Causes and symptoms of peptic ulcers in children

Gastric ulcers are open sores on the lining of the stomach or membrane of any organ in your body. Gastric ulcers can interfere with the function of your organs. There are many types of ulcers that occur in the body such as genital ulcers, diabetic foot ulcers, stomach ulcers, and mouth ulcers. Gastric ulcers are actually the most common type of ulcer. There are three forms of peptic ulcers:

Duodenal ulcer: a stomach ulcer that forms at the top of the small intestine. This condition is the most common type.
Peptic ulcers: peptic ulcers that form in the stomach and are less common.
Esophageal peptic ulcers: rare ulcers of the esophagus.

Many people, including doctors, think that children have a slight risk of developing stomach ulcers. But there are some studies that show that children often develop stomach ulcers as well.

What are the causes of stomach ulcers?

The most common causes of peptic peptic ulcers are bacterial infection from H. pylori bacteria or from taking aspirin or non-steroidal anti-inflammatory drugs (NSAIDs). However, in children, it was found that H. pylori was not the cause in most cases of gastric ulcers unlike in adults. Several studies have shown that different types of stomach ulcers can have different causes.

Children are more susceptible to certain medical conditions than adults. Taking NSAIDs, such as aspirin, ibuprofen and naproxen sodium, can make the stomach more susceptible to acids and pepsin.

Stress, anxiety or spicy food cannot cause stomach ulcers, but these foods can irritate the stomach and cause ulcer sores to spread.

What are the symptoms of stomach ulcers?

Gastric ulcer symptoms depend on your child's age and the position of the ulcer. The most common symptom for peptic peptic ulcers in children is pain that is more focused on the affected area and can be made worse by the acid. Pain is usually described as a burning, gnawing feeling that lasts from 30 minutes to 3 hours. This pain is worse before and after eating and may even wake your child up at night. Your child may have a period of pain remission during which one week there is no pain at all.

Gastric ulcer symptoms often don't follow a consistent pattern (for example, eating sometimes worsens rather than relieves pain). This is especially true for pyloric tract gastric ulcers that are often associated with obstructive symptoms (eg, bloating, nausea, vomiting) caused by edema and scarring.
Duodenal gastric ulcers tend to cause more consistent pain. Pain does not appear when the patient wakes up but appears in the middle of the morning, pain disappears when eating food, but recurs 2 to 3 hours after eating. Pain can wake the patient at night is common and characterizes a duodenal gastric ulcer. In neonates, perforation and bleeding may be the first manifestations of duodenal gastric ulcer. Bleeding can also be the first sign in late pregnancy and early childhood, although repeated vomiting or evidence of abdominal pain may be clues.

Symptoms vary from child to child, with only about half of the patients presenting with the same characteristic symptom patterns. Other symptoms may include:

Burning pain in the abdomen between the sternum and navel
Stomach discomfort that comes and goes
Nausea
Gag
Fatigue
Bloating
Gas
Difficulty eating
Loss of appetite
Weight loss
Blood in vomit or stool.

How are stomach ulcers diagnosed?

If you suspect your child has a stomach ulcer, please contact the doctor. If your child has been diagnosed with a gastric ulcer, contact the doctor immediately if the following symptoms occur as they may cause symptoms of gastro-intestinal bleeding or perforated gastric ulcer:

Abdominal pain is severe and sudden
Bloody or black stools
Bloody vomit or vomit that looks like coffee grounds.

To diagnose a stomach ulcer, your doctor will perform these tests on your child to identify the cause:

eEdoscopy of upper body: Uses a thin, flexible tube to view your child's digestive tract.
Barium X-ray: is done to make contrast imaging to see its size and severity.
Sometimes the measurement of the serum gastrin level.
Blood tests and tests for H. pylori.

If a stomach ulcer is found, the doctor will then test for H. pylori. If H. pylori is not the cause of peptic ulcers, this bacterial infection needs to be ruled out as a cause because treatment for gastric ulcers caused by H. pylori is different from treatment for peptic ulcers caused by NSAIDs.

What are the treatments for stomach ulcers?

If the cause of an ulcer is H. pylori, antibiotics may be needed to treat the ulcer effectively. You should make sure your child takes these medications as directed by the doctor and finishes taking the medication even if symptoms have disappeared.

If a peptic ulcer is due to medication, your pediatrician will advise you not to give your child NSAIDs, such as ibuprofen or naproxen. The pediatrician will most likely prescribe a medication that reduces acid. This medicine must be given as prescribed by the doctor.

For severe peptic peptic ulcers that are causing complications, your child may need surgery. You should consult your pediatrician about the effects of surgery before making a decision. Your child may need surgery if these complications occur:

Bleeding: blood loss characterized by vomiting of fresh blood or vomiting of coffee grounds as part of bloody or black stools and weakness, orthostasis, syncope, thirst, and sweating.
Perforation: a stomach ulcer becomes a hole in the intestinal wall, allowing stomach fluids and acid to leak out into the body and nearby organs. Your child may feel pain and shock. This complication requires immediate surgery.
Obstruction: Obstruction can be caused by scar tissue, spasms, or inflammation from a stomach ulcer. Symptoms include repeated large volume vomiting, occurring more frequently at the end of the day and at least 6 hours after the last meal. Loss of appetite with persistent bloating or feeling full after eating also indicates gastric obstruction. Prolonged vomiting can lead to weight loss, dehydration, and alkalosis.

What are the tips for dealing with peptic peptic ulcers in children?

You should learn the symptoms of peptic peptic ulcers and how to recognize them in your child in case of recurrence. Take your child to the doctor as soon as you see symptoms appear. The sooner the diagnosis, the more chance that gastric ulcers can be treated with drugs, such as ranitidine (Zantac®), famotidine (Pepcid®), or lansoprazole (Prevacid®).

Your child's stomach can hurt more if it's empty. So to prevent pain, you have to make sure that your child is eating enough food. As with peptic peptic ulcers in adults, you should feed your child frequent, small meals, perhaps five or six times per day, not three. Teach your child to rest after eating.

Children need a balanced and nutritious diet so most doctors will not recommend strict dietary restrictions unless certain foods are causing problems for the child. You should supervise how your child reacts to certain foods and drinks.

There are several foods that can stimulate acid production in the stomach and can make stomach ulcers worse. Some foods may not cause peptic peptic ulcers but they can make them worse, such as foods or drinks that contain caffeine, alcohol and smoking. Even if children don't smoke, they may be affected by secondhand smoke. While you shouldn't worry about children because they don't consume alcohol, you should talk to your teen about quitting alcohol and smoking.

Peptic gastric ulcers can make eating difficult for children. However, peptic peptic ulcers can be avoided with good hygiene to prevent bacterial infection and limit triggers that can aggravate stomach ulcers such as the use of NSAIDs. Peptic peptic ulcers are treatable and most pediatric patients can function normally after treatment. If you notice the symptoms of a peptic peptic ulcer in your child, please take them to the doctor right away.