H. Pylori May Protect Against Diarrheal Disease in Children
I still remain on the fence about H. pylori. The is too much evidence both pro and con for the presence of this organism. A few questions need to be answered before we indiscriminantly eradicate H. pylori in every patient. Is H. pylori normal flora? How does transmission/infection take place? What percentage of healthy persons have H. pylori and no conditions associated w/ it? Current standard of care is to eradicate whenever found. It may be that in 20 or 30 years we will find that H. pylori protects against some GI cancers and may even act as a sentry for infection from other organisms. We just don’t have enough data yet.
J Infect Dis 2000;182:1446-1449 An inverse relationship has been observed between Helicobacter pylori colonization and diarrheal disease in children. According to the results of a population-based study published in the November issue of the Journal of Infectious Diseases, these findings suggest that H. pylori may protect against gastrointestinal infection. The results of previous studies have suggested that H. pylori infection protects against colonization by other bacteria by inducing the production of immunoglobulin A and secreting its own antibacterial peptides, Dr. Dietrich Rothenbacher, from the University of Ulm, Germany, and colleagues explain. Dr. Rothenbacher’s group points out that “although certain H. pylori strains are associated with increased risk of illnesses…in adult Western populations, it may well be that the benefits of colonization in most carriers outweigh the costs, since only a small proportion of H. pylori carriers develop clinically related diseases during any time during their life.” The investigators believe the findings, if confirmed, “could substantially change management and prevention strategies, especially for children in the developing world, where both diarrheal illnesses and H. pylori are highly prevalent.”