Background:Helicobacter pylori infection is a ubiquitous gastric infection, seen in almost half of the world's population. Majority of them acquire the infection by the age of 10 years. However, only a small proportion become symptomatic. Methods: This narrative review examines the clinical features, histology, diagnostic approach and treatment options in children as per recent updated guidelines and comparison vis-à-vis with adult's guidelines at appropriate places. In brief; peptic ulcer disease (PUD) is a main manifestation in children. While in adults, in addition to PUD, it is associated with MALToma and distal gastric adenocarcinoma. There is no specific symptom of H. pylori disease; the evaluation is a part of all the diagnostic studies of upper GI symptoms. Confirmation requires histological presence of H. pylori in the biopsy sample along with atleast one biopsy based test (rapid urease test and PCR). On confirmation; PUD, MALToma, iron refractory iron deficiency anemia, chronic ITP requires treatment based on antimicrobial susceptibility. Eradication is confirmed by a noninvasive test such as stool antigen or C-13 urea breath test (13C-UBT test). Persistence of infection in a symptomatic child requires second line antimicrobials. Conclusion:H. pylori is becoming common infection in children with myriad presentations. Protocol based approach and planned treatment is necessary to eradicate and prevent complications.
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