H. pylori is a spiral-shaped germ (bacteria) that infects the stomach.

It can damage the tissue in your child's stomach and the first part of the small intestine (duodenum). This can cause redness and swelling (inflammation). It may also cause painful sores, called peptic ulcers, in the upper digestive tract.

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Health experts don't know for sure how H. pylori infection is spread. They believe it's passed through the fecal-oral route. This means you take the germs into your body through contact with infected stool (feces) from another person.

Your child may also come into contact with the bacteria if your child:

• Eats food that was not cleaned or cooked in a safe way.
• Drinks water that is infected with the bacteria.
• Doesn't wash their hands well after going to the bathroom.

Most people are first exposed to the bacteria during childhood or adolescence or by early adulthood.

Most people first get the bacteria when they are children. But adults can get it too.

Experts are not sure if H. pylori infection runs in families (hereditary). It's more common where people live in crowded or unclean conditions. It may affect up to 75% of children in developing countries. It occurs at a lower rate in the U.S. but is still common.

Most people have the H. pylori bacteria for years without knowing it because they don't have any symptoms. Experts don't know why.

After being infected with H. pylori, your child may have a swelling (inflammation) of the stomach lining. This is called gastritis. Your child may develop ulcers in their stomach or the first part of the small intestine (duodenum). But most people never have symptoms or problems from the infection.

When symptoms do occur, they may include belly pain, which can:

• Be a dull, gnawing pain.
• Happen 2 to 3 hours after a meal or immediately after a meal.
• Come and go for a few days or weeks.
• Occur in the middle of the night, when your child's stomach is empty.
• Be eased by eating or taking an antacid medicine.

Other symptoms may include:

• Loss of weight.
• Loss of appetite.
• Swelling or bloating.
• Burping.
• Having an upset stomach or nausea.
• Vomiting.

Other health problems can cause symptoms similar to H. pylori. Always see your child's doctor for a diagnosis.

Your child's doctor will ask about your child's health history and do a physical exam. The doctor may also order other tests, including:

• A stool antigen test. This looks for any abnormal bacteria in your child's digestive tract that may cause diarrhea and other problems. A small stool sample is collected and sent to a lab. A test called an H. pylori antigen test will check for the bacteria. But in recent guidelines, this test is not recommended in children.
• Breath tests. These tests check whether there is any labelled carbon dioxide present after your child drinks a special fluid. If labelled carbon dioxide is found, that means that H. pylori is present. In recent guidelines, this test is recommended to check whether H. pylori has been cured after treatment in children.
• An upper endoscopy (EGD). This test looks at the lining of the throat (esophagus), the stomach, and the first part of the small intestine (duodenum). It uses a thin, lighted tube called an endoscope. The tube has a camera at one end. The tube is put into your child's mouth and throat. Then it goes down into the esophagus, stomach, and duodenum. The doctor can see the inside of these organs. A small tissue sample (biopsy) is taken, if needed. The sample can be checked under a microscope for signs of infection or of H. pylori bacteria. A special H. pylori test called a urease test can also be done on the sample. The H. pylori bacteria in the sample can also be tested to learn which antibiotics will work best. In recent guidelines, this test is the recommended way to check for H. pylori in children and decide on treatment.

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

Your child's treatment will include antibiotics to kill the bacteria.

Your child will also take medicines to decrease stomach acid and allow the antibiotics to work better. These acid-blocking medicines are called proton pump inhibitors.

A very bad ulcer can wear away your child's stomach or the lining of the first part of the small intestine (duodenum). It can also cause problems such as:

• Bleeding, when a blood vessel is worn away.
• A hole (perforation) in the stomach or small intestine wall.
• Blockage when the ulcer is in a spot that blocks food from leaving the stomach.
• Stomach cancer (after years to decades of having H. pylori).

Health experts don't know for sure how the H. pylori bacteria passes from person to person. But having good health habits (personal hygiene) can help keep your child safe. These habits include making sure:

• Your child practices good hand hygiene by scrubbing their hands for at least 20 seconds with soap and water. It's very important for your child to do this before eating and after using the bathroom, touching pets, sneezing, coughing, blowing their nose, or playing outside.
• Your child eats foods that have been cleaned and cooked safely.
• Your child drinks water that is safe and clean.

Contact your child's doctor if your child has:

• Ongoing belly (abdominal) pain.
• Loss of appetite.
• Weight loss.
• Vomiting that continues.
• Blood in the vomit or stools.
• Burning stomach pain that is worse between meals and in the early morning hours, but gets better after eating.
• Difficulty taking the medicines, or the medicines have negative side effects.
• Symptoms that get worse or are new.

• H. pylori is a spiral-shaped germ (bacteria). It attacks the stomach and the first part of the small intestine (duodenum).
• This causes swelling (inflammation). It can also cause open sores, called peptic ulcers, in the upper digestive tract.
• Most people with H. pylori won't have any symptoms or get an ulcer. But it's a main cause of ulcers.
• It is spread fecal-orally. This means taking in the bacteria by mouth through water or food that has been in contact with infected stool (feces) from another person.
• Having good personal health habits (hygiene) can help protect your child.

Here are some tips to help you get the most from a visit to your child's doctor:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of any new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your doctor gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child's condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child's doctor after office hours. This is important if your child becomes ill and you have questions or need advice.