The IX t h Makassed Medical Congress - American University of Beirut

T h e I X t h M a k a s e d M e d i c a l C o n g r e s s
Currently, there are no consensus guidelines for the management of H pylori infected children.
Duodenal ulcer disease associated with H pylori is the only definite indication to treat this infection
in children.
Treatment studies on children are particularly difficult because of the small number of infected
children in each individual center. As a first-line treatment, bismuth triple therapies (Bis, Clari, and
Metro) were more efficacious than proton pump inhibitor triple therapies. Compliance is a very
important factor in achieving high eradication rates in children.
Reinfection in adults and older children following successful treatment is rare. A treated child for
H pylori infection should be assessed to whether that treatment has been successful or not. This
can be achieved noninvasively using the 13C-urea breath test.
Conclusion:
• Should receive treatment: All children with a duodenal ulcer who have H pylori infection
• Consider treatment: If infected children have a strong family history of duodenal ulcer
disease or gastric cancer.
• May be of benefit treatment: Children with sideropaenic anaemia which is refractory to
treatment with iron should be screened for H pylori infection.
• No data/Benefit treatment: Children with recurrent abdominal pain.
NUTRITION IN PREVENTION OF FOOD ALLERGY
Dominique Turck MD
Both the frequency and severity of food allergy are increasing. The primary strategy in the
prevention of food allergy relies first on the detection of at risk newborns, i.e. with allergic first degree
relatives. In this targeted population, as well as for the general population, exclusive breastfeeding
is recommended until the age of 6 months. In the absence of breastfeeding, prevention consists
in feeding at risk newborns until the age of 4 to 6 months with a partially hydrolysed formula or
“hypoallergenic” formula, provided that its efficiency has been demonstrated by well-designed
clinical trials. Soy based formulae are not recommended for allergy prevention. Complementary
feeding, i.e. solid foods and liquids other than breast milk or infant formula and follow-on formula,
should not be introduced before 17 weeks and not later than 26 weeks. There is no convincing
evidence that avoidance or delayed introduction of potentially allergenic foods, such as fish
and eggs, reduces allergies, either in infants considered at risk for the development of allergy,
or in the general population. It is prudent to avoid both early (