Peptic Ulcer Disease in Children

Peptic ulcer disease (PUD) in children is a condition in which painful sores or ulcers form on the inner lining of the stomach, duodenum (the first part of the small intestine), or, rarely, the esophagus.

While ulcers are more common in adults, they can also affect children of all ages. These ulcers occur when the protective mucosal layer of the digestive tract is weakened or damaged, allowing stomach acid to erode the underlying tissues.

Early diagnosis and treatment are important to prevent complications and promote proper healing.

Peptic Ulcer in Children: Causes

Several factors can contribute to the development of peptic ulcers in children. The most common cause is an infection by Helicobacter pylori (H. pylori), a type of bacteria that weakens the stomach’s mucosal defense.

When this bacterium colonizes the stomach, it increases acid production and causes inflammation, leading to ulcer formation.

Another significant cause is the prolonged use of certain medications, especially nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin. These drugs reduce the stomach’s ability to produce protective mucus and bicarbonate, making the lining more vulnerable to acid damage.

Other less common causes include stress-related ulcers due to severe illness, burns, or major surgery. In rare cases, conditions that increase acid production, such as Zollinger-Ellison syndrome, can also lead to ulcer formation.

Dietary factors, though not direct causes, may aggravate symptoms or delay healing if spicy or acidic foods are consumed in excess.

 What Are the Signs and Symptoms of a Peptic Ulcer?

The symptoms of peptic ulcer disease in children can vary depending on the location and severity of the ulcer. The most common symptom is abdominal pain, especially in the upper abdomen or around the navel.

The pain often occurs between meals or at night and may improve temporarily after eating or taking antacids.

Other symptoms include nausea, vomiting, bloating, and loss of appetite. Some children may complain of heartburn or a burning sensation in the chest or stomach area.

Weight loss and fatigue may occur if the condition persists without treatment. In severe cases, complications such as bleeding ulcers can develop, leading to vomiting of blood (which may look like coffee grounds) or black, tarry stools.

If a child shows these symptoms, medical attention should be sought immediately, as untreated ulcers can lead to serious complications such as perforation or obstruction of the digestive tract.

What Is the Treatment for Ulcers in Children?

The treatment of peptic ulcer disease in children depends on the underlying cause. If H. pylori infection is present, doctors usually prescribe a combination of antibiotics and acid-suppressing medications such as proton pump inhibitors (PPIs) or H2 blockers.

This therapy helps eradicate the bacteria and allows the ulcer to heal. If NSAIDs are the cause, the medication should be discontinued or replaced with a safer alternative as advised by the physician.

Dietary modifications, including avoiding spicy, fried, and acidic foods, can help reduce discomfort. Ensuring the child eats small, regular meals and avoids long gaps between meals is also beneficial.

Follow-up care is important to confirm that the ulcer has healed completely. In rare cases where ulcers do not respond to medical therapy, surgical intervention may be necessary.

Conclusion

Peptic ulcer disease in children, though uncommon, is a significant health issue that requires timely diagnosis and proper treatment. Recognizing the symptoms early and addressing the underlying causes—such as H. pylori infection or medication overuse—can prevent complications and ensure a full recovery.

With appropriate medical care, dietary adjustments, and regular monitoring, most children with peptic ulcers can lead healthy, pain-free lives.

Dr. Kailash Mishra
Director & Gastroenterologist Consultant
Prime Gastro Liver Clinic