They are nonspecific and can be a symptom of various organic diseases and, more often, of functional gastrointestinal disorders. Whether H. pylori infection without PUD can cause recurrent abdominal pain remains a matter of debate. Recently Alectinib datasheet published studies further indicate that testing for H. pylori should only be performed when, based on alarm features, organic disease is suspected [17, 18]. Iron deficiency anemia is common in pediatric population, and a wide range of different

causes could be involved in the etiology. Whether H. pylori infection is one of them is still controversial. Afifi et al.[19] found no correlation between ferritin levels and H. pylori infection, in contrast to other authors who reported that iron deficiency anemia is significantly more frequent in H. pylori-infected children. Interestingly, randomized controlled trial performed in non-iron-deficient, asymptomatic H. pylori-infected children living in the USA found no effect of H. pylori eradication on iron storage [20]. However, children in whom the infection was eradicated had a significantly larger

increase in serum ferritin at follow-up compared to baseline [20]. Several other conditions including upper respiratory tract infections, periodontal disease, food allergy, idiopathic thrombocytopenic purpura, and short stature have been connected with H. pylori infection. However, literature is insufficient to support their causal relationship [13]. Subsequently, a study investigated the long-term BIBW2992 effect of H. pylori infection on growth velocity in 295 Columbian children [21]. This study showed a significant negative effect of H. pylori infection on gain in weight and in height, highlighting a need for further studies in different geographic areas. H. pylori was also discovered in adenoidal tissue and middle ear fluid, and it was postulated that the bacteria might be a cause of ear infection. Furthermore, a Korean study found higher prevalence of H. pylori infection

in children with otitis media, and the authors concluded that H. pylori could be considered as one of the causes of ear infection [22]. However, for definitive conclusion, more studies are Inositol monophosphatase 1 required. In the past few months, more data have been published on previously described inverse relationship of H. pylori infection and gastroesophageal reflux disease (GERD). An Iranian study included of 263 pediatric patients found a lower prevalence of H. pylori among patients with GERD (OR 0.54, CI 0.27–0.93) than in patients without GERD [23]. Moreover, Fixa et al.[24] explained a decrease in PUD and increase in reflux esophagitis in the past 18 years with a decreasing prevalence of H. pylori infection in the studied population. Furthermore, it has been recently hypothesized that an increased prevalence of allergic diseases could be, at least partially, explained by the decreased incidence of H. pylori infection.