Although they are less common in children than in adults, stomach ulcers, also known as peptic ulcers, are more common than one may think. Helicobacter pylori, or H. pylori, is the bacteria that commonly causes stomach ulcers, but it can also be connected to more serious illnesses like cancer.

Since certain tests are less accurate in diagnosing stomach ulcers in children than in adults, the process of doing so differs slightly. Simple instances may typically be treated with ease using antibiotics and medications that lower stomach acid and shield the stomach lining.

The risk of complications from stomach ulcers is low (between 1% and 2%) and the casualty rate is about one death per 100,000 cases, unless there is a major underlying reason.


Stomach Ulcer Symptoms

Simply said, a stomach ulcer is an open painful that forms on the stomach lining. A duodenal ulcer is a sore that grows more along in the small intestine than a gastric ulcer, which is a sore that happens in the stomach itself.


Typical indications of a gastric ulcer include:


  • A gnawing or slow burning pain in the stomach
  • Bloating and gas                                      
  • Vomiting or feeling queasy
  • Appetite decline
  • Weary

Although discomfort is usually more penetrating when the stomach is empty, pain that persists after eating can frequently be used to differentiate between gastric and duodenal ulcers. discomfort from a duodenal ulcer typically appears two or three hours after eating, whereas discomfort from a gastric ulcer typically occurs shortly after.

If a youngster has acute, targeted pain instead of long-lasting, throbbing agony from a stomach ulcer, the ulcer may be deemed serious. This could be a sign that the ulcer is bleeding, which is frequently followed by tarry or bloody stools or vomit that looks like coffee.

Symptoms like as chills, vomiting, fever, and trouble swallowing indicate an illness that has to be treated urgently.

Malnutrition, stomach perforation, and bowel obstruction due to duodenal inflammation are among the complications associated with stomach ulcers. A perforation and an obstruction are both stared as medical emergencies that need to be treated right away.

 

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What Causes Stomach Ulcers in Children?

The corkscrew-shaped bacterium H. pylori is frequently connected to stomach ulcers and persistent gastritis. It is estimated that H. pylori infection affects about 50% of people on the planet.

Although H. pylori is frequently the cause of stomach ulcers in children, other variables may also be involved in the development of these lesions. Among them are:


  • Aspirin and ibuprofen are examples of nonsteroidal anti-inflammatory medications (NSAIDs), which when taken excessively can cause stomach bleeding and ulcers.
  • Genetics, with 20% of children with stomach ulcers having a family history of the condition.
  • Events that are extremely stressful (such severe injuries, infections, surgeries, or life traumas) may cause acute symptoms to appear three to six days later.
  • Obesity, which can result in altered gut flora and increased gastrointestinal inflammation
  • Gastric reflux disorder (GERD), in which severe cases of persistent acid reflux can result in stomach ulcers.

Similar to this, any illness that raises intracranial pressure—the pressure within the skull—may also cause the stomach to produce too much acid, which can result in a Cushing ulcer. Rarely, stomach ulcers can indicate lymphoma, a type of blood cancer.


Diagnosis of Stomach Ulcers

It is difficult to diagnose stomach ulcers in youngsters. Certain adult-use assays, such the H. pylori antibody blood test, are less reliable when conducted on younger patients.

A healthcare professional will typically begin the inquiry with less invasive testing unless the symptoms are really severe. Among them are:

Blood tests called GastroPanel can identify H. pylori, high amounts of acid, and pepsin, an enzyme in the stomach that is indicative of gastritis.

Tests for fecal antigens, which search a stool sample for genetic evidence of H. pylori

Tests for urea, which quantify carbon dioxide levels in exhaled air and may reveal the presence of an active H. pylori infection

In the event that these tests yield negative results, your healthcare professional can proceed to more invasive procedures only after ruling out digestive diseases as the cause.

 

Imaging Tests

The recommended course of action to detect a stomach ulcer in a child would be an upper endoscopy if the tests are positive and the symptoms are severe. A flexible fiberoptic scope is inserted down the throat during an endoscopy in order to observe the stomach lining.

It can be used to pinch off tissue samples (called a pinch biopsy) for laboratory analysis. It is done under light sedation. Six Possible side effects are as follows:


  • A sore throat
  • Indigestion
  • Reflux
  • Emesis
  • Virus infection
  • Breach
  • Gushing blood

Although far less intrusive, a barium X-ray—also known as an upper gastrointestinal series or barium swallow—is also less precise. This is particularly valid in cases where a youngster has a little stomach ulcer.

They would be required to consume a chalky liquid that contained barium for this test. Barium coats the stomach and makes it easier to spot abnormalities on X-rays. Constipation, nausea, vomiting, and upset stomach are among the side effects.


Stomach Ulcer Treatment

Should the cause of your child's stomach ulcer be H. pylori, the physician will treat the infection by administering a series of medications designed to restore normal gastric acid levels, allowing the stomach to heal. A proton pump inhibitor (PPI), an acid-reducing medication, and two or more antibiotics may be used in combination to treat your child's stomach ulcer in many circumstances. Additionally, they might take bismuth subsalicylate tablets, which can cover and shield the stomach (like chewable Pepto-Bismol).

Other medication combinations will be used until the infection shows no more symptoms if this treatment doesn't work. The course of treatment usually consists of 14 days with clarithromycin and amoxicillin as the conventional medications. The following treatments could involve metronidazole or tetracycline.

Antibiotic resistance cannot arise if these medications are not taken as prescribed and in their whole. To lessen gastrointestinal stress, stay away from NSAIDs and manage your child's pain and fever with Tylenol (acetaminophen).


Diet

Giving your youngster foods that are simple to digest and don't put a lot of strain on the stomach can be your main priority during treatment. These consist of lean meats and fish, probiotics like yogurt, and fruits and vegetables high in fiber. Steer clear of anything fried, spicy, acidic, carbonated drinks, or containing caffeine (including chocolate and tea).


Procedures Including Surgery

Children's stomach ulcers can frequently be cured during their endoscopy. Various tools can be fed through the endoscope to close off a damaged blood vessel when an ulcer is detected. In order to burn the tissue, a laser or electrocautery instrument may be used. Alternatively, an injection of adrenaline (epinephrine) may be used to quickly widen the blood artery.

In children, surgery is rarely used to heal stomach ulcers. It is only recommended in cases of severe bleeding, blockage, perforation, or significant danger of perforation. While emergency operations are typically carried out as an open procedure, elective surgeries can frequently be completed with laparoscopy (using keyhole incisions) when necessary.


Conclusion

It can be distressing to learn that your child has a stomach ulcer. Although stress at home or at school might be your first thought, there are typically underlying, curable physical factors. However, you should try to stay as stress-free as possible while your child is receiving care. It will be beneficial if you could tell your youngster the facts about stomach ulcers and what to expect in the future. 


Please book an appointment with the best Pediatrician in Lahore, Karachi, Islamabad, and all major cities of Pakistan through InstaCare, or call our helpline at 03171777509 to find the verified doctor for your disease.