How to use Helicobacter pylori testing in paediatric practice.

The current reference standard for investigating H. pylori associated disease in children remains upper intestinal endoscopy and biopsies for histology and culture or RUT. Non-invasive tests should be used to confirm H. pylori eradication following treatment. Currently there is insufficient evidence to recommend them over invasive tests in symptomatic children, because they cannot be used reliably in children to diagnose or distinguish H. pylori-associated diseases from conditions that are not H. pylori related. Recent evidence-based guidelines recommend treatment in children with confirmed H. pylori–related diseases. However, with further knowledge of the measurable health risks for H. pylori–infected children, or with the availability of vaccination or future treatment options, the risk-benefit relationship and recommendations regarding non-invasive testing may change.