Specific conditions: Children

Abstract

Helicobacter pylori (H. pylori) infection is usually acquired during childhood, causing various diseases even in children. When applying diagnostic tests to children suspected of H. pylori infection, there are some differences between children and adults, although endoscopy with biopsies is also recommended for the initial diagnosis of H. pylori infection in children. On endoscopy, nodular gastritis is a pathognomonic gross finding of childhood H. pylori infection. On histopathology of gastric tissues, infiltration of lymphocytes and plasma cells and formation of mucosa-associated lymphoid tissue are the prominent features in children. Noninvasive diagnostic methods are also available and well validated in children. Both the 1 3C-urea breath test (UBT) and the H. pylori stool antigen test based on the enzyme immunoassay using monoclonal antibody are reliable in identifying H. pylori status before and after therapy. However, when applying UBT to children younger than 6 years, test results should be interpreted cautiously because they tend to have high false positives. Serologic tests or urine tests are not recommended in children because of low diagnostic accuracy.