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Canadian Journal of Gastroenterology
Volume 13, Issue 7, Pages 553-559

Canadian Helicobacter Study Group Consensus Conference on the Approach to Helicobacter Pylori Infection in Children and Adolescents

P Sherman,1 E Hassall,2 RH Hunt,3 CA Fallone,4 S Veldhuyzen van Zanten,5 ABR Thomson,6 and Canadian Helicobacter Study Group

1Division of Gastroenterology and Nutrition, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
2Division of Gastroenterology, Department of Pediatrics, BC’s Children’s Hospital, Vancouver, British Columbia, Canada
3Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
4Division of Gastroenterology, Department of Medicine, McGill University, Montreal, Quebec, Canada
5Division of Gastroenterology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
6Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada

Copyright © 1999 Canadian Association of Gastroenterology. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (, which permits reuse, distribution, and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


Gastric infection with Helicobacter pylori is common in both children and adults, but children are considerably less susceptible to peptic ulcers and other pathological sequelae. As a result, the risk to benefit ratio of diagnostic studies and therapeutic regimens for H pylori in adults are likely different from those in paediatric populations. These guidelines for the management of paediatric H pylori infection, developed by the Canadian Helicobacter Study Group, are designed to identify when the diagnosis and treatment of H pylori may improve patient care. Given the low prevalence of this infection in Canada, it is important to recognize that indiscriminate testing and treatment programs in children are not recommended, and indeed may threaten the optimal care of children. Diagnostic tests should be employed judiciously and be reserved for children who are most likely to derive measurable benefit, such as those likely to have peptic ulcer disease. At this time a test and treat strategy in children cannot be considered prudent, evidence based or cost effective. It is appropriate to limit diagnosis and treatment to children and adolescents in whom H pylori has been identified during endoscopic investigation.