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Peptic Ulcer

What Is a Peptic Ulcer?
A peptic ulcer is a sore on the lining of the stomach or duodenum. A common cause of peptic ulcers is infection with the H. pylori bacterium, but a class of medications called non-steroidal anti-inflammatory agents (NSAIDs), like aspirin and ibuprofen, can lead to such ulcers as well. Contrary to popular belief, stress and spicy foods do not cause ulcers, but can exacerbate existing ones. H. pylori leads to an ulcer by attacking the mucous shield that coats the stomach and duodenum, allowing digestive acid to get through to the lining beneath. The acid and the bacteria irritate the lining and cause an ulcer. H. pylori is a well known culprit in adult peptic ulcers but may not be as common in children. Peptic ulcers are unusual in healthy children. Children who have serious medical conditions may develop peptic ulcers as a secondary condition. Also, children may be more vulnerable to the effects of NSAIDs and therefore peptic ulcers in children may be caused by such medications more often than in adults.

Symptoms 

  • dull stomach ache or pain
  • abdominal discomfort that comes and goes
  • pain and discomfort that typically occur several hours after a meal or in on an empty stomach
  • pain, discomfort that may be relieved by eating
  • pain and discomfort that are usually relieved by antacid medications
  • bloating
  • gas
  • nausea 
  • less commonly, vomiting 

Diagnosis
X-ray of the gastrointestinal tract
Endoscopy, an exam of the stomach and duodenum with an endoscope, a thin, lighted tube with a tiny camera on the end
Blood test or stool test for H. pylori 

Treatment 
Ulcers caused by H. pylori are treated with a course of antibiotics to eradicate the bacterium from GI tract, as well as with drugs to reduce stomach acid, and protect the stomach lining. Ulcers caused by NSAIDs are treated by stopping the medications that caused them and by taking drugs that promote healing of the stomach lining.

When to Call for Help?
Call your pediatrician if your child has any symptoms suggestive of peptic ulcer.
If your child has been diagnosed with an ulcer, call a doctor immediately if the following occur as they may be symptoms of gastro-intestinal bleeding or ulcer perforation:

At Hopkins Children’s, peptic ulcers are treated by the Division of Gastroenterology and Nutrition.

External Links:

National Library of Medicine
http://www.nlm.nih.gov/medlineplus/pepticulcer.html

National Institute of Diabetes and Digestive and Kidney Diseases
http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/#1