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Helicobacter pylori: getting to grips with the guidance
  1. David I F Wands1,
  2. Emad M El-Omar2,
  3. Richard Hansen1
  1. 1Department of Paediatric Gastroenterology, Royal Hospital for Children, Glasgow, UK
  2. 2Microbiome Research Centre, St George & Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Dr Richard Hansen, Paediatric Gastroenterology, Royal Hospital for Children, Glasgow, UK G51 4TF; richard.hansen{at}


Helicobacter pylori is a Gram-negative bacterium that inhabits the mucus layer above the gastric mucosa. While infection rates vary by region, the global prevalence is estimated at 50%. While asymptomatic carriage is common, infection can result in significant morbidity and mortality from complications including peptic ulcer disease, atrophic gastritis and gastric cancer. Paediatric and adult practices diverge due to differences in complication rate, symptomatology, practicalities with investigations and treatment options. Widespread use of standard antibiotic regimens has however resulted in a rapid global increase in antibiotic resistance and treatment failure in all ages. There is urgent need to optimise treatment regimens and maximise first-time eradication rates. This need is reflected in the latest guidelines from the European Society for Paediatric Gastroenterology Hepatology and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition for paediatric practice and the Maastricht Guidelines for adult practice. This article aims to provide a practical overview of the investigations and management of H. pylori by comparing and contrasting these guidelines.

  • paediatric gastroenterology
  • Helicobacter pylori
  • Helicobacter therapy

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  • Contributors The paper was commissioned to RH. DIFW wrote the initial paper. RH and EME-O edited and revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Emad El-Omar and Richard Hansen are active members of the editorial teams of Gut and Frontline Gastroenterology.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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