Tummy Troubles

Is it just a bellyache, or could it be an infection?

As a parent or caregiver, when a child tells you that his or her belly hurts, you want to help make it better. Upset stomachs are a normal part of childhood. They can come and go quickly. Sometimes, though, your child may have symptoms that seem more severe or last longer than you think is normal. Could it be more than a virus or something they ate?

H. pylori is a common chronic infection that affects 1 in 4 children in the United States.1

Many times children who have the infection never show any signs or symptoms.2,3 But, when present they can include gnawing pain and burning feelings in the stomach.

If left untreated, H. pylori can lead to gastritis (inflammation of the stomach lining) and ulcers (sores in the lining of the digestive tract) in the stomach or upper part of the small intestine, and it could put them at future risk for stomach cancer.4 Some international studies have also suggested that H. pylori infection may delay growth in children.2,4

H. pylori infections in children

How do children get infected with H. pylori?

While it is not known exactly how children become infected with H. pylori, studies have shown that infection begins most often during childhood and can last a lifetime.4 Some international studies also suggest that H. pylori can be passed between mother and child, and between brothers and sisters.5

How is H. pylori infection diagnosed in children?

The urea breath test is the most reliable noninvasive diagnostic test in children with suspected H. pylori infection.6 BreathTek® UBT for H. pylori is a noninvasive, convenient way to test your child, and it can be given to children as young as 3.7 The test can be taken at the doctor’s office or at a local lab as prescribed by a health care provider. There are other testing options available, but some of them can be uncomfortable or even a little painful, especially for kids.

Testing options available for children:

BreathTek UBT
BreathTek® UBT for H. pylori
Stool test
Stool test
Blood test
Blood test
Endoscopy and biopsy
Endoscopy and biopsy

4 Simple Steps to Rule Out an H. pylori Infection

During the test, a health care professional will ask your child to perform a few simple steps:

exhale into blue collection bag

Step 1

Your child will inhale, hold their breath momentarily, then exhale into a blue collection bag.

drink the solution

Step 2

After the HCP prepares the Pranactin®-Citric drug solution using water, your child will drink the solution through a straw from the plastic cup provided.

wait 15 minutes

Step 3

Wait 15 minutes.

exhale into pink collection bag

Step 4

Your child will once again inhale, hold their breath momentarily, then exhale into a pink collection bag.

Preparing Your Child to Take BreathTek UBT

For the best test results:
  • Your child should not have anything to eat or drink for at least 1 hour before taking the test.
  • Your child should not take any of the following medications for 2 weeks prior to the test
    • All antibiotics
    • Proton pump inhibitors (PPIs) or their generic versions such as Aciphex® (rabeprazole), Nexium® (esomeprazole), Prevacid® (lansoprazole), Prilosec® (omeprazole), Prilosec OTC® (omeprazole), Protonix® (pantoprazole), Zegerid® (omeprazole/sodium bicarbonate), and Dexilant® (dexlansoprazole)
    • Bismuth preparations such as Pepto-Bismol®
If your child is currently taking a PPI:
  • It is still recommended that antibiotics, PPIs, or bismuth preparations not be taken within 2 weeks prior to administering BreathTek UBT.
  • If your child is taking a PPI and tests positive for H. pylori infection, the result is considered positive and eradication therapy can be started immediately. If the test is negative, it may be a false negative and results should be confirmed with a second breath test 2 weeks after discontinuing the PPI.
  • Histamine blockers (H2 antagonists) may be substituted for PPIs. These medications include Zantac® (ranitidine), Tagamet® (cimetidine), Pepcid® (famotidine), and Axid® (nizatidine). The effect of histamine blockers may reduce urease activity on urea breath tests. Histamine blockers may be discontinued for 24-48 hours before the BreathTek UBT.8
If your child is taking antacids:
  • Your child may continue taking antacids prior to testing. The use of antacids does not appear to affect the accuracy of the BreathTek UBT.

BreathTek UBT delivers excellent sensitivity* (96%) and specificity (99%) for diagnosing H. pylori in children.

BreathTek UBT delivers excellent sensitivity BreathTek UBT delivers excellent sensitivity BreathTek UBT delivers excellent sensitivity
*Sensitivity refers to the percentage of people with an infection who get a positive result.
Specificity refers to the percentage of people without an infection who get a negative result.

Study design: A multicenter, open-label study. The primary endpoint analysis was conducted to determine the sensitivity and specificity of the BreathTek UBT UHR to the composite reference method criteria for the 176 evaluable cases. The table demonstrates the diagnostic performance of the BreathTek UBT (expressed as UHR) compared to the composite reference method criteria in pediatric patients aged 3 to 17 years old.

Inaccurate results may be caused by certain drugs taken within 2 weeks prior to this test. These may include:
  • Proton pump inhibitors (PPIs) such as Aciphex® (rabeprazole), Nexium® (esomeprazole), Prevacid® (lansoprazole), Prilosec® (omeprazole), Prilosec OTC® (omeprazole), Protonix® (pantoprazole), Zegerid® (omeprazole/sodium bicarbonate), and Dexilant® (dexlansoprazole)
  • Antibiotics
  • Bismuth-based drugs (Pepto-Bismol®)
Inaccurate test results can also occur if:
  • The second breath sample is collected too soon.
  • The infection was treated with antibiotics, but the confirmation test was taken with BreathTek UBT less than 4 weeks after completing the therapy.
  • The straw provided in the kit is not used.

If you’d like to know more about BreathTek UBT, please visit Test Information.

Antibiotics Can Battle the Infection

If your child has an H. pylori infection, your health care provider can treat it with antibiotics. Even after finishing the treatment, children will sometimes still have the infection.9 This could be because the bacteria develops a resistance to the antibiotics.9 Talk with your doctor about taking a second BreathTek UBT to be confident that the treatment cured your child’s infection!

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References
1
Staat MA, Kruszon-Moran D, McQuillan GM, Kaslow RA. A population-based serologic survey of Helicobacter pylori infection in children and adolescents in the United States. J Infect Dis. 1996;174(5):1120-1123. http://jid.oxfordjournals.org/content/174/5/1120.full.pdf. Accessed Oct 10, 2014.
2
Goodman KJ, Correa P, Mera R, et al. Effect of Helicobacter pylori infection on growth velocity of school-age Andean children. Epidemiology. 2011;22(1):118-126. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143001/pdf/nihms302033.pdf. Accessed Oct 10, 2014.
3
Gold BD, Colletti RB, Abbott M, et al. Helicobacter pylori infection in children: recommendations for diagnosis and treatment. J Pediatr Gastroenterol Nutr. 2000;31:490-497. http://journals.lww.com/jpgn/Fulltext/2000/11000/Helicobacter_pylori_Infection_in_Children_.7.aspx. Accessed Oct 10, 2014.
4
Pacifico L, Anania C, Osborn JF, Ferraro F, Chiesa C. Consequences of Helicobacter pylori infection in children. World J Gastroenterol. 2010;16(41):5181-5194. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2975089/pdf/WJG-16-5181.pdf. Accessed Oct 10, 2014.
5
Kivi M, Tindberg Y. Helicobacter pylori occurrence and transmission: a family affair? Scand J Infect Dis. 2006;38(6- 7):407-417. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870291/pdf/16050509.pdf. Accessed Oct 10, 2014.
6
Ables AZ, Simin I, Melton ER. Update on Helicobacter pylori treatment. Am Fam Physician. 2007;75(3):351-358. http://www.aafp.org/afp/2007/0201/p351.html. Accessed Oct 10, 2014.
7
Package Insert for BreathTek UBT. Otsuka America Pharmaceutical, Inc; 2016.
8
Chey WD, Wong BCY; Practice Parameters Committee of the American College of Gastroenterology. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007;102(8):1808-1825. http://s3.gi.org/physicians/guidelines/ManagementofHpylori.pdf. Accessed Oct 10, 2014.
9
Koletzko S, Jones NL, Goodman K, et al; H pylori working groups of ESPGHAN, NASPGHAN. Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr . 2011;53(2):230-243. http://www.naspghan.org/files/documents/pdfs/position-papers/H%20pylori%20Evidence_based_Guidelines_From_ESPGHAN_and.24[1].pdf. Accessed Oct 10, 2014.

Did You Know?

H. pylori is a common stomach bacteria that can cause infection.

Learn About H. pylori

Curious About the Test?

Learn how BreathTek UBT is administered in this instructional video.

Watch the Video Watch the Video

Taking BreathTek UBT?

Learn about BreathTek UBT and how to prepare for the test.

See Test Details