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World J Gastroenterol. Nov 7, 2010; 16(41): 5181-5194
Published online Nov 7, 2010. doi: 10.3748/wjg.v16.i41.5181
Consequences of Helicobacter pylori infection in children
Lucia Pacifico, Caterina Anania, John F Osborn, Flavia Ferraro, Claudio Chiesa
Lucia Pacifico, Caterina Anania, Flavia Ferraro, Department of Pediatrics, Sapienza University of Rome, 324, I-00161 Rome, Italy
John F Osborn, Department of Public Health Sciences, Sapienza University of Rome, I-00185 Rome, Italy
Claudio Chiesa, Department of Molecular Medicine, National Research Council, I-00133 Rome, Italy
Author contributions: Pacifico L, Anania C and Chiesa C designed the study; Anania C and Ferraro F were responsible for the review of the literature and the initial preparation of the paper; Osborn JF analyzed the data; Pacifico L and Chiesa C prepared the final version of the manuscript.
Correspondence to: Claudio Chiesa, MD, Department of Molecular Medicine, National Research Council, Via del Fosso del Cavaliere, 100, I-00133 Rome, Italy.
Telephone: +39-6-49979215 Fax: +39-6-49979216
Received: May 20, 2010
Revised: June 21, 2010
Accepted: June 28, 2010
Published online: November 7, 2010

Although evidence is emerging that the prevalence of Helicobacter pylori (H. pylori) is declining in all age groups, the understanding of its disease spectrum continues to evolve. If untreated, H. pylori infection is lifelong. Although H. pylori typically colonizes the human stomach for many decades without adverse consequences, children infected with H. pylori can manifest gastrointestinal diseases. Controversy persists regarding testing (and treating) for H. pylori infection in children with recurrent abdominal pain, chronic idiopathic thrombocytopenia, and poor growth. There is evidence of the role of H. pylori in childhood iron deficiency anemia, but the results are not conclusive. The possibility of an inverse relationship between H. pylori and gastroesophageal reflux disease, as well as childhood asthma, remains a controversial question. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae.

Keywords: Helicobacter pylori, Children, Gastrointestinal diseases, Epigastric pain, Anemia, Growth retardation, Chronic idiopathic thrombocytopenic pupura