The stomach maintains a highly acidic environment, with a pH of only about 1-2, capable of eliminating most bacteria. However, Helicobacter pylori (HP) is one of the few bacteria that can survive in this harsh environment. It does so by secreting urease, an enzyme that neutralizes the surrounding acid. This mechanism allows HP to adhere to the stomach lining and persist for many years.

HP primarily spreads through the gastrointestinal tract, specifically via oral-oral and fecal-oral routes. It easily transmits within families due to close contact, shared eating habits, and inadequate hygiene practices. While contagious, this bacterium does not spread as rapidly as respiratory illnesses; its transmission is slow and often goes unnoticed for a long time. Children living in households with an infected family member are at a higher risk of contracting HP due to close interaction and shared living conditions. Most children infected with HP show no obvious symptoms and rarely experience immediate acute complications.

For healthy children without symptoms, routine screening or treatment for HP is generally not recommended as it is often unnecessary. Furthermore, treatment regimens in Vietnam frequently have significant side effects because the rate of antibiotic resistance among HP bacteria in the country is very high, necessitating the use of multiple medications. There is also a risk of re-infection if the source of transmission within the family is not controlled.

The extent of clinical manifestation and the risk of complications from HP infection depend on several factors, including the degree of stomach lining damage, the body's immune response, and environmental factors. In many cases, HP infection can lead to peptic ulcers. If not treated promptly, recurrence is likely, potentially leading to severe complications such as gastrointestinal bleeding or stomach perforation.

Doctors typically prescribe HP eradication treatment when a child presents with specific conditions: peptic ulcers confirmed by endoscopy, prolonged abdominal pain accompanied by mucosal damage, or unexplained iron-deficiency anemia. In such instances, HP treatment helps reduce ulcer recurrence and limits the risk of long-term complications.

Parents should take their child for a check-up if they exhibit signs such as recurrent prolonged abdominal pain, weight loss, or poor appetite. It is important to instruct children to practice good hygiene habits, including washing hands before eating and using separate eating utensils. Families should also avoid pre-chewing food for children to reduce the risk of transmission.

Dr. Vu Truong Khanh

Head of Gastroenterology - Hepatobiliary - Pancreatic Department

Tam Anh General Hospital Hanoi