It is less common for children to develop stomach ulcers than for adults, but they do occur more often than one might expect.
As many as 8.1% of European children and 17.4% of Americans under the age of 18 will develop a stomach ulcer, a new study published in the medical journal Ulcers in 2011 shows.
Several factors may contribute to the development of peptic ulcers, such as preexisting diseases such as Helicobacter pylori, or less serious but related conditions like cancer.
Usually diagnosing children is harder than diagnosing adults since some diagnostic tests might not give reliable results. Children with simple cases usually receive antibiotics or other oral medications.
Peptic ulcers usually do not cause permanent damage unless there is an underlying cause that necessitates surgery (1% to 2%).
Peptic or stomach Ulcers Symptoms in children
In general, peptic ulcers are nothing more than tiny sores on the lining of the stomach. The ulcer may form directly in the stomach or further along in the digestive tract as manifested as a duodenal ulcer.
Stomach ulcers can present in the following ways: [1]
- A dull, gnawing stomach ache
- Bloating and gas
- Vomiting or nausea
- Appetite loss
- Fatigue
While the pain is usually most noticeable when the stomach is empty, a gastric ulcer can sometimes be distinguished from one that occurs in the duodenum because of the reactive pain after eating. When a duodenal ulcer develops, however, the pain usually develops more than two hours later, while gastric ulcers usually cause pain soon after food is consumed.
There are two main types of ulcer, depending on the degree of pain, a sign that the ulcer may be bleeding. This can involve the vomiting of blood or coffee-like material or the passing of bloody or tarry stools.
The following symptoms indicate a condition that needs immediate medical attention: fever, chills, vomiting, and difficulty swallowing.
In addition to malnutrition and perforation, other complications from an ulcer include obstruction and loss of bowel function (caused by inflammation of the duodenum). Obstructions and perforations are considered medical emergencies that require immediate attention. [2]
Causes of stomach ulcers in children
Around 50% of the world’s population has a strain of H. Pylori, which can cause chronic gastritis and peptic ulcers. pylori.
While H. Children who have peptic ulcers are more likely to suffer from an infection caused by Helicobacter pylori. However, other factors could contribute to the occurrence of their ulcers. Among them:
- Aspirin and ibuprofen, both of which contain nonsteroidal anti-inflammatory drugs, are independently linked to gastric bleeding and ulcers if taken too often.
- Peptic ulcers are thought to be linked to genes because up to 20% of children will have family histories of the condition.
- Both children and adults with ulcers are commonly affected by highly stressful events manifesting in acute symptoms within three to six days. Examples include major life traumas, injuries, infections, or surgeries.
- Increased levels of intestinal inflammation and changes in normal bacterial flora are linked with increased risk of pediatric ulcers during obesity.
- Gastric reflux disease (GERD) is characterized by acid reflux, often with the development of stomach ulcers.
The tendency for generalized stress, anxiety, and spicy foods to exacerbate existing ulcers does not occur without cause.
Many unusual conditions have been associated with excess stomach acid production. Examples include cystic fibrosis, basophilic leukemia, Zollinger-Ellison syndrome, and multiple endocrine tumors.
Furthermore, peptic ulcers may be the sign of blood cancer known as lymphoma in the unlikely event it causes increased intracranial pressure, leading to the overproduction of stomach acids.
Diagnosis of stomach ulcers in children
Taking an antibody blood test for the presence of H. pylori, a stomach ulcer test used for adults is an objective test that shows high accuracy in children (obtained by using dissection).
A doctor generally starts with a minimally invasive procedure unless the symptoms are severe. Among these:
- With GastroPanel blood tests, you can test for H. pylori as well as detecting high levels of stomach acid and pepsin, which are both signs of an aggravated stomach.
- A stool sample is tested for the presence of the H. pylori antigen in a fecal sample.
- By using urea breath testing, it can be detected what amount of carbon dioxide is present in the exhaled air which can indicate the presence of an active H. pylori infection.
An anti-inflammatory drug test may permit a doctor to rule out digestive disorders as the cause of your symptoms, allowing for avoidance of invasive procedures.
Should the test results have shown that the patient has a stomach condition that threatens life and limb, an upper endoscopy would be ordered. A gastroenterologist uses an upper endoscope that is inserted into the mouth to view the lining of the stomach.
During the procedure, one is sedated and samples of tissue are taken for evaluation in the laboratory. Side effects include a sore throat, heartburn, nausea, and indigestion. Infection, bleeding, or perforation is possible but rare.
Usually, you have to drink a thick, oily liquid with barium in it. This coating coats the stomach and helps your doctor identify new anomalies on X-ray. Short-term side effects include upset stomach, nausea, vomiting, and constipation.
Treatment
pylori have proved difficult to eradicate due to increasing antibiotic resistance. Combining the right antibiotic for the infection and normalizing stomach acid levels can help heal ulcers.
An antibiotic is taken along with an acid-reducer, typically referred to as a proton pump inhibitor (PPI), and modified subsalicylate tablets (such as chewable Pepto-Bismol), which reduces the possibility of gastrointestinal symptoms.
Further treatments may include tetracycline or metronidazole, depending on the severity of the infection. In the first instance, clarithromycin and amoxicillin are usually used. Additional drugs may include other antibiotics.
NSAIDs should not be used to treat pain or fever; Tylenol (acetaminophen) may be used instead. Antibiotics should be taken as instructed — and to completion — to avoid the development of antibiotic resistance.
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Diet
It is best to avoid high-fat foods, spicy foods, acidic foods, carbonated drinks, or things with caffeine while you are undergoing treatment. This includes high-fiber foods, lean poultry and fish, yogurt, and probiotics.
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Surgical and Other Procedures
It is possible to use various instruments to seal off a ruptured blood vessel during an endoscopic examination. This means conducting a laser or electrocautery to burn the tissue or injecting epinephrine to dilate the blood vessel.
Modern ulcer surgery can be done laparoscopically (with keyhole incisions), whereas emergency surgery is usually done as an open procedure. If appropriate, elective surgery is performed laparoscopically when there is an obstruction, severe bleeding, or a high risk of perforation.
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A Word From KidsRush
Your child’s peptic ulcer can be incredibly upsetting. Your first thought maybe that it is because of stress in school or at home. However, there are cases where it is actually a physical problem that can be treated quite easily.
It is best to keep your child informed about stomach ulcers and what to expect moving forward to help reduce their stress during investigations and treatment.
The time to lose weight for your child is not now. You should first help your child heal the ulcer, all the time. Once that has been accomplished, you should look at weight loss holistically with an appropriate diet and exercise plan.