New insights regarding Helicobacter pylori infection in children

Helicobacter pylori (H. pylori) are one of the most common infections during childhood, and if left untreated it might persist lifelong resulting in severe complications such as gastric malignancies. The epidemiology of this infection has wide variations along the continents, countries and sub-regions being related mainly to the socio-economic status, hygiene and sanitary conditions. Nevertheless, a descending trend of H. pylori prevalence was noticed worldwide during the last decades, fact that might decrease in time the incidence of gastric cancer in adults. The diagnosis of this infection remains tricky in children and the selection of the most effective diagnostic tool is essential in order to early diagnose H. pylori associated gastropathies and extraintestinal manifestations. In spite of the lack of symptoms which occurs especially in pediatric subjects, H. pylori infection might result in severe damage to the gastric mucosa and further complications requiring close monitoring after the eradication regimen. Therefore, multiple non-invasive and invasive methods were designed to identify properly the presence of this bacterium within the individual’s stomach and for enabling the clinician to use to most adequate method based on its sensitivity and specificity, but also based on the specific clinical situations. Aside from the well-known standard triple therapy used for the eradication of this infection, multiple other regimens were lately proposed in order to prevent failure of eradication. Moreover, probiotics were recently proved to improve the eradication rate, and at the same time to decrease the side effects of the antibiotics therapy. The proper eradication of H. pylori infection during childhood remains the cornerstone in preventing gastric cancer during adulthood.