par Bontems, Patrick ;Cadranel, Samy
Référence Acta endoscopica, 28, 3, page (213-220)
Publication Publié, 1998
Article révisé par les pairs
Résumé : The prevalence of Helicobacter pylori infection is very high in the developing world where primary infection is acquired during early infancy. It may play a role as aggravating factor of malnutrition. Its incidence during childhood is decreasing in industrialised countries. In children, peptic ulcers are rare whereas chronic gastritis is common. A typical micronodular endoscopic aspect of the antrum is frequently observed, together with lymphoid folicles. Other characteristics include a low serologic response, probably due to immunologic immaturity. Symptomatogy is versatile and, in many cases can be silent whereas in small children it may present with vomiting and perhaps diarrhoea. The non-invasive 13C-urea breath test is particularly indicated in children and has been simplified and validated as a reliable diagnostic tool. Emerging resistant strains are a problem of concern, especially in Africa. Although treatment has not yet been standardised, triple therapy including proton pump inhibitors is recommended but controlled studies, rare in this age group are necessary.