Are Stool H. pylori Antigen Tests Being Abused in Pediatric Diagnosis? Clinical Dilemma: A 6-year-old with chronic abdominal pain and no alarm features is tested with a stool H. pylori antigen — it’s positive. Treatment is started immediately. Was this justified? ⸻ What’s the Controversy? • Stool H. pylori antigen tests are widely used due to ease and non-invasiveness. • However, in children, testing should be limited to those with clear symptoms and indications. • Guidelines (ESPGHAN/NASPGHAN) recommend diagnosing H. pylori by endoscopy and biopsy, not stool test alone. ⸻ Current Best Practice: • Do not use stool antigen testing to screen or diagnose H. pylori without GI indications. • Reserve testing for treatment follow-up — not initial diagnosis. • Use endoscopy-based diagnosis in children with ulcer-like symptoms or alarm signs. ⸻ Bonus Insight: A positive stool test without symptoms is not an indication to treat. H. pylori can be a harmless colonizer in many children. #drmohamedezz #إذكروا_الله ❤ #صلى_على_الحبيب_قلبك_يطيب ❤