An ulcer is an open sore. Peptic ulcers develop in the lining of the stomach or upper part of the small intestine (duodenum). An ulcer in the stomach is called a gastric ulcer, and an ulcer in the duodenum is called a duodenal ulcer.
Most ulcers are caused by bacteria called Helicobacter pylori (H. pylori), which are believed to be transmitted from person to person through close contact and exposure to fecal matter or vomit. The bacteria cause an infection that weakens the protective mucus in the stomach and duodenum, allowing acid to get through to the sensitive lining beneath. Both the acid and bacteria irritate the lining and cause an ulcer to form.
If left untreated, a H. pylori infection can cause gastritis (inflammation of the lining of the stomach). Gastritis can occur suddenly (acute gastritis) or gradually (chronic gastritis). An untreated H. pylori infection may also progress into peptic ulcer disease or stomach cancer later in life. Another common cause of gastritis is long-term use of aspirin, ibuprofen and other anti-inflammatory drugs.
In the past, children with peptic ulcers lived with the chronic condition for several years or even a lifetime. Today, we have a better understanding of what causes peptic ulcers and how to treat them, meaning most children can be cured.
Symptoms of peptic ulcers, gastritis and H. pylori infection can be very mild in some children.
Abdominal discomfort is the most common symptom of peptic ulcers and usually feels like a dull, gnawing ache. The pain often occurs two or three hours after a meal or in the middle of the night when the stomach is empty. The pain may come and go for several days or weeks. Eating and taking antacid medicine helps relieve the discomfort. It is not clear if H. pylori infection without ulcers causes abdominal pain.
Other symptoms include:
- Dark stool (with gastritis or an ulcer)
- Poor appetite
- Weight loss
Diagnosis of Peptic Ulcers, Gastritis & Helicobacter Pylori
If your child experiences symptoms of peptic ulcers, gastritis or H. pylori infection, a pediatric gastroenterologist can perform the following exams and tests to make a diagnosis:
- Physical exam. A physician will examine the abdomen for signs of bloating and can track your child's weight loss.
- Complete medical history. Your child’s physician will review your child’s health records and family health history.
- Upper gastrointestinal (GI) endoscopy. Your child's doctor can perform an upper gastrointestinal (GI) endoscopy to examine the esophagus, stomach and duodenum.
- Biopsy. A pediatric gastroenterologist may take a stomach tissue sample to study the cells for signs of damage or infection.
- Blood tests. A variety of blood tests can indicate the presence of other reasons for abdominal pain.
- Breath tests. Breath tests measure the amount of gases, such as hydrogen, in the breath which can be a sign of bacterial overgrowth in the intestines or lactose intolerance.
- Stool tests. By studying the contents of your child’s stool, the physician can get information about infections that may be upsetting the digestive tract.
Treatment for peptic ulcers, gastritis and H. pylori usually involves a combination of antibiotics, acid suppressors and stomach protectors. Gastritis treatment is based on the cause of the inflammation. Types of medicines that may be prescribed include:
- Antibiotics. A combination of antibiotics is used to kill the H. pylori bacteria. Antibiotic regimens recommended for patients may differ across regions of the world because different areas have begun to show resistance to particular antibiotics.
- Proton pump inhibitors. Proton pump inhibitors suppress acid production by halting the mechanism that pumps the acid into the stomach.
- Bismuth subsalicylate. Bismuth subsalicylate is a component of Pepto-Bismol. It is used to protect the stomach lining from acid and kill H. pylori.
These treatments reduce symptoms and allow inflamed tissues to heal over time.
Key Points To Remember
Key Points To Remember
- A peptic ulcer is a sore in the lining of the stomach or duodenum.
- Some ulcers are caused by the H. pylori bacterium.
- H. pylori can be transmitted from person to person through close contact and exposure to fecal matter or vomit.
- A combination of antibiotics and acid blockers is the most effective treatment for H. pylori peptic ulcers.
- Gastritis (inflammation of the lining of the stomach) can be caused by H. pylori infection or long-term use of aspirin or anti-inflammatory drugs. It is unclear whether H. pylori infection without ulcers causes abdominal pain.
Support Services & Resources
Support Services & Resources
Visit the website below to find support groups and services and learn more about peptic ulcers, gastritis and H. pylori infection.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This website from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition provides information for families of children with peptic ulcers, gastritis and H. pylori infection.
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