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What is the treatment of Helicobacter Pylori in the pediatric population? Do they need further radiological investigation? While H Pylori is not uncommon in children, pathological sequelae are considerably less when compared to adults. Diagnostic tests and treatment therefore should be employed judiciously and reserved for those who are most likely to derive measurable benefit, such as those likely to have peptic ulcer disease. This diagnosis is made difficult because the symptoms of H Pylori-related disease in children are nonspecific and may include epigastric pain, unexplained nausea or recurrent vomiting, unexplained anorexia, hematemesis and iron deficiency anemia. There are no data on symptoms in children under the age of 5 years. In terms of investigation; serology for H Pylori antibodies has low specificity and sensitivity in children, barium studies have a high false positive rate for peptic ulcer disease and the most optimal approach is upper gastrointestinal endoscopy with multiple biopsies. Treatment in children should only be considered after H Pylori infection has been confirmed by appropriate testing for an appropriate indication. First line treatment is a two week course of twice daily, triple-drug regimen comprising a proton pump inhibitor plus two antibiotics (e.g. clarithromycin and amoxicillin). Reference:Sherman P et al. Canadian Helicobacter Study Group Consenus Conference in Children and Adolescents. Can J Gastroenterol 1999;13:553-559.
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