By: Sarah Abu-Alreesh, MD, FAAP & Anthony Porty, MD, MPH, FAAP
Helicobacter pylori (H. pylori) is a bacterium that can cause an infection in your child's stomach. H. pylori infection can cause inflammation in the lining of the stomach, known as gastritis, and peptic ulcers (sores) in the stomach and duodenum (the first section of the small intestine).
How does H. pylori spread?
No one is certain how H. pylori is transmitted. However, person-to-person contact could play a role. So could transmission through contaminated food and water. H. pylori infections occur at a low rate among U.S. children, but it may infect more than 75% of children in low- and middle-income countries.
Signs & symptoms of H. pylori infection
When
H. pylori causes an ulcer, the intensity of the symptoms can vary. In some cases, there will be no symptoms at all.
Ulcers can cause a burning or gnawing pain in upper area of abdomen that may come and go. The pain can be aggravated by meals if the ulcer is in the stomach. Or, it can be relieved by meals if the ulcer is in the duodenum. Pain can occur during the night.
Other H. pylori symptoms may include:
When to call your pediatrician
Contact your pediatrician if your child:
Has burning stomach pain that is aggravated or relieved by meals.
Has persistent abdominal pain, vomiting, loss of appetite, or weight loss
Has bloody stools or bloody vomit
How is h. pylori infection diagnosed?
Your pediatrician will take a medical history of your child. They may also perform some simple tests. Your pediatrician may sometimes refer your child to a pediatric gastroenterologist for evaluation and additional tests needed to diagnose an
H pylori infection.
Tests to diagnose H. pylori infection include:
Upper endoscopy with biopsy: An endoscope is a evice that allows the doctor to view the stomach and duodenum, identify location of an ulcer, and visualize the degree of inflammation caused by
H. pylori. A small piece of tissue (a biopsy) from the stomach is obtained through the endoscope, which is threaded down the throat to the stomach. The tissue sample is then examined under the microscope and tested for evidence of
H. pylori infection.
Non-invasive testing can also be done. This may include analyzing a stool sample to check for an H. pylori-specific protein. Or, a breath test can detect carbon dioxide released by a product made by
H. pylori.
Blood tests to detect presence of
H. pylori antibodies have limited accuracy and are not recommended.
Treatment of ulcers from H. pylori infection
Typically, doctors only prescribe treatment for
H pylori infections if they have progressed to an actual ulcer. Combinations of antibiotics such as amoxicillin, clarithromycin and metronidazole can be taken by your child to kill the bacteria.
Make sure your child takes the full course of these antibiotics as directed by your pediatrician for the treatment to be effective and to prevent antibiotic resistance. Antibiotics are usually prescribed in combination with drugs called proton pump inhibitors that interfere with the production of acid in the stomach (antacids).
After treatment is completed, non-invasive tests such as a stool antigen or breath test is done again to ensure resolution of the infection.
Most of the time
H. pylori infection is cleared by treatment, but sometimes it can persist. This will require more medications and a different regimen of antibiotics.
What is the prognosis for H. pylori?
Overall, the outlook for a child with an H. pylori infection is good. After treatment with antibiotics, reinfection may occur in approximately 20% or more of patients. Untreated
H pylori infection increases the risk of developing stomach cancer later in life.
How to prevent H. pylori infection
Spread of H. pylori infections can be prevented with good hand hygiene including washing hands before you eat or after using the bathroom. There are no other ways to prevent
H. pylori infection. However, a vaccine that could someday prevent the infection is currently being researched.
More information
About Dr. Porto
Anthony Porto, MD, MPH, FAAP is a board-certified pediatrician and board-certified pediatric gastroenterologist. He is an Associate Professor of Pediatrics and Associate Clinical Chief of Pediatric Gastroenterology at Yale University and Director, Pediatric Gastroenterology at Greenwich Hospital in Greenwich, CT. He is also the medical director of the Yale Pediatric Celiac Program. Within the American Academy of Pediatrics, Dr. Porto sits on the PREP Gastroenterology Advisory Board and is a member of the Section on Gastroenterology, Hepatology and Nutrition. He is also a member of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition's Public Education Committee, a pediatric expert on nutrition for The Bump's Real Answers, and is the co-author of
The Pediatrician's Guide to Feeding Babies and Toddlers. Follow him on Instagram
@Pediatriciansguide. |
About Dr. Abu-Alreesh
 Sarah Abu-Alreesh, MD, FAAP, is a Pediatric Gastroenterology, Hepatology and Nutrition Fellow at Yale University School of Medicine. Within the AAP, Dr. Abu-Alreesh is a member of the Section on Gastroenterology, Hepatology and Nutrition and the Section on Obesity.
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