How Do We Treat Stomach And Duodenal Ulcers
Treatment may include:
- Lifestyle changes: In the past, physicians advised parents to avoid feeding their children with ulcers spicy, fatty, or acidic foods. However, a bland diet is now known to be ineffective for treating or avoiding ulcers. No particular diet is helpful for most children with ulcers.
- Stop smoking: Some children and teenagers smoke, with or without their parents’ knowledge or permission. Smoking has been shown to delay how fast their ulcers heal and has been linked to the ulcer recurring.
- Medications: Physicians may treat stomach and duodenal ulcers with several types of medications, including the following:
- H2-blockers to reduce the amount of acid the stomach produces by blocking histamine, a powerful stimulant of acid secretion
- proton pump inhibitors to more completely block stomach acid production by stopping the stomach’s acid pump the final step of acid secretion
- mucosal protective agents to shield the stomach’s mucous lining from the damage of acid, but do not inhibit the release of acid
- When treating H. pylori, these medications or procedures are often used in combination with antibiotics.
However, children who don’t respond to medication or who develop complications may require surgery. Types include:
What Causes Stomach And Duodenal Ulcers In A Child
Experts used to think that stress, diet, and stomach acid caused ulcers. Today, research shows that most ulcers form because of an infection with Helicobacter pylori bacteria. Other things play a role, but this germ is often the main cause of most ulcers.
The following things may play a role in stomach or duodenal ulcers:
Diagnosis Of A Stomach Ulcer
Diagnosing a stomach ulcer is done using a range of methods, including:
- Endoscopy a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia. The endoscope is fitted with a small camera so the physician can see if there is an ulcer.
- Barium meal a chalky liquid is drunk and an x-ray is performed, showing the stomach lining. These tests are less common nowadays, but may be useful where endoscopy is unavailable.
- Biopsy a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found.
- C14 breath test this checks for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.
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What Kind Of Doctor Treats Peptic Ulcers
- If you suspect you may have a peptic ulcer, you may first be diagnosed by your family practitioner or internist.
- Children or teenagers may see a pediatrician.
- For further treatment you will likely be referred to a gastroenterologist, a specialist in disorders of the digestive tract.
- If you have an emergency such as vomiting or severe abdominal pain you will be seen by an emergency medicine specialist in an emergency room.
- In the rare case where surgery is needed, you may see a general surgeon.
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Treating Helicobacter Pylori Infection
If your stomach ulcer’s caused by a Helicobacter pylori bacterial infection, you’ll be given:
- a course of antibiotics
- a medication called a proton pump inhibitor
This is also recommended if it’s thought your stomach ulcer’s caused by a combination of an H. pylori infection and non-steroidal anti-inflammatory drugs .
What Triggers Stomach Ulcer Symptoms
Stomach ulcers are irritated by stomach acid. Some people notice this irritation more after they eat, and some people notice it more on an empty stomach. There are also certain irritants that seem to make ulcer symptoms worse and make them more difficult to heal. Smoking and alcohol are the biggest ones.
What Is The Most Common Cause Of Duodenal Ulcer
The main cause of this damage is infection with bacteria called Helicobacter pylori, or H.pylori. The bacteria can cause the lining of your duodenum to become inflamed and an ulcer can form. Some medications can also cause a duodenal ulcer, particularly anti-inflammatory drugs such as ibuprofen and aspirin.
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Symptoms Of A Peptic Ulcer
Contrary to conventional wisdom, peptic ulcers are not caused by stress or spicy foods but both of these factors are known to exacerbate symptoms. The most common culprits of peptic ulcers, according to the Mayo Clinic , are infection by a bacterium known as Helicobacter pylori or the extended use of nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen sodium .
What Causes Gastric And Duodenal Ulcers
In the past, lifestyle factors, such as stress and diet, were believed to cause ulcers. More recently, research has shown that stomach acids contribute to ulcers. Research also shows that ulcers can develop as a result of an infection caused by the bacterium Helicobacter pylori . While all of these factors play a role in why your child may have an ulcer, H. pylori is most likely to be the cause.
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How Do Symptoms Differ
One way of telling if you may have a gastric or duodenal ulcer is to figure out where and when your symptoms occur. For some, the time between meals aggravates an ulcer. For others, eating may be a trigger for the pain.
The exact location of the pain doesnt always match up with the location of the ulcer, though. Sometimes the pain is referred. This means that a person may have pain in a location away from the actual ulcer.
Other symptoms can include:
Pearls And Other Issues
In younger patients who have duodenal ulcers that are distal to the duodenal bulb, always check a fasting gastrin level to evaluate for a hyper-gastrin state, such as gastrinoma. In older patients with the same finding, consider CT angiography, especially of the celiac trunk and superior mesenteric artery, to assess chronic ischemia.
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When Should I Call My Healthcare Provider
See your healthcare provider right away if you have any of these symptoms:
- Vomiting blood or dark material that looks like coffee grounds
- Extreme weakness or dizziness
- Blood in your stools
- Nausea or vomiting that doesnt get better, or gets worse
- A sudden, severe pain that may spread to your back
- Losing weight without even trying
Untreated peptic ulcers may cause other health problems. Sometimes they bleed. If they become too deep, they can break through your stomach.
Ulcers can also keep food from going through your stomach.
Types Of Stomach Ulcers
Ulcers can develop in various parts of the GI tract, including the esophagus, stomach and duodenum. Contrary to popular belief, research shows that men develop duodenal ulcers more often than any other kind, including stomach ulcers. On the other hand, the opposite is true for women: They tend to develop more stomach ulcers and fewer ulcers of the duodenal.
Many doctors refer to stomach ulcers simply as peptic ulcers. A few other types of ulcers and names that ulcers sometimes go by include:
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What Are Possible Complications Of Stomach And Duodenal Ulcers In A Child
Your child could have severe complications if his or her ulcer isnt treated well. The most common problems include:
Bleeding. An ulcer can harm blood vessels. This can cause bleeding.
Hole . An ulcer can wear a hole through the wall of the stomach or duodenum. Bacteria and partially digested food can spill through the opening into the abdominal cavity . This can cause peritonitis. This is inflammation of the abdominal cavity and wall.
Narrowing and blockage . Ulcers at the end of the stomach where the duodenum is attached can cause swelling and scarring. This can narrow or close the intestinal opening. This blockage can stop food from leaving the stomach and going into the small intestine. This can cause vomiting.
Stomach cancer. H. pylori infection increases the risk for stomach cancer later in life.
What Is A Stomach Ulcer
A stomach ulcer, also called a gastric ulcer, is an open sore that develops in your stomach lining. You can also get one in your duodenum, the first part of the small intestine that your stomach feeds into. Duodenal ulcers and stomach ulcers are both types of peptic ulcers. Theyre named for pepsin, one of the digestive juices that are found in the stomach and that sometimes leak into the duodenum. These juices are a contributing factor in peptic ulcer disease.
Peptic ulcers occur when the protective mucous lining in your stomach and duodenum has been eroded, allowing gastric acids and digestive enzymes to eat away at your stomach and duodenal walls. This eventually results in open sores that are continually irritated by the acid. If left untreated, they can begin to cause serious complications, such as internal bleeding. Over time, they can even wear a hole all the way through. This is a medical emergency.
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Can You Prevent A Peptic Ulcer
While stress and spicy foods can make symptoms of a peptic ulcer worse, they donât seem to make you more likely to have one. But a few other things can raise your chances.
Be careful when you take pain relievers. Some people who have arthritis or other conditions that cause chronic pain take nonsteroidal anti-inflammatory drugs for weeks or months at a time to ease pain and swelling. These medicines can affect the mucus that protects your stomach against acid and make you more likely to have peptic ulcers.
These pain relievers include:
Youre more likely to get an ulcer while taking one of these if you:
- Are over age 65
- Are infected with H. pylori bacteria
- Take more than one NSAID at a time
- Have had a peptic ulcer in the past
- Also take a steroid drug or selective serotonin reuptake inhibitor
To lower your chances for peptic ulcers while you take NSAIDs:
- Use the lowest possible dose to control your symptoms, and stop taking them as soon as you no longer need them.
- Take your medicine with food.
- Dont drink alcohol while youâre taking these medicines.
While youre on NSAIDs, you can take medicine to lower the amount of acid your stomach makes. Drugs that can do that include:
You can do some things to make an infection less likely:
What Is Peptic Ulcer Disease
Peptic ulcer disease is a condition in which painful sores or ulcers develop in the lining of the stomach or the first part of the small intestine . Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing stomach acid to damage the tissue.
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How Can I Be Sure Its An Ulcer
The only way to be sure an ulcer is causing your discomfort is with a medical diagnosis. We will evaluate your medical history and conduct a thorough physical examination.
To determine the root cause of your ulcer, we may run blood, stool, or breath tests. These tests are designed to look for signs of helicobacter pylori, the bacteria linked to ulcers.
Depending on your unique symptoms, we may also order an endoscopy. During an endoscopy, we insert a tube with a tiny camera down your throat and into your stomach to take pictures of any potential damage and collect tissue samples for analysis.
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What Are The Symptoms Of Stomach And Duodenal Ulcers In A Child
Ulcers dont always cause symptoms.
The most common symptom is a gnawing or burning pain in the stomach. This is often felt between the breastbone and the belly button . Your child may feel the pain more between meals and in the early morning. It may last from a few minutes to a few hours.
Less common ulcer symptoms include:
Tiredness and weakness
The symptoms of ulcers may look like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.
How Are Duodenal Ulcers Treated
If your ulcer is caused by H pylori, the usual treatment is ‘triple therapy’. This involves taking 2 antibiotics and a medicine. The antibiotics kill the bacteria, while the medicine reduces the acid made by your stomach.
If you don’t have an H. pylori infection, and you have been using anti-inflammatory drugs, you will need to stop taking them . You will also need to start taking a drug to reduce the acid production in your stomach.
You can make some other changes to improve your symptoms, such as:
- taking antacids
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How Are Stomach Ulcers Treated
Ulcers can heal if they are given a rest from the factors that created them. Healthcare providers treat uncomplicated ulcers with a combination of medicines to reduce stomach acid, coat and protect the ulcer during healing and kill any bacterial infection that may be involved. Medicines may include:
- Antibiotics. If H. pylori was found in your digestive tract, your healthcare provider will prescribe some combination of antibiotics to kill the bacteria, based on your medical history and condition. Commonly prescribed antibiotics include tetracycline, metronidazole, clarithromycin and amoxicillin.
- Proton pump inhibitors . These drugs help reduce stomach acid and protect your stomach lining. PPIs include esomeprazole,dexlansoprazole,lansoprazole, omeprazole,pantoprazole and rabeprazole.
- Histamine receptor blockers . These reduce stomach acid by blocking the chemical that tells your body to produce it . H2 blockers include famotidine, cimetidine and nizatidine.
- Antacids. These common over-the-counter medicines help to neutralize stomach acid. They may bring some symptom relief, but they arent enough to heal your ulcer. They also might interfere with some antibiotics.
- Cytoprotective agents. These medicines help to coat and protect your stomach lining. They include sucralfate and misoprostol.
- Bismuth Subsalicylate. This over-the-counter medicine, commonly found as Pepto-Bismol, can help coat and protect your ulcer from stomach acid.
Signs Of A Duodenal Ulcer
1. Stomach pain which sometimes becomes more severe and then gets better depending on what you are eating and drinking.
2. Bloating and an overall feeling of fullness especially after you eat
3. Increased gas and a need to burp
4. Nausea and even feeling like you might need to vomit
5. Weight loss which can happen if the ulcer causes any type of blockage in your digestive track which makes it difficult for food to travel through your stomach.
6. Weight gain through comfort eating in order to find pain relief through food that neutralizes the acid build up.
7. Indigestion, sometimes called dyspepsia, which is characterized by discomfort and a burning feeling in your upper abdomen area.
8. Extremely serious ulcer cases can cause more severe symptoms and complications that require immediate medical attention including blood in your stool.
If you think that you might be suffering from a duodenal ulcer, you should seek out experienced medical attention. When left untreated, duodenal ulcers can lead to more serious complications including bleeding and even perforations in your intestine. There are certain tests that your gastroenterologist may perform for diagnostic purposes. An endoscopy is often used to diagnose a duodenal ulcer. Through this test your physician is uses a flexible telescope which provides visibility in the duodenum so that ulcers can be detected. Your doctor may also test you to see if you have H. pylori.
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What Is A Stomach Or Duodenal Ulcer
An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body.
- An ulcer in the lining of the stomach or duodenum, where hydrochloric acid and pepsin are present, is referred to as a peptic ulcer.
- When the ulcer is in the stomach, it is called a gastric ulcer.
- When the ulcer is in the duodenum, it is called a duodenal ulcer.