Rediscovering Helicobacter pylori in Pediatric and Young Populations through Histopathological Evidence

Purpose: This study aimed to characterize the clinical and histopathological profile of H. pylori infection in patients under 20 years, challenging the assumption that this diagnosis belongs solely to adult medicine. 
Materials and Methods: This study reviewed gastric biopsy specimens from 15 consecutive pediatric and young adult patients (ages 9–19 years), the data were collected between 2023-2024 from private clinics from Zawia-Libya. Clinical presentations, endoscopic findings, and histological severity were analyzed retrospectively. 
Results: The median age was 17 years, with a slight female predominance (53%). Chronic epigastric pain brought most children to medical attention (80%), often accompanied by anemia or vomiting. Endoscopic findings ranged from subtle erythema to severe pangastritis with ulceration. Histologically, 60% showed moderate-to-severe chronic active gastritis patterns traditionally dismissed as "adult disease." Two cases demonstrated intestinal metaplasia, a precancerous change rarely discussed in pediatric contexts. 
Conclusion: H. pylori does not respect age boundaries. Our findings suggest that what we dismiss as "functional abdominal pain" in young patients may, in fact, represent active, sometimes aggressive, H. pylori infection requiring targeted therapy and surveillance. (Open J Biomed Res 2025;4:24-29)