What is helicobacter pylori (H. pylori)?

Helicobacter pylori (H. pylori) is a spiral-shaped bacterium that can infect the stomach and cause damage to the tissue of the stomach and first part of the small intestine. This includes inflammation and sometimes ulcers in the area it affects.

How does H. pylori cause damage?

H. pylori's is a bacteria that can weaken the stomach's protective mucous lining which allows the bacteria to damage the tissue leading to inflammation or ulcers in the stomach or duodenum (first part of the small intestine). H. pylori can also stimulate the stomach to produce more acid.

What causes an H. pylori infection?

H. pylori is an infection that is contracted from contaminated water, undercooked foods, crowded conditions and possibly from certain animals. While H. pylori exists in most countries, some countries have a higher incidence of this infection. It has been estimated that about 14% of children born in the US and about 35% of children worldwide will have this infection.

What are the symptoms of H. pylori-related ulcers?

The majority of H. pylori infections actually do not cause symptoms. Symptoms may start when ulcers form or if inflammation of the stomach lining is severe. However, each individual may experience symptoms differently.
If symptoms are present, they may include the following:

• Dull, gnawing pain, which may:
  • Occur two to three hours after a meal.
  • Come and go for several days or weeks.
  • Occur in the middle of the night when stomach is empty.
  • Be relieved by eating.
• Loss of weight.
• Loss of appetite.
• Bloating.
• Burping.
• Nausea.
• Vomiting.

The symptoms of ulcers may resemble other conditions or medical problems. Consult your child's physician for a diagnosis.

How is H. pylori diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for H. pylori may include the following:

• Tissue tests - This the most accurate way to diagnose H. pylori. With an upper endoscopy (EGD) with biopsies we can take small superficial biopsies to examine the stomach tissue and see if the H. pylori bacteria is present. This can sometimes help us determine what medications will best treat the infection.         
• Other tests, including:
  • Stool test – to identify the bacterium (antigen). This test is usually used to see if the infection has cleared but can sometimes be used to diagnose the infection in specific situations.
  • Breath tests –While these test can be used, breath tests are often not offered at pediatric centers as it can be difficult for pediatric patients to participate in this testing and results are not always accurate.

Treatment for H. pylori ulcers:

Specific treatment will be determined by your child's physician based on the following:

• Your child's age, overall health and medical history.
• Your child's tolerance for specific medications, procedures or therapies.
• The expectations for the course of the disease.
• Your opinion or preference.

Treatment of H. pylori typically requires 3-4 medications for a 14 day period. The treatment is a combination of antibiotics and medication that suppress stomach acid to treat symptoms and kill the H. pylori bacteria that causes the symptoms and inflammation.