Best Practice Helicobacter Pylori Infection in Paediatric Practice

Correspondence to: Dr David I Campbell, Queen Elizabeth Hospital, Children’s Department, Sheriff Hill, Gateshead NE9 6SX, UK; [email protected] _________________________ T his article summarises the epidemiology and pathophysiology of Helicobacter pylori related disease in childhood, to enable the general paediatrician to develop an informed and evidence based approach to management. H pylori is a unique bacterial pathogen: c it is widespread, so that around 50% of people throughout the world are colonised c it occupies an inhospitable niche (H pylori survives gastric acidity even down to pH of , 2) c colonisation is chronic and may be lifelong. H pylori was first conclusively identified as a human pathogen, and an aetiological agent of acute gastritis, in 1984. The discovery that this bacterium is the cause of most peptic ulcer related disease in adult life has been arguably the most important advance in gastroenterology in recent decades. Approximately 0.5% of the UK population (around 290 thousand people, 20% of all general practice workload) are on long term acid suppression because of peptic ulcer related disease attributable to chronic H pylori infection.