Chronic Helicobacter pylori (H. pylori) infection is an important cause of gastrointestinal disease in both adults and children.
However, severe ulcers or gastroduodenal ulcers are much less common in children than in adults. When complications arise, most children will show warning signs.
Therefore, screening, diagnosis and treatment of H. pylori in children are very different from those in adults.
I/ WHEN SHOULD CHILDREN BE TESTED FOR H.PYLORI?
- When children have epigastric pain with warning symptoms:
- Losing weight
- Vomiting
- Waking up at night with stomach pain
- Hidden blood in stool
2. Families with parents or siblings with stomach cancer.
3. Children diagnosed with MALT TUMOR
4. Consider testing if the child has chronic immune thrombocytopenic purpura or iron deficiency anemia that does not respond to treatment.
II/ WHICH TEST SHOULD BE CHOSEN TO DIAGNOSE H.PYLORI INFECTION IN CHILDREN?
Invasive tests: Gastroduodenoscopy
Although it is an invasive method, endoscopy is recommended for diagnosing H.pylori in children rather than other tests. Because it helps We diagnose correctly when:
- Direct observation of lesions
- Take samples to identify bacteria
- Antibiotic resistance testing to choose the right drug
Non-invasive tests include:
- Urea Breath Test
- Finding H.pylori antigen in stool
- Blood test for HP antibodies – less accurate, cannot distinguish between past and current infection.
Noninvasive testing may be used when a patient has a family history of stomach cancer or to check for eradication after treatment for H. Pylori infection.
III/ IMPORTANT NOTES WHEN TREATING H.PYLORI IN CHILDREN?
- Treatment should only be given when clearly indicated and should be carefully considered because:
- The child was given a two-week course of multiple antibiotics.
- Choosing antibiotics for children is difficult because many antibiotics cannot be used for children, and those that can be used have high resistance rates in Vietnam.
- So when deciding to treat H. pylori, parents need to help their children take the right dose of medicine at the right time. for 2 weeks for best results.Overdose increases the risk of treatment failure and drug resistance.
- Treatment failure rates can be as high as 20%. Re-infection rates are also high, especially in young children and in countries with high infection rates like ours.
- Need tFollow-up visit after 4 weeks to check whether H.pylori has been eradicated by breath test or stool test.
