Treatment Approaches for Chronic Gastritis in Children

Chronic gastritis in children is often diagnosed through endoscopic examination. Without this procedure, making an accurate diagnosis can be challenging. In many cases, chronic gastritis in young patients doesn't require aggressive treatment. If the child isn't experiencing severe abdominal pain and there's no impact on growth, development, or appetite, the recommended approach typically involves dietary and lifestyle modifications rather than medication.

Identifying Underlying Causes Is Crucial

It's important to determine whether the gastritis is linked to food allergies or Helicobacter pylori (H. pylori) infection. Many children are tested for H. pylori due to complaints of stomach pain, and a positive result is not uncommon. However, it's essential to understand that abdominal pain and H. pylori infection don't always go hand in hand. Recent studies suggest that the correlation between H. pylori and chronic gastritis or recurrent abdominal pain in children is weaker than previously believed.

Not Every Case Requires Medical Intervention

In China, more than 60% of children over the age of five test positive for H. pylori, and the rate climbs to over 80% in adults. Despite these high numbers, most infected individuals do not develop symptoms or complications. Therefore, detecting H. pylori in a child with chronic gastritis does not automatically mean it is the cause of the condition. Deciding on treatment should be done carefully and based on clinical findings.

When Treatment Is Necessary

The majority of children—over 90%—with H. pylori infection do not require treatment. Therapy is generally considered only in specific situations:

1. If an endoscopy reveals gastric or duodenal ulcers;
2. If there is a family history of stomach cancer or if the child has lymphoma;
3. If the parents strongly request treatment despite the low risk profile.

It's important to note that treating H. pylori requires a prolonged course of antibiotics and other medications, usually lasting two weeks or more. This regimen can have side effects and may not be suitable for children without serious symptoms or complications.

A Common Infection With Limited Treatment Needs

While H. pylori infection is widespread among children, the need for treatment remains relatively rare. A thoughtful, evidence-based approach is key to managing chronic gastritis in pediatric patients, focusing on quality of life, symptom relief, and avoiding unnecessary interventions.