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Peptic Ulcers in Children

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Updated June 11, 2014

Many people, including some doctors, think children don't develop peptic ulcers. Popular opinion used to be that peptic ulcers were caused by either living with intensive stress or frequently eating spicy foods.

Now, however, most experts agree the H. pylori bacteria is the primary cause of peptic ulcers in adults. When studies and experience concluded that children also can suffer from ulcers, it was found that, unlike ulcers occurring in adults, H. pylori wasn't seen as the culprit in most cases of childhood ulcers. Some doctors make the distinction between duodenal ulcers, which are commonly associated with H. pylori infection, and gastric ulcers, which may stem from other causes and appear to be the most common form of peptic ulcer to occur in children.

Certain medical conditions can contribute to the development of peptic ulcers in children. For example, children with severe burns may develop ulcers secondary to the stress of their injuries. The use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen sodium, can make the stomach vulnerable to the harmful effects of acid and pepsin and may contribute to the development of ulcers.

Signs and Symptoms of Ulcers in Children

The following symptoms are also common with many other childhood illnesses, and not ulcers, but should be discussed with the child's doctor for a definite diagnosis.

  • Burning pain in the abdomen between the breastbone and the belly button
  • Nausea
  • Vomiting
  • Feeding difficulties
  • Loss of appetite
  • Weight loss
  • Blood in vomit or bowel movements

Diagnosing Ulcers in Children

The following tests are most commonly used to diagnose ulcers:

If an ulcer is found, the doctor will then test for H. pylori. While H. pylori usually isn't the cause of ulcers in children, it needs to be ruled out as a cause since the treatment for an ulcer caused by H. pylori is different from the treatment for an ulcer caused by NSAIDs.


Treatment of Ulcers in Children
  • If the ulcer is H.pylori-related, the child's doctor will prescribe antibiotics. These antibiotics need to be taken as directed by the child's doctor, finishing the medication even if the symptoms disappear early.

  • If the ulcer is medication-related, the child's doctor will advise you to not give your child NSAIDs, such as ibuprofen or aspirin, or any medications containing ibuprofen or aspirin.

  • The child's doctor will most likely prescribe acid-reducing medications. These should be given as prescribed by the doctor.

  • Most doctors won't recommend big dietary restrictions unless certain foods cause problems for the child. There are some foods, though, that stimulate the production of acid in the stomach and can make an ulcer worse. These include any foods and beverages that contain caffeine, such as sodas and chocolate.

Emergency Situations

You should call your child's doctor immediately if your child has any of these symptoms:

  • Sudden and persistent pain in the belly
  • Blood in bowel movements (the bowel movement will appear black or tarry)
  • Blood in vomit
  • Vomit that looks like coffee grounds

These symptoms can indicate the following serious problems:
  • Perforation. This is when an ulcer becomes too deep and breaks through the stomach or duodenal wall.
  • Bleeding. This is when stomach acid or an ulcer breaks a blood vessel.
  • Obstruction. This is when an ulcer will block food and it can't pass through to the intestines.
Ulcers in children can be an upsetting experience for parents and child, but with timely and proper treatment, almost all ulcers can be cured.

Sources:
Mohammad Issa El Mouzan and Asaad Mohammad Abdullah, "Peptic Ulcer Disease in Children and Adolescents.[/link" Oxford University. 6 Aug 2008

"Stomach and Duodenal Ulcers (Peptic Ulcers)." 2004 50(6):328-330; doi:10.1093/tropej/50.6.328. Journal of Tropical Pediatrics - Children's Hospital Boston - Harvard Medical School. 6 Aug 2008

William D. Chey, M.D., F.A.C.G., A.G.A.F., F.A.C.P., Benjamin C.Y. Wong, M.D., Ph.D., F.A.C.G., F.A.C.P., "American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection." doi: 10.1111/j.1572-0241.2007.01393.x. American College of Gastroenterology. 6 Aug 2008.

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