HELICOBACTER-PYLORI GASTRIC INFECTIONS IN CHILDREN

Variable incidence: Helicobacter pylori infection is frequent in child ren. its incidence in Europe is approximately 6% in children from 6 to 16 years of age and varies with their socio-economic level and nutrit ional status. In Africa, it may be as high as 46% and reaches up to 75 % in certain institutions. Clinical manifestations: Clinical expressio n of H. pylori infection is still under debate. Vomiting, dyspepsia an d acute pain related to ulcer disease are certainly linked to H. pylor i, whereas its role in chronic abdominal pain gives rise to contradict ory reports. Diagnostic tools: Direct isolation of the bacteria is cla ssically obtained from perendoscopic antral biopsies followed by cultu re and histology. Noninvasive diagnostic methods are more widely used in children. IgG serodiagnosis is reproductible and easy only in older children. The 13-carbon urea breath test is sensitive and specific an d seems perfectly suitable in pediatrics. DNA ampliciation techniques (PCR) remain experimental bur appear promising. Therapeutic trends: Tr iple therapy using amoxicillin or macrolide/metronidazole or tinidazol e/bismuth salts or anti-secretory agents are recognized as the most ef ficient combination regimen.