease. In: Guandalini, S., Dhawan, A., Branski, D. (eds) Textbook of Pediatric Gastroenterology, Hepatology and Nutrition. Springer, Cham. https://doi.org/10.1007/978-3-319-17169-2_12

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  • DOI: https://doi.org/10.1007/978-3-319-17169-2_12

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