A child with a sore tummy is a miserable little one indeed. There is nothing worse than witnessing a child staring wide-eyed at her parents, clutching her stomach in pain. Stomach ailments, including vomiting, nausea, bloating and diarrhea, are not uncommon for children to experience now and again. But they are not always caused by what we have come to know as the 24-hour “stomach flu.”
A true stomach virus should only cause temporary distress. Any chronic stomach complaints are always worth investigating with your child’s pediatrician because they could be caused by a very common stomach infection called Helicobacter Pylori (or H. pylori as it is readily known by).
It's the most common bacterial infection worldwide and is extremely prevalent in developing nations. The following guidelines will tell you more about this tricky bacterium and how it operates, including how to recognize symptoms and get treatment.
10 What is H.Pylori?
The H. Pylori bacterium is spiral-shaped and lives in the digestive tract. It's unique because it is able to live quite comfortably in the mucous lining of the stomach and eventually wears this delicate lining down. H. Pylori can survive the harsh and acidic gastric environment by adapting and reducing the acidity in order to thrive.
This makes this bacterium harder to destroy. Over time, as the stomach lining gets destroyed, painful peptic ulcers (sores) can form and cause bleeding and other health problems.
9 How Prevalent is H. Pylori?
The H. Pylori bacterium is more common than you may think. In fact, it is believed that more than 50 percent of the world’s population harbours the H. Pylori bacteria in their stomach linings. That is a staggering number, but it’s important to note that not everyone who is infected with H. Pylori will exhibit symptoms. Approximately 10 to 15 percent will develop obvious symptoms of a peptic ulcer, while others never develop any complications.
8 How is the Infection Spread?
The infection is easily spread through contaminated food and water. It's also thought to spread from one person’s mouth to another and from feces to the mouth. This can happen when someone does not wash their hands properly and after using the bathroom. It's important to be vigilant with personal hygiene for this reason.
7 Who is at Risk?
Children are more likely to be infected with H. Pylori simply due to hygiene – or lack thereof. If you’ve ever had to fight with your child to wash his/her hands after using the bathroom, you know what I’m talking about. The risk is higher in developing countries when the following is not possible:
- Access to clean water
- Access to hot water
- Living in overcrowded dwellings
- Sharing a home with someone infected with H. Pylori
6 When Does Someone Typically Become Infected With H. Pylori?
It is believed that we first contract H. Pylori during childhood. More specifically, it is acquired almost always within the first five years of life. This is certainly true for developing countries. A recent study showed H. pylori were 15% and 46% in Gambian children aged less than 20 months and 40–60 months.
5 What are the Symptoms of H. Pylori?
Many people have literally no symptoms of H. Pylori. It can sit lurking for years with no sign of being there at all. When the infection results in a peptic ulcer, your symptoms can include some, if not all, of the following:
- A gnawing, burning pain that worsens when the stomach is empty
- Feeling bloated
- Excessive belching
- Unexplained weight loss
- Loss of appetite
- Black or tarry stools (indicating old blood from the stomach)
The above symptoms can also mimic other gastrointestinal disorders, so it’s important to see your child’s doctor when he or she is experiencing them over a period of time. Then process of elimination can properly be used to rule out other ailments.
4 Aren’t Peptic Ulcers Caused By Stress?
For decades we lived with the belief that stress was the main cause of peptic ulcers. If one of your relatives lost her husband, AND had a spicy diet, she was guaranteed to develop an ulcer later in life, right? Not quite. Stress does lower your immunity, but won’t cause your stomach lining to bleed.
After 1982, when H. Pylori was discovered by two Australian scientists, it was touted as the main cause of ulcers, along with overuse of NSAIDs, such as Ibuprofen and excessive smoking.
3 The Diagnosis
Diagnostic testing for the H. Pylori infection is recommended only if you have active gastric or duodenal ulcers, or if you have a past history of ulcers. The easiest way to diagnosis H. Pylori is through a blood or stool test. Blood tests look for antibodies against H. Pylori and a stool test will look for signs of the infection in your feces.
Other options include a breath test, which involves swallowing a preparation containing urea. If the bacteria are present, they will release an enzyme that breaks down this combination and will release carbon dioxide, which a special device then detects.
A more invasive test is an endoscopy. A doctor will insert a long thin instrument called an endoscope into your mouth and down into the stomach and duodenum. Any questionable areas will be inspected, and special tools used with the endoscope will take samples from these areas if that’s necessary. For children, the test may seem a bit daunting, so blood work or the breath test may be the best route to go.
2 What are the Complications of H. Pylori?
H. Pylori, at its worst, can cause painful peptic ulcers. These ulcers can lead to complications such as:
- Perforation, when the ulcer breaks through the abdominal wall
- Obstruction, when the ulcer prevents food from leaving your stomach
- Peritonitis, which is an infection of the peritoneum, or the lining of the abdominal cavity
- Internal bleeding
The H. Pylori bacterium is also a known identified cause of gastric cancer. If you have a history of gastric cancer in your family, it should be brought up to the doctor during the testing of H. Pylori.
1 How is H. Pylori Treated?
If H. Pylori is not causing your child any significant problems, the pediatrician may choose to not treat the infection and wait things out. Treatment means taking a harsh round of medications. Most of the treatment regimens include a medication called a proton pump inhibitor and two antibiotics, to be taken for seven to 14 days.
This medication decreases the stomach's production of acid, which allows the tissues damaged by the infection to heal. Once treated, patients have a higher risk of recurrence within the first six months. H. Pylori is stubborn and resistant and harsh treatments must be used to ensure it is successfully eradicated.
That being said, depending on the child, the treatment can be worse than the infection itself. I underwent treatment for H. Pylori when I was 21 and it was quite the assault on the digestive system. I had a very extreme reaction to the treatment, and developed antibiotic-induced Irritable Bowel Syndrome that plagued me for years.
This is why doctors must carefully weigh the options before deciding when to treat a child for this common infection and when to watch and wait.