Makindo Medical Notes

🧒 Peptic ulcer disease (PUD) and gastritis affect the lining of the stomach and duodenum in children. ⚠️ Early recognition prevents complications such as bleeding or perforation. PUD occurs when open sores (ulcers) form in the stomach or upper small intestine (duodenum).

🧾 Causes

• 🦠 Helicobacter pylori infection
• 💊 Use of NSAIDs
• 🔥 Excess stomach acid
• 😰 Stress-related ulcers (rare in children)

⚡ Symptoms

• 🔥 Burning epigastric pain, worse after meals
• 🤢 Nausea & vomiting
• 🍽️ Loss of appetite & weight loss
• 🩸 Dark, tarry stools (GI bleeding)
• 🎈 Bloating or early satiety

🚨 Note: Complications include bleeding, perforation, or obstruction → urgent medical care needed.

🌿 Gastritis

Gastritis = inflammation of the stomach lining, acute (sudden) or chronic (long-term).

🧾 Causes

• 🦠 H. pylori infection
• 💊 NSAIDs
• 🦠 Viral or bacterial infections
• 🩹 Stress/trauma (injury, surgery)
• ♻️ Bile reflux
• 🧬 Autoimmune gastritis

⚡ Symptoms

• 🤕 Epigastric pain/discomfort
• 🤢 Nausea, vomiting, indigestion
• 🎈 Bloating, early satiety

📌 Chronic gastritis may → ulcers or ↑ risk of gastric cancer. Early treatment matters.

🔬 Diagnosis

• 👩‍⚕️ Clinical history & exam
• 🩸 Blood tests (anaemia, infection)
• 💩 Stool antigen test (H. pylori, blood)
• 📷 Endoscopy (visualise ulcers/inflammation)
• 💨 Urea breath test (H. pylori)

💊 Treatment

• 🦠 Antibiotics → eradicate H. pylori
• 💊 PPIs (reduce acid)
• 💊 H2 blockers (acid suppression)
• 💊 Antacids (symptomatic relief)
• 🚫 Avoid NSAIDs / use safer alternatives
• 🥗 Dietary: avoid spicy, acidic, or fatty foods

👩‍⚕️ Note: Refer to a paediatric gastroenterologist for persistent/recurrent cases.

💡 Clinical Pearls

• 📍 Epigastric pain relieved by food → duodenal ulcer; worsened by food → gastric ulcer.
• 🧪 Always test for H. pylori in suspected cases.
• 📉 Anaemia in a child with PUD may signal chronic bleeding.
• 🧃 Milk can temporarily soothe pain but stimulates acid → not a long-term fix.