This is an automatically translated article.
The percentage of children infected with H.P. is increasing. According to the results of epidemiological investigation in 2016, the rate of H.P. infection in children in Vietnam is about 40%, and children tend to be infected with H.P very early and the rate of H.P. infection increases fastest during the period when children eat solid foods. go to kindergarten (2-6 years old). The following article guides the treatment regimen for hp gastritis in children.
Abbreviations:
PPI: Proton-pump-inhibitor (proton pump inhibitor) H.pylori, HP: Helicobacter pylori.
1. Causes and symptoms of HP infection in children
1.1 Causes The cause of H.P infection is from person to person (via mouth-to-mouth, faecal-oral, stomach-to-mouth), while children do not know how to maintain food hygiene, along with eating habits. Drinking together, adults often hugging and kissing children can also lead to children being infected with H.P. bacteria from adults.
1.2 Symptoms Most people infected with H.P. have no symptoms including adults and children.
Symptoms are most likely caused by a stomach ulcer:
Pain or discomfort in the upper abdomen, Feeling full, stomach fullness, indigestion despite eating a small amount of food, Loss of appetite, weight loss , Nausea or vomiting, Black stools, Paleness, dizziness, fatigue due to anemia.
2. Diagnosis of HP infection in children
Diagnostic criteria for peptic ulcer disease caused by Helicobacter pylori:
Diagnosis of peptic ulcer based on endoscopy. Diagnosis of gastritis is based on histopathology. Diagnosis of infection with Helicobacter pylor i : when one of the following conditions is present: Histopathology has Helicobacter pylori(+) and Urease(+) test. Culture of gastric biopsies with HP(+) bacteria. If only 1 of 2 histopathological tests and urease test (+), perform additional breath test or stool test (all ages), if positive breath test or stool test confirm Helicobacter pylori infection. Exceptions:
If family refuses endoscopy: suggest breathing test or stool test (any age) If test (-) find other cause If test (+) discuss family: Gastroscopy Treatment according to protocol 1 Children with breathing test or stool test (+), parents treated for stomach cancer or peptic ulcer => treatment according to regimen 1.
3. HP treatment regimen for children
Treatment regimen for HP in children < 8 years old:
Amoxicillin + Clarithromycin + PPI Amoxicillin + Metronidazole + PPI Treatment regimen for HP in children > 8 years old:
Amoxicillin + Clarithromycin + PPI Amoxicillin + Metronidazole + PPI Tetracycline (or) Doxycyclin + Metronidazol + PPI Dosage:
Amoxicillin: 50mg/kg/day Clarithromycin: 20mg/kg/day PPI (omeprazole): 1mg/kg/day Metronidazol: 20mg/kg/day Tetracycline: 50mg/kg/day Doxycycline: 5mg/kg/day Evaluation of effectiveness against H. Pylori:
Conduct after:
Stop antibiotics for 4 weeks Stop PPI for 2 weeks. Methods: C13 breath test or stool test
Result:
If test (-) is clear of bacteria If (+) still has bacteria, the regimen fails. In case of failure of treatment: The patient was carried out gastroscopy, urease test, histopathology, HP culture and antibiogram.
If H.pylori (+) culture and antibiogram can be done: treat according to antibiogram: combine 2 sensitive antibiotics + PPI for 2 weeks antibiotics used in regimen 1 Increase dose Prolong treatment duration Combination of Bismuth
4. How to prevent H.P infection in children?
Currently there is no vaccine to prevent H.P. To limit the spread of H.P., families need to pay attention to:
Wash hands cleanly, Ensure hygiene of food, drinking water, clean processing equipment, Avoid sharing eating utensils: share soup bowls , pick up food for each other, dip in condiments, drink from the same glass of water, prepare food for children,... Do not share toothbrushes, cups, personal hygiene items, H.P. infected adults should Limit cooking, seasoning, feeding food, and not kissing children to avoid infecting children. When should a child see a doctor?
Take your child to the doctor right away if:
Severe abdominal pain, Vomiting blood, Blood in stools, or black stools, The child has pain in the area below the ribs, the pain subsides after eating. However, it should be noted that not all stomach pain is caused by H.P. bacteria, but also by many other causes, children will need to be examined by a doctor to determine the cause.
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