Peptic ulcer disease (PUD) and gastritis in Children
๐ง Peptic ulcer disease (PUD) and gastritis affect the lining of the stomach and duodenum in children.
โ ๏ธ Early recognition prevents complications such as bleeding or perforation. PUD occurs when open sores (ulcers) form in the stomach or upper small intestine (duodenum).
๐งพ Causes
- ๐ฆ Helicobacter pylori infection
- ๐ Use of NSAIDs
- ๐ฅ Excess stomach acid
- ๐ฐ Stress-related ulcers (rare in children)
โก Symptoms
- ๐ฅ Burning epigastric pain, worse after meals
- ๐คข Nausea & vomiting
- ๐ฝ๏ธ Loss of appetite & weight loss
- ๐ฉธ Dark, tarry stools (GI bleeding)
- ๐ Bloating or early satiety
๐จ Note: Complications include bleeding, perforation, or obstruction โ urgent medical care needed.
๐ฟ Gastritis
Gastritis = inflammation of the stomach lining, acute (sudden) or chronic (long-term).
๐งพ Causes
- ๐ฆ H. pylori infection
- ๐ NSAIDs
- ๐ฆ Viral or bacterial infections
- ๐ฉน Stress/trauma (injury, surgery)
- โป๏ธ Bile reflux
- ๐งฌ Autoimmune gastritis
โก Symptoms
- ๐ค Epigastric pain/discomfort
- ๐คข Nausea, vomiting, indigestion
- ๐ Bloating, early satiety
๐ Chronic gastritis may โ ulcers or โ risk of gastric cancer. Early treatment matters.
๐ฌ Diagnosis
- ๐ฉโโ๏ธ Clinical history & exam
- ๐ฉธ Blood tests (anaemia, infection)
- ๐ฉ Stool antigen test (H. pylori, blood)
- ๐ท Endoscopy (visualise ulcers/inflammation)
- ๐จ Urea breath test (H. pylori)
๐ Treatment
- ๐ฆ Antibiotics โ eradicate H. pylori
- ๐ PPIs (reduce acid)
- ๐ H2 blockers (acid suppression)
- ๐ Antacids (symptomatic relief)
- ๐ซ Avoid NSAIDs / use safer alternatives
- ๐ฅ Dietary: avoid spicy, acidic, or fatty foods
๐ฉโโ๏ธ Note: Refer to a paediatric gastroenterologist for persistent/recurrent cases.
๐ก Clinical Pearls
- ๐ Epigastric pain relieved by food โ duodenal ulcer; worsened by food โ gastric ulcer.
- ๐งช Always test for H. pylori in suspected cases.
- ๐ Anaemia in a child with PUD may signal chronic bleeding.
- ๐ง Milk can temporarily soothe pain but stimulates acid โ not a long-term fix.