Portal de Periódicos da CAPES

Helicobacter pylori infection: Detection, investigation, and management

2005; Elsevier BV; Volume: 146; Issue: 3 Linguagem: Inglês

10.1016/j.jpeds.2004.11.037

1097-6833

Steven J. Czinn,

Eosinophilic Esophagitis

H pylori is an important human pathogen that is a significant source of gastroduodenal disease in adults as well as children. Overall, approximately one half of the world's population is infected with the bacterium, with acquisition of the infection commonly occurring before age 10 and in some developing populations before age 6 years. Person-to-person transmission occurs through several routes, oral-oral, gastric-oral, and fecal-oral, and may occur through contaminated water and/or air. Children living in low socioeconomic, crowded conditions with infected household members are at greatest risk of acquiring the infection and may transmit the infection to their siblings. Specific symptoms suggestive of H pylori infection are vague, inconsistent, and similar to several other more common childhood disorders, manifesting as recurrent abdominal pain, dyspepsia, or epigastric pain. Generally, one does not investigate for H pylori unless the child has symptoms suggestive of an ulcer. Although several noninvasive tests have been evaluated, endoscopy with gastric biopsy is, at present, considered the gold standard to confirming the diagnosis of H pylori. Despite the lack of clinical evidence, the clinical trend has been to more aggressively test children for the presence of H pylori and to treat those children who are found to have the infection. H pylori infection can be eradicated by antimicrobial therapy, but no treatment regimen is 100% effective, and the multiple drugs, frequent dosing, and length of treatment often contribute to poor patient compliance, and antibiotic eradication therapy is associated with increasing drug resistance.