Clinical Dilemmas for the Diagnosis and Treatment of Helicobacter pylori Infection in Children: From Guideline to Practice.

IF 1.3 Q3 PEDIATRICS Pediatric Gastroenterology, Hepatology & Nutrition Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI:10.5223/pghn.2024.27.5.267
Susanne Jenneke Van Veen, Elvira Ingrid Levy, Koen Huysentruyt, Yvan Vandenplas
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Abstract

Helicobacter pylori infection is often acquired in early childhood. While most infected children remain asymptomatic, H. pylori can cause chronic gastritis, gastric ulceration, and, in the long term, gastric cancer. This article aimed to review different diagnostic and treatment options and discuss the challenges associated with applying the current guidelines in the real world. Relevant articles published from 2015 to August 2023 in the English language in PubMed and Medline electronic databases were extracted using subject headings and keywords of interest to the topic. References of interest in the selected articles were also considered. Invasive and noninvasive diagnostic tests have advantages but also disadvantages and limitations according to the clinical setting and age of the child. Guidelines recommend not performing diagnostic testing in children with long-lasting or recurrent abdominal complaints or cases of a family history of severe disease caused by H. pylori. However, parents regularly consult with the explicit demand to test for H. pylori because of them or a close family member experiencing severe gastric disease caused by H. pylori. In some situations, it may be challenging for the healthcare professional to stick to evidence-based guidelines and not consider "patient-centered care," with the risk of putting a trustful relationship in danger. Physicians may find it challenging not to perform diagnostic tests for H. pylori and prescribe eradication treatment in specific clinical settings when maintaining a trusting patient-physician relationship by applying this "patient-centered care" method when evidence-based guidelines recommend differently.

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诊断和治疗儿童幽门螺旋杆菌感染的临床难题:从指南到实践。
幽门螺杆菌感染通常发生在儿童早期。虽然大多数受感染的儿童仍无症状,但幽门螺杆菌可导致慢性胃炎、胃溃疡,长期可引发胃癌。本文旨在回顾不同的诊断和治疗方案,并讨论在现实世界中应用现行指南所面临的挑战。使用主题标题和与主题相关的关键词提取了2015年至2023年8月在PubMed和Medline电子数据库中发表的相关英文文章。同时还考虑了所选文章中的相关参考文献。根据临床环境和儿童年龄的不同,侵入性和非侵入性诊断测试各有利弊和局限性。指南建议,对于长期或反复腹部不适或有幽门螺杆菌引起严重疾病家族史的儿童,不要进行诊断检测。然而,经常有家长咨询,明确要求检测幽门螺杆菌,因为他们或他们的近亲属经历过由幽门螺杆菌引起的严重胃病。在某些情况下,医护人员可能很难坚持循证指南,而不考虑 "以患者为中心的护理",这有可能会危及彼此间的信任关系。医生可能会发现,在特定的临床环境中,当循证医学指南提出不同建议时,如果采用这种 "以患者为中心的护理 "方法来维护医患之间的信任关系,而不进行幽门螺杆菌诊断检测和开具根除治疗处方,可能会很有挑战性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
43
期刊介绍: Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.
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