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Helicobacter pylori

Helicobacter pylori. Ricardo A. Caicedo, M.D . Pediatric Gastroenterology. 2005 Nobel Prize for Medicine. J.R. Warren & B. Marshall. Infects > 50% humans Most are asymptomatic 10-15% will develop PUD Almost always acquired in childhood Risk factors Infected family member

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Helicobacter pylori

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  1. Helicobacter pylori Ricardo A. Caicedo, M.D. Pediatric Gastroenterology

  2. 2005 Nobel Prize for Medicine J.R. Warren & B. Marshall

  3. Infects > 50% humans Most are asymptomatic 10-15% will develop PUD Almost always acquired in childhood Risk factors Infected family member Crowded living conditions Lower socioeconomic status Daycare Immigrant/international adoptee Transmission Fecal-oral Oral-oral Within famililes The Dreaded Helicobacter CzinnS (2005) J. Pediatr 146: S21-26

  4. Why care about H. pylori infection? • - Peptic ulcer disease • Atrophic gastritis: precursor to gastric • adenocarcinoma or MALT lymphoma • - Iron deficiency anemia • - Growth retardation (possible association)

  5. Diagnosis • Indications for testing • DU or GU • Endoscopically dx’d • Radiographically definitive • MALT lymphoma • Follow-up of documented H. pylori disease • Not recommended • Asymptomatic children • Recurrent abdominal pain without documented PUD • Family hx of gastric cancer or recurrent PUD Gold Std Gold BD et al.(2000) NASPGHAN GuidelinesJPGN 31: 490-97.

  6. Treatment • Indications • DU/GU with Hp on bx • Prior hx DU/GU with active Hp • Atrophic gastritis w/intestinal metaplasia + Hp • Judgement call: • Hp+ gastritis w/o PUD • Not recommended • Asymptomatic child + family member w/Hp, PUD, or gastric cancer • Hp+ child with nonulcer dyspepsia or functional abdominal pain CzinnS (2005) J. Pediatr 146: S21-26

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