Helicobacter pylori infection in children: update

Despite its worldwide distribution, the pathogenesis of Helicobacter pylori associated gastroduodenal disease remains poorly understood. What is clear is that H. pylori infection rarely resolves spontaneously and that the chr onic gastritis that accompanies infection is typically maintained for the d uration of infection. Ultimately, if untreated, this chronic inflammation p redisposes a subset of individuals to develop gastric or duodenal ulcers an d even gastric cancer. Chronic long-lasting H. pylori infection, particular ly when acquired early in childhood, can predispose an individual to a sign ificantly increased risk of developing gastric cancer. These studies were s o compelling that the World Health Organization has recently classified H. pylori as a type 1 human carcinogen. Since the discovery of H. pylori less than 20 years ago, this infection has continued to generate considerable in terest in the medical and scientific community. As we enter the new milleni um, there are now a number of effective treatments for children in whom H, pylori-associated peptic ulcer disease is diagnosed. Although there is now overwhelming evidence to confirm that H. pylori plays an etiologic role in the development of peptic ulcer disease, only a small number of these child ren develop H. pylori disease. In this review, we highlight some of the rec ently published pediatric studies addressing the role H. pylori plays in th e development of gastroduodenal disease in children. (C) 2000 Lippincott Wi lliams & Wilkins, Inc.