Acute gastritis in children: symptoms and signs, what complications are dangerous, treatment. Treatment of gastritis in children

There are acute and chronic. More often gastritis occurs in children at the age of 5-6 years, 9-12 years, during periods of the most intensive development of all organs and systems. The incidence of girls and boys is the same, but during puberty it is more common in girls.

Acute gastritis - acute inflammation gastric mucosa, caused by short-term exposure to strong irritants.

Acute gastritis can be primary or secondary. The reasons for the primary acute gastritis most often are the effects on the mucous membrane of pathogenic microbes and their toxins, medications, rough and spicy food, overloading the stomach with large amounts of food, eating foods containing food allergens.

The cause of secondary acute gastritis in children There may be diseases such as measles, acute renal failure.

The main factor in the development of the disease is the invasion of the mucous membrane by microbes and toxins, which have an irritating effect on the mucous membrane, where an inflammatory process develops, which causes disruption of the trophism of the mucous membrane. All this leads to a violation of secretion gastric juice and the digestive process.

The hematogenous route of spread of infection and toxins in secondary acute gastritis also leads to inflammatory changes in the mucous membrane.

In acute gastritis of nutritional origin, inadequate food has a direct effect on the gastric mucosa, depletes its secretory apparatus, and leads to slower digestion of food. Food stays in the stomach. Products of incomplete breakdown of food irritate the gastric mucosa and cause inflammation. When taking medications, their overdose, or long-term use, irritation of the mucous membrane also occurs and an inflammatory process develops. Inflammation of the mucous membrane is accompanied by infiltration, hyperemia, as well as dystrophic changes in the epithelium of the mucous membrane.

At acute gastritis in children A superficial change in the mucous membrane or deep damage up to its necrosis may develop.

The main manifestations of the disease are characterized by disruption of the secretory and motor functions of the stomach, the depth and severity of inflammatory phenomena, as well as the addition of symptoms of damage to other organs and systems to the inflammatory process.

There are clinically simple and catarrhal gastritis, as well as corrosive and phlegmonous gastritis. Catarrhal gastritis develops 4-8 hours after the etiological factor.

The main symptoms are:

• general malaise;
• nausea;
• vomit;
• salivation or dry mouth.

With gastritis of toxic-infectious origin, intoxication, prolonged vomiting, dehydration, febrile or high temperature appear.

Usually the tongue is covered with a grayish-whitish coating. Pain is noted on palpation in the epigastric region. Noted rapid pulse, slightly reduced. There is a lot of mucus in the stomach contents, secretory and acid-forming functions are reduced, and motor function is impaired.

Acute corrosive necrotic gastritis differs in severity. It develops when substances with irritating and damaging local effects enter the stomach. These include acids, alkalis, and salts of heavy metals.

In addition to local effects, symptoms of shock may appear in the clinical picture when severe course. The severity of damage to the gastric mucosa corresponds to the amount and concentration of substances that enter the stomach. It also matters whether the stomach is full of food or empty. Symptoms also depend on whether there is damage to the lining of the mouth and esophagus. The child may experience pain in the mouth, behind the sternum, in the epigastric region (this symptom is characteristic of all gastritis).

Reactive gastritis is usually associated with the use of medications or with the duodeno-gastric reflex.

Symptoms of chronic gastritis associated with impaired secretory and motor functions of the stomach. There are two types of disease:

• ulcer-like (associated with H. pyloru);
• gastritis-like (autoimmune).

During the period of exacerbation, pain, dyspeptic and asthenic syndromes are characteristic.

Clinical manifestations of ulcer-like chronic gastritis are similar to peptic ulcers and manifest as acute paroxysmal pain in the epigastric region, which occurs 1.5 hours after eating, but is sometimes detected on an empty stomach.

In addition, belching of sour contents appears and is noted.

Asthenic syndrome is characterized by fatigue, weakness, headaches, and emotional lability.

For autoimmune chronic gastritis in a child Pain that occurs 15-20 minutes after eating is typical. They appear in the navel and epigastric region and go away on their own within 1.5-2 hours.

When dyspeptic syndrome appears, a feeling of heaviness appears in the stomach, belching of air, nausea, and loss of appetite appear. There is an aversion to fatty foods, cereals, and dairy products. Loss of body weight may develop. Characteristic symptoms include paleness, dry skin, swelling in the corners of the mouth, and brittle nails.

At objective research moderate pain is detected on palpation in the epigastric region.

Diagnosis is carried out on the basis of clinical data and additional examination methods. The most significant are fibrogastroscopy, fractional study of gastric contents, ultrasound abdominal cavity, scatological examinations of feces.

Endoscopic examination can determine widespread or focal edema and hyperemia, superficial defects of the mucous membrane, erosions in the antrum and bulb duodenum. Endoscopy reveals an inflammatory process in the area of ​​the body of the stomach or in all its parts.

When studying the secretory function of the stomach, the amount of of hydrochloric acid, pH level, proteolytic activity of gastric juice - the latter is usually reduced.

An X-ray examination reveals a change in the relief of the mucous membrane and a violation of its motor function.

In some cases, a biopsy is performed during gastroscopy and a histological examination, which reveals changes in the gastric mucosa and impaired epithelial regeneration. Usually a distinction is made between superficial gastritis with or without atrophy of the glands.

Treatment. The main thing in treatment is diet, which can lead to recovery.

Diet for chronic gastritis and gastroduodenitis

First breakfast. Milk porridge, a sandwich with mild cheese, butter, tea or surrogate coffee with milk.
Lunch. Grated apple with cream; sweet, natural juice diluted with water; cookie.
Dinner. Soup from pureed vegetables, milk jelly.
Afternoon snack. Surrogate tea or coffee with milk, white crackers or unsweetened cookies.
Dinner. A piece of boiled soft meat or fish with vegetable puree, pudding, tea.
Before bedtime. A glass of milk, kefir or fermented baked milk, cottage cheese with cream and sugar.

Diet therapy is based on the principle of mechanical, chemical and thermal sparing, treatment tables 1b, 5 are prescribed.
Table 1b is prescribed in the first 5-10 days, food is given in puree or mushy form. If the condition improves, diet No. 1 is prescribed for up to 6 months, then table No. 5.
With reduced secretion, diets No. 2 and No. 5 are prescribed. drug therapy are prescribed depending on the existing symptoms:

• antacid therapy (magnesium oxide, Almagel, Vikalin, Maalox, Gastal);
• antispastic drugs (papaverine, no-spa);
• mineral waters (“Truskavets”, “Borjomi”, “Essentuki”);
• to eliminate dyspeptic symptoms - cerucal, motilium;
• to destroy Helicobacter, complex therapy with antibacterial drugs is prescribed;
• for increased secretion - H2-histamine receptor blockers (cimetidine, ranitidine), bismuth preparations - denol, vikalin;
• in case of severe pain, antispasmodics.

To increase appetite, trefoil juice, aralia tincture, etc. are prescribed. physical methods Diatherapy, electrotherapy and hydrotherapy are used for treatment. Sanatorium-resort treatment for chronic gastritis prescribed no earlier than 3 months after clinical remission. At gastritis in a child with increased secretory function of the stomach, treatment is indicated in the sanatoriums of Essentuki, Zheleznovodsk, Kislovodsk or in the sanatoriums of the local climatic zone. For chronic gastritis with reduced secretory function of the stomach, treatment is recommended, including the administration of sodium chloride or sodium bicarbonate chloride waters (Essentuki, etc.). The prognosis for recovery is questionable.

In a children's clinic, you can see many small children in line to see a gastroenterologist. Children often suffer from gastritis, which causes not only unpleasant symptoms in the form of nausea and stool upset, but also pain. The disease often appears in children who have started school, are constantly stressed, eat poorly and are in a group environment. How to treat the disease?

What is gastritis?

Gastritis is an inflammation of the stomach lining. It contains special glands that produce stomach acid and the enzyme pepsin. The action of acid is aimed at breaking down food, and pepsin is designed to break down proteins. The organ is lined with a layer of mucus, which acts as a protection: it does not allow gastric juice to destroy the mucous membrane.

When the mucosa is inflamed, it not only produces less enzymes and acid, but also reduces the secretion of mucus and other useful substances creating a protective barrier. Under these conditions, digestive juices damage the walls of the organ.

Usually the term “gastritis” is used to explain all episodes of paroxysmal, transient abdominal pain, nausea and vomiting. However, the disease is usually not the cause of these symptoms. The diagnosis is made only when an endoscope detects damage to the mucous membrane.

According to the duration of the flow, they are distinguished:

1. acute gastritis, occurring suddenly and not lasting long;
2. chronic, characterized by a long course (without treatment, it can bother you even throughout your life).

Based on the degree of damage, a distinction is made between erosive gastritis (with the formation of ulcers and wounds on the mucous membrane) and non-erosive gastritis (accompanied only by inflammation). According to the nature of acid production in the stomach, gastritis is distinguished with reduced, constant and increased secretion.

It is necessary to distinguish traditional gastritis from gastroenteritis. The second is an infectious disease caused by viruses and bacteria (most often rotavirus).

Why do children develop gastritis?

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Often the disease is diagnosed in children from 6 to 10 and from 13 to 17 years old. Most often, children are affected by infectious gastritis, the causative agent of which is a microorganism Helicobacter pylori. The danger is that the bacterium is transmitted by contact: through a kiss, eating from the same cutlery, or using a towel.

The frequency of detection of H. pylori in the body with gastritis in children reaches 85%. Another 5% comes from autoimmune diseases. In other patients, the disease is caused by chemical, medicinal and other irritants.

Gastritis in children develops for the following reasons:

• The disease affects babies under one year old due to frequent changes of formula during artificial feeding. Also, the cause may be improper complementary feeding if it is introduced untimely or prohibited foods were used. early age products.
• In children 5-8 years old, the disease occurs due to poor nutrition (the child eats dry food, ignores hot dishes, abuses fast food, etc. junk food, drinks water with dyes and gas).
• Irregular meals in large portions.
• Food poisoning leading to disruption of the gastrointestinal tract.

• Deterioration psychological state due to constant stress and nervous tension. Gastritis often occurs in children 6-7 years of age who are faced with unusual workload at school and do not have enough time to rest.
• The disease can be provoked by both excessive exercise and its absence in the baby’s life.
• Autoimmune diseases. Sometimes the immune system produces antibodies that attack the body's cells.
• Long-term exposure to toxic substances (the disease develops while taking medications).
• Chronic infections that are ignored for a long time and proceed without proper treatment.

Symptoms of pathology

Gastritis in children is manifested by the following symptoms:

• pain in the abdominal area, the strength of which depends on the degree of inflammation;
• frequent belching of air (sometimes a small amount of food returns to the esophagus);
• heaviness in the stomach;
• heartburn, which gets worse when running or active games;
• sometimes – the appearance of a sour taste in the mouth;
• loss of appetite;
• intestinal dysfunction, increased gas formation;
• pain in the stomach when pressed;
• weight loss, pale skin;
• constant weakness.

Acute form

Acute gastritis in children develops quickly - the body reacts sharply to negative impact on the gastric mucosa. Call unpleasant manifestations may be poor quality nutrition or pathogenic microorganisms. In children under one year of age, inflammation can be triggered by accidentally swallowed toxic substances. There are 4 forms of acute gastritis:

• inflammation of the mucosal surface;
• tissue damage throughout its thickness;
• inflammation with the appearance of erosions on the surface;
• inflammatory process with a significant degree of tissue damage.

The disease is accompanied characteristic features:

• severe spastic or It's a dull pain in the abdominal area;
• heartburn and acid reflux after eating;
• frequent vomiting with a sour odor of the contents (sometimes inclusions of bile are visible);
• excessive saliva secretion or dry mouth;
• constipation or infrequent bowel movements;
• cardiopalmus;
• frequent headache;
• fever and profuse sweating.

The acute form of the disease requires immediate treatment, since with the development destructive processes An ulcer or bleeding may occur. With properly selected therapy, the gastric mucosa regenerates.

Chronic form

Chronic gastritis In children it takes a long time to develop, the symptoms are mild. Periodically, exacerbations occur with characteristic symptoms that need to be stopped, otherwise the disease again takes on a sluggish form. Parents should go to the hospital if the following symptoms The child has:

• dull pain that occurs within 20 minutes after eating;
• lack of appetite, nausea after eating;
• belching is accompanied by the smell of rot;
• a gray coating forms on the tongue, an unpleasant aftertaste appears;
• the child is bothered by diarrhea or constipation;
• possible weight loss;
• hair breaks easily, nails peel;
• general weakness, drowsiness, causeless irritability.

Danger and complications of gastritis

Lack of understanding of the seriousness of the problem, lack of adequate treatment gastritis can cause serious diseases and conditions:

• perigastritis and peritonitis;
• perforation of the organ wall;
• bleeding in the stomach;
• infectious-toxic shock.

The development of such diseases can be fatal, even if therapy has been prescribed. The disease can also contribute to the occurrence of:

• peptic ulcer (wound of the stomach lining);
• anemia (lack of iron due to bleeding or impaired absorption of microelements);
• atrophy of the mucous membrane with a decrease in the number of glands;
• proliferation of the mucous membrane with the subsequent appearance of neoplasms of various types.

Diagnostic measures

Many parents are interested in the question: how do they check for the presence of a disease in a child? The diagnosis can be confirmed by the only method - FGDS, which is also used for adults.

The procedure allows you to visually examine the mucous membrane and periodically analyze its condition. FGDS is accompanied by technical difficulties (the younger the age, the more difficult it is to conduct the study), so it is easier to monitor the child’s symptoms.

If signs of the disease persist for a long time, this is a direct indication for fibrogastroduodenoscopy. Ultrasound and radiological methods are not very informative for diagnosing gastritis. They will only help to exclude or confirm the presence of other disorders of the gastrointestinal tract (pancreatitis, bile duct dyskinesia).

To determine the severity and presence of complications of gastritis, additional methods diagnostics:

• CBC and urine examination;
• blood biochemistry;
• stool occult blood test.

Helps check for H. pylori breath test. The child swallows a capsule or special liquid that contains urea labeled with a carbon atom. If bacteria are present, urea is converted to carbon dioxide. After a few minutes, the baby exhales into a container, which is sent to a laboratory where carbon atoms are identified.

Complex treatment

Gastritis must be treated comprehensively. Children are prescribed a diet and several main groups of drugs:

• antibiotics for 9-14 days to eliminate the bacteria Helicobacter pylori;
• medications including omeprazole, pantoprazole to block stomach acid secretion;
• means to reduce the production of acid in the stomach;
• antacids that neutralize the effect of acid on the walls of the organ.

Medications

A child can only be treated after consultation with a specialist. He will select medications that will reduce discomfort and speed up the recovery of the stomach.

Folk remedies

Before it was discovered that the cause of gastritis in most cases is a bacterium, the basis of treatment was diet therapy and traditional methods. IN different countries was created by trial method great amount recipes that helped stop the manifestations of the disease. Let's introduce some of them:

It's worth remembering that folk recipes are not able to destroy the causative agent of the disease - H. pylori. Unconventional treatment should be combined with medications prescribed by a doctor.

Diet

Nutrition for gastritis affects not only the speed of treatment, but also the duration of remission in the chronic form of the disease. During an attack of illness, it is forbidden to feed the child for the first 8-12 hours; you should only provide plenty of fluids: weakly brewed tea, NaCl solution with glucose. When dieting, you should follow the following basic principles:

• feed the child fractionally, 5 times a day in small portions;
• It is forbidden to eat less than 3 hours before bedtime;
• food should not be coarsely chopped, excessively hot or cold;
• You can’t eat dry food or consume more than 8 g of salt per day.

The following are completely excluded from the diet:

• pickles, fried and smoked foods;
• meat broths;
• carbonated drinks;
• fast food, ketchup, mayonnaise;
• fresh buns, bread, cakes;
• fresh milk (boiled milk can be added to porridge).

Difficulties arise with the diet of one-year-old babies, since they are just starting to be introduced to complementary foods. However, parents can prepare delicious and healthy dishes:

• slimy, pureed milk and vegetable soups;
• steamed lean meat and fish;
• liquid, well-cooked porridge;
• baked fruits (not sour);
• steam omelette.

Junior kids school age They eat the same way as adults; their stomachs are accustomed to many foods. You can add butter to dishes, make cottage cheese casseroles, and you can eat “yesterday’s” bread, crackers, and honey. A child at any age should drink sufficient quantity water. For an infant this is 300 ml, for children 10-11 years old and older - 1.2-1.7 liters per day.

According to the generally accepted opinion among gastroenterologists, the causes of gastritis, in particular childhood gastritis, lie in inflammatory processes in the gastric mucosa. Moreover, both adults and children have approximately the same predisposition to this disease. On the other hand, in adolescents it develops, as a rule, in parallel with other concomitant ailments, often not immediately revealing itself, and in many cases giving out, “like a carbon copy,” the symptoms of completely different diseases. In this regard, it is very important to carry out early diagnosis of childhood gastritis in order to prevent it from developing into a chronic stage.

It is important to know: Peptic ulcer disease in almost half of cases forms at an early age and is the result of a frivolous attitude to the symptoms of the disease in its initial stage, and consequently – the lack of proper therapy.

In order to understand the signs by which gastritis can be recognized, one should understand the features of the development of the disease in children. Stomach pathologies very often affect children due to the vulnerability of their body, since digestive system is still in the final stages of improvement. In adolescence, glandular papillae are finally formed, capable of reproducing the same amount and concentration of gastric juice as those inherent in adults. At the same time, due to insufficient “training” of the child’s stomach, it reacts hypersensitively to all kinds of irritating factors, including for medicines.

It is important to know! The vast majority of cases of gastritis are provoked by the bacterium Helicobacter pylori, and the infection process is facilitated by shared dishes and other household items, unwashed hands, and kisses.

The insidiousness of the disease lies in the fact that for a long time it can be hidden - despite the fact that the gastric mucosa is already undergoing inflammatory changes. Only months and even years later, the disease begins to manifest itself in the form stomach pain and disorders.

Less commonly, “school” gastritis can be provoked by stress: psycho-emotional stress and physical fatigue have a negative effect on the stomach, which, in turn, worsens the blood circulation in its mucosa. As a result, the walls are covered pinpoint hemorrhages turning into erosion. In this case, the test result for Helicobacter will be negative. Makes the situation worse poor nutrition: the disease may also be accompanied by biliary dyskinesia.

Despite the differences in the manifestation of various forms of gastritis, the symptoms of gastritis in children have much in common.

Firstly, this appearance painful sensations With varying degrees intensity, which depends both on the magnitude of the spread inflammatory process, and on the individual pain threshold of the patient. In this case, as a source of pain, children point to the upper central point of the abdomen - in the place where the stomach is located. The pain is often paroxysmal, less often aching in nature. Eg, antral gastritis characterized by a decrease in pain for some time after eating; then they appear again. In this case, they talk about the so-called Miningham rhythm, noted during exacerbation phases in approximately a quarter of patients. In most cases, it is not possible to identify a connection between snacking and non-systemically occurring pain.

Secondly, the occurrence of discomfort and heaviness in the stomach area with periods of relief and worsening of discomfort.

Impaired digestion is also indicated by such manifestations as flatulence, frequent diarrhea or vice versa - constipation, anemic symptoms in the limbs, low hemoglobin, vitamin imbalance. The reason for all these pathological phenomena lies in inflammatory processes that prevent the normal processing of consumed food.

The next symptom manifests itself in the form of nausea and vomiting, alternately accompanying each other or occurring independently.

You cannot do without external changes: in patients with gastritis, the skin has a pale tint, the tongue, as a rule, is surrounded by a grayish-whitish coating.

Spasmodic peaks in the development of the disease are observed in children during certain active periods of the body’s development: firstly, preschool and early school age, ranging from 3-4 years to 7-8 years. Next active phase falls on the so-called transitional age– from 10-12 years until adulthood. It is during these periods that the most negative preconditions for the occurrence of the disease are formed.

Manifestations of acute gastritis

The only type of food that protects against acute gastritis is mother's milk. That is why it is believed that a newborn or infant who is on natural nutrition, gastritis cannot exist in principle. Despite this, unfortunately, there are exceptions here - we will talk about them below.

All other food products can provoke it, since they are not guaranteed against harmful effects surrounding space. If in older children the cause of infection can be poor-quality or contaminated food, then the little one is more “adventurous” in this regard: by chance, out of pure curiosity or for other “noble” motives, the kids may well try the same potassium permanganate, dishwashing detergent or removing cockroaches, rat poison and other nasty things - not to mention medicines in attractive packages.

Contacting the delicate gastric lining, which is not accustomed to such irritants, this substance leads to a burn or an acute inflammatory process. Sometimes it is possible to get by with basic gastric lavage, and in some cases you have to resort to medications. Depending on the intensity of such contact and the degree of damage received, the following manifestations are characteristic of acute gastritis:

• Superficial inflammation occurring in the upper layers. This picture is observed when moderate degree illnesses with weak nagging and sometimes bursting pain, stool upset, bloating and gas formation, slight heartburn, single vomiting. Superficial changes are considered the most common and at the same time do not pose a serious threat to children: after passing the peak of a slight deterioration, the child is cured in just a few days and subsequently forgets about the disease completely - naturally, with proper treatment.
• Deep inflammation penetrating the mucous membrane;
• Small eroded changes of a superficial nature, formed under the influence of inflammation;
• Deep destructive inflammatory processes affecting the mucous membrane.

As for the symptoms of acute gastritis in children with severe forms, they manifest themselves primarily:

• General weakness and feeling of discomfort. Repeated vomiting can lead to unacceptable dehydration of the child’s body, intoxication and even gastric bleeding, so adults are required to exercise maximum care and caution;
• Unfortunately, the child almost always experiences pain. These may be stomach cramps, giving off severe pain in the upper peritoneum.

With a toxic foodborne infection, the gastric mucosa is attacked by pathogens, for example, salmonella and its toxin. Exogenous gastritis is characterized by disruption of the digestive process under the influence of poor-quality food, and with endogenous gastritis, the cause of inflammation is the penetration of etiological agents.

The clinical picture as a whole is characterized by general weakness, profuse salivation, and sometimes chills, turning into low-grade fever, with further intensification of pain and vomiting.

How does chronic gastritis manifest?

The difference between chronic gastritis and acute gastritis lies in the duration of therapy and the mechanisms of occurrence. Besides, clinical picture chronic gastritis in children is not so pronounced, and sluggish phases are replaced by periods of exacerbations. How does the disease begin? Due to the weakening of the protective capabilities of the gastric mucosa, its motor and secretory functions are disrupted and it cannot put a barrier to the aggressive environment. As if sensing that an emergency situation has arisen, the body instinctively uses “internal reserves”: the process of self-digestion of the delicate walls of the mucous membrane with the contents of the stomach occurs - this turns into inflammation. The sensations that arise in this case are unpleasant and are manifested by nausea, belching, heartburn, and a feeling of heaviness. In rare cases, all this may be accompanied sharp deterioration children's well-being.

Strictly speaking, chronic gastritis manifests itself in two main types of symptoms - gastritis-like and ulcer-like. In the first type, inflammation occurs at the bottom of the stomach, is accompanied by low acidity and is characterized by the appearance of predominantly low-intensity pain immediately after eating, which subside within an hour to an hour and a half. It is logical that such a child suffers from lack of appetite.

In the second type, the source of inflammation becomes the pyloric region with normal or increased acidity, and the pain manifests itself exactly the opposite: after eating, it disappears. Approximately every tenth teenage child experiences night pain.

Depending on the state of the secretory function of the stomach (decreased, increased, within normal limits), chronic gastritis can manifest itself in three types. In all cases, the main clinical sign is pain in the epigastric region (located in the middle under the ribs). The doctor will be able to judge a specific type of violation only after interviewing the child, during which he must find out:

• The nature of the pain (most often aching);
• The time of its appearance (mostly immediately after eating). In this case, the specialist needs to find out what food provoked pain syndrome. If pain occurs in response to eating spicy food and it decreases after taking an alkaline food, for example milk, we can talk about increased acidity. If the pain intensifies after use alkaline products, therefore, the acidity is reduced.

Patients often complain of a lack of appetite with a simultaneous feeling of fullness and heaviness in the abdomen; Clinical manifestations in the form of dyspeptic disorders are also possible - nausea, belching, vomiting, heartburn, regurgitation, bowel disorders (alternating diarrhea and constipation).

Headaches, fatigue, irritability and general malaise, which appear in every second patient, indicate asthenovegetative syndrome, and in two thirds symptoms are obvious vegetative dystonia in the form of increased sweating, red-resistant dermographism, arterial hypotension, bradycardia and so on.

You should know that with chronic gastritis, hyperemia (increased blood supply) progresses, swelling occurs, and the walls of the stomach can swell on both the external and internal sides, affecting the normal temperature background. Such negative changes are immediately followed by a reaction from the liver, gallbladder, spleen and pancreas, as a result of which in the colon and small intestines Insufficiently digested food accumulates with all the ensuing consequences.

Another important point: any chronic disease, including gastritis, becomes the patient’s companion throughout his life, accompanied by periods of exacerbations and remissions (a period without signs of the disease), often of a cyclical nature. When giving a child such a diagnosis, parents must clearly understand this and not indulge him in his desire to violate the regime and menu. In this case, the digestive tract will immediately respond with an “extraordinary” exacerbation.

Exception to the rule: gastritis in infants

Alas, many diseases these days have sharply rejuvenated - we have to take this negative dictate of the times into account. Children's gastritis is no exception, especially if the child is fed artificial formula.

In very young children, the disease usually appears suddenly. This happens due to inflammation of the mucous membrane, followed by an imbalance between hydrochloric acid and other gastric enzymes that play important roles in digestive processes.

The main difficulty is that at this age the baby cannot express in words everything that is happening to him, so parents should be especially attentive to the symptoms listed below.

So, if your little one shows symptoms like...

• Constant anxiety;
• Belching with air after feeding, which then turns into vomiting. It is explained by insufficient formation of the cardiac sphincter, which causes an increase in intragastric pressure (pressure inside the stomach). Incorrect feeding techniques for the baby also play a negative role here;
• Periodic refusal to eat;
• Antispasmodic pain cramps (this will be noticeable even to not the most experienced young mothers);
• The presence in the vomit, in addition to food particles, also contains blood, bile and mucus;
• Skin pallor;
• Dry tongue. At the same time, it may become covered with a grayish and powdery coating;
• Bloating;
• Increased sweating;
• Rapid heartbeat;
• Frequent constipation or, on the contrary, profuse light-colored diarrhea with a strong nauseating odor,

...parents should be concerned and immediately show the child to a specialist.

Another feature of the youngest is the occurrence of regurgitation, in which abdominal Press practically does not strain. They can serve as a sign of incipient intestinal infections, or be observed in completely healthy children and speak, for example, of a short esophagus, cardiospasm - a more detailed study is needed here. That is why the presence of symptoms alone is not an indication for treatment of one or another form of gastritis. Before doing this, it is necessary to carry out thorough diagnostic measures, during which the diagnosis may not be confirmed. Moreover, it is possible that cases where suspected gastritis turns into much more serious diseases. Research combined with laboratory methods may be prescribed to exclude accompanying illnesses gastrointestinal tract or determine the severity of gastritis manifestations.

As for older children: already two or three year olds can express their feelings in words and accurately show the place where they experience increased discomfort. At this age, most of the unpleasant syndrome occurs in the child in the form of pain in the area solar plexus. At this age, at the initial stage, gastritis is also manifested by bloating, “hungry stomach” syndrome (pain on an empty stomach), increased salivation, bruises under the eyes, general weakness.

The child has a stomach ache - Dr. Komarovsky School

Finally…

Finally, childhood gastritis can be caused by bad environmental situation, especially in megacities, excessive psycho-emotional stress, not enough or too much active image life and far from regular nutrition of school-age children.

Last article updated: April 10, 2018

In children's medical institution You can always see a lot of small children in line to see a gastroenterology specialist. Why does gastritis occur in these babies? How to treat gastritis in children? And what measures should be taken to avoid this disease? Gastritis in a child often manifests itself at school age, when the student comes into contact with a large number of people, does not always eat properly, and experiences stress.

Pediatrician, gastroenterologist

The surface inside the stomach is covered with mucous membrane. And sometimes the mucous membrane is involved in the inflammatory process. This process is called gastritis.

Forms of gastritis

The disease is classified according to various criteria. Today medicine distinguishes several types of gastritis. The symptoms and treatment for each type are different. That is why it is necessary to consult a specialist if you suspect the presence of a disease.

1. According to the course of the disease, childhood gastritis is divided into acute and chronic gastritis.

2. Types of gastritis according to acid secretion:

• gastritis with high acidity;
• gastritis with low acid production;
• gastritis with normal secretion.

Common to all forms signs of gastritis in a child:

1. Pain. As a rule, children with gastritis experience pain in the upper abdomen (in the stomach area). The intensity of pain depends on the degree of inflammation and the pain threshold of the individual child. Therefore, the pain can be mild, not intense, or too severe.
2. Heaviness and discomfort in the abdomen. It occurs both as an isolated symptom and in combination with pain.
3. Heartburn. It is observed to increase in children when the body is tilted and physical activity. The symptom is described as a burning sensation in the area upper sections stomach and behind the chest. Some children may notice a burning sensation all the way down the esophagus to the throat, followed by a sour taste in the mouth.
4. Belching and reflux. In this case, the child develops bad smell in the mouth.
5. Poor appetite and refusal to eat.
6. Nausea and vomiting. Both of these manifestations either complement each other or appear separately.
7. Disturbance of digestive processes. Due to gastritis, the first stage of food processing is disrupted. This leads to disturbances at all stages of the digestive process. The child experiences bloating, diarrhea or constipation, anemia, hypovitaminosis and other signs of malabsorption of nutrients.
8. External changes. Pale skin, a tongue with a grayish or whitish coating may indirectly indicate the existence of gastritis with impaired digestion.

The signs that characterize the disease are very extensive. But there are specific symptoms that indicate the development of a certain form.

Signs of acute gastritis in a child:

1. Abdominal pain. Both severe spasmodic pain and constant aching pain can be observed.
2. Heartburn, sometimes acid reflux after eating.
3. Frequent nausea, vomiting. Vomit has sour smell. Sometimes the child vomits bile.
4. Excessive salivation or dry mouth.
5. Abnormal stool. Manifests itself in the form of constipation or diarrhea.
6. Weakness of the body, which is accompanied by dizziness and headache.
7. Heavy sweating, fever.
8. Reduced blood pressure and tachycardia (rapid heartbeat).

General signs of chronic gastritis

Sometimes signs of this type are mild. Therefore, pay attention to all the symptoms:

Specific manifestations of the atrophic form of gastritis:

1. In the foreground is not painful, but dyspeptic syndrome in the form of heaviness in the abdomen, disruption of the digestive process and absorption of nutrients.
2. The atrophic form of gastritis disrupts the general condition of the child, causing anemia and hypovitaminosis.

Symptoms of gastritis with high acidity, when excess gastric secretion occurs:

1. Pain is the main manifestation. It can be triggered by food or physical activity of the child.
2. Heartburn and sour belching.
3. The child's condition as a whole is rarely disturbed.

• infectious gastritis;

Not everyone knows that gastritis is a contagious disease. Previously, it was believed that all varieties of this disease were not infectious. As it became known recently, this statement is incorrect. When inflammation or infection occurs in a child's body, an allergic reaction and gastritis may occur.

In turn, infectious gastritis in children is caused by bacteria or viruses.

Helicobacter pylori (H. Pylori). This common reason gastritis. The role of Helicobacter in the occurrence of chronic gastritis has been precisely proven. This microorganism can only exist in the stomach with high acidity.

Therefore, the bacterium causes chronic gastritis only if there is increased production of gastric juice and hydrochloric acid. Inflammation of Helicobacter pylori origin with reduced secretory activity of the stomach is impossible.

Viral gastritis in children is an inflammation of the gastric mucosa caused by viral infections such as cytomegalovirus, herpes, etc.

• malnutrition of the child;

Ideally, all babies should be breastfed. But it happens that a mother cannot breastfeed her child. And it’s good if you can immediately choose a formula that is suitable for your baby.

The baby's first year is the most important. Frequent change infant formula, incorrect choice of baby food, untimely or incorrect introduction of additional products - all this leaves an imprint. Considering that children's digestive systems are still immature, the burden becomes serious.

Further, in older age, irregular meals, refusal of the first course, a snack instead of a full meal, a diet devoid of nutrients, very hot or, conversely, too cold dishes are a direct path to the development of the disease.

Remember that chocolate, cookies and even regular caramel contribute to gastritis. Children's doctors prohibit offering children any sweets until at least three years of age. This also applies to liver. The exception is those specially prepared for small children.

• stressful situations;

Gastritis often develops due to stress. There is no less stress in a child’s life than in adults. And sometimes even more.

Among the most common stresses in children are moving to another city, moving to a new educational institution, the appearance of a younger brother or sister, unfavorable interpersonal relationships in kindergarten or school. Stress is especially severe for those children whose parents often quarrel with each other.

And don't forget about one more thing important factor. What does your child watch on TV? What games does he play? And how many times a day? Remember that even good cartoons and fairy tales large quantities have a very serious effect on the children's nervous system.

• food poisoning;

Toxins have a destructive effect on the lining of the stomach, causing inflammation. And inflammation is gastritis.

Carefully monitor the quality of children's products. Pay attention to the date of manufacture and temperature conditions storage

• other diseases;

Sometimes gastritis occurs as a result of existing childhood diseases, for example, pancreatitis, hepatitis, cholecystitis.

Therefore, if crumbs in the body have a source chronic infection– nephritis, sinusitis, dental caries – the risk of gastritis increases significantly.

In addition, gastritis can be caused by the presence of Giardia and other intestinal worms in the child's body. They severely damage the gastric mucosa, causing irritation and inflammatory processes.

• medicines;

Gastritis can be caused by a variety of pharmacological agents. Medicines often cause severe irritation and inflammation of the gastric mucosa. It is unlikely that a single use of the drug will lead to gastritis. But systemic use of certain medications can provoke inflammation of the gastric mucosa.

However, in some cases this cannot be avoided. For example, when a child gets sick and needs a course of treatment with some aggressive drugs. The doctor must take into account the threat of gastritis and try to prevent it. But very often it is the parents who are the culprits of such gastritis.

Often adults independently treat a child, giving him certain medications without consulting a doctor. And How natural result– development of gastritis. All medications should be prescribed only by a pediatrician.

• genetic factors.

It is known that many diseases tend to be inherited. Gastritis is no exception. If the mother, father or one of the child’s immediate relatives has gastritis, only the slightest provoking aspect is needed (for example, a small mistake in diet), and gastritis will immediately make itself known.

Clinical symptoms and complaints of the child will prompt the doctor or parents to assume the presence of gastritis. Since a more dangerous disease of the stomach or other organs may be hidden under the guise of ordinary gastritis, such a child needs detailed diagnosis and careful observation.

How can you determine for sure that a child has gastritis?:

The methods used to treat gastritis differ depending on the aspects that cause the condition. Therefore, the treatment of chronic gastritis may be slightly different from the treatment of acute gastritis, since their causes are usually different.

Since chronic gastritis is caused by the bacterium H. Pylori, treatment for the chronic form should be aimed at eradicating the bacteria.

On the other hand, acute gastritis usually results from food poisoning or excessive use of non-steroidal anti-inflammatory drugs. Most doctors advise taking medications to regulate stomach acids so that symptoms remain under control.

Medicines that are part of the treatment of gastritis:

1. Antacids to neutralize acids in the stomach.
2. Medicines to block acids and promote healing.
3. Antibiotics to kill H. Pylori bacteria.
4. Medicines to reduce acid production.

How and how to treat various forms of gastritis in a child?

The treatment regimen for acute gastritis consists of several steps:

1. Gastric lavage using a tube or drink plenty of fluids with further provoking vomiting.
2. Application of sorbents ( Activated carbon, Smecta, Enterosgel).
3. Taking antacids (Venter, Almagel, Phosphalugel, Maalox).
4. At long term during the inflammation process, it is recommended to reduce the production of gastric acid (Famotidine, Ranitidine).
5. Enzymatic medications (Creon, Pancreatin).
6. Diet food. Gentle products that do not irritate the gastric mucosa.
7. For severe pain, antispasmodics are indicated (Baralgin, Papaverine, No-shpa).

Never give your child any medications yourself. Drug treatment must be carried out exclusively under the strict supervision of a specialist. And, of course, only by prescription. Therefore, doctors prefer to treat childhood gastritis in a hospital setting.

Treatment of gastritis in a child depends on what exactly caused the disease. Treatment success is possible when the causes are eliminated. Otherwise the disease will return.

But there are general provisions that are relevant for all cases. If they are not followed, the treatment will not be successful.

Psychological atmosphere

Remember that all types of stress are the most fertile soil for gastritis. Thus, it is necessary to eliminate these stresses. It is necessary to create the most comfortable psychological situation for the child.

Gastritis cannot be cured without changing the child’s diet. Talk to your doctor. This will help you choose a menu that is ideal for your baby.

For any form of childhood gastritis, special importance is attached to dietary nutrition. The duration of treatment depends on the severity of the disease and the period of relapse-free progression of chronic processes.

Nutrition tips for children with gastritis:

This problem worries many parents whose child with excess body weight and chronic gastritis limits food for a long time and cannot lose it. This question also applies to those who lose weight while acute form gastritis, but after a while he suddenly begins to gain weight.

Sample menu for one day:

When a child is diagnosed with gastritis (and it doesn’t matter what form), do not be upset and do not be afraid that full-fledged, healthy life ended. It just takes time to reconsider the principles of nutrition and level physical activity in family.

How to prevent gastritis? Prevention of gastritis in children:

1. Keep batteries and similar items out of the reach of children. Button batteries are easy to swallow and can cause serious harm. Keep all batteries and toxic artifacts out of reach of children. Use child locks to protect children from dangerous objects.
2. Do not give your child foods that cause irritation. Foods such as oranges and other citrus fruits can cause a burning sensation or even pain. Give your baby a variety of healthy foods. Examples: fruits (not citrus fruits), vegetables, low-fat dairy products, beans, whole grain bread, lean meats and fish. Encourage your child to eat small meals and not drink water during meals. Do not allow your child to eat 3 hours before bedtime.
3. Don't smoke around your child. Nicotine and other substances in tobacco products may worsen symptoms and cause lung damage.
4. Help your child relax and reduce stress. Nervous stress can increase the amount of stomach acid and make gastritis more severe.

Thus, when a child is diagnosed with gastritis, it is unpleasant, but not fatal. Treatment must be approached comprehensively. In addition to medications, the baby must strictly follow a diet. This will prevent the appearance painful attacks and speed up the healing of the mucous membrane.

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Category: Gastritis

Gastritis is a consequence of a disorder of the gastric mucosa. Most often, gastritis in children develops during periods of abrupt growth of internal organs: 5-6 and 9-12 years, but it also occurs in children under 3 years of age. Timely diagnosis and compliance with all medical prescriptions allows you to cure gastritis; delaying treatment is fraught with the development of a chronic form of the disease that will accompany the person throughout his life.

Causes

Doctors identify a certain risk group among children of all ages: children who are in the phase of active growth and development of internal organs. These are children of primary school age, as well as teenagers 12-13 and 16-17 years old. Age-related changes in combination with certain negative factors lead to the occurrence of gastritis.

Factors influencing the development of the disease:

• violation of the diet: irregular eating schedule, different portions;
• eating unhealthy foods: fried, salty, chips, carbonated drinks, fast food, spicy and smoked foods, fatty foods, spoiled foods;
• long-term use of medications;
• Excessive brain and emotional stress: constant stress, workload school subjects leads to a failure in the production of gastric juice, appetite disturbance, and stomach problems;
• excess physical activity;
• Helicobacter bacterium, which lives in the stomach with high acidity of gastric juice;
• autoimmune and infectious diseases: inflammation or infection is not limited to one organ, but can cause allergies or inflammation in the stomach.

Plays a major role in the development of the disease hereditary factor. Parents suffering from gastritis can pass on a predisposition to their child at the genetic level, which can be activated by one of negative factors impact.

Important! Gastritis caused by an infectious component is contagious. Parents can easily infect their baby through close contact (kissing), sharing dishes, toys.

Symptoms

There are several types of the disease, differing in symptoms, but they also have common symptoms.

• persistent pain in the stomach;
• vomit;
• lethargy, general deterioration of the child’s condition.

The occurrence is associated with the structural features of the child’s gastrointestinal tract. Wrong food entering the stomach causes negative stimulation mucous membrane. Taking medications may also play a role.

• gastric lavage, inducing profuse vomiting;
• taking sorbents: Enterosgel, Smecta;
• enzyme preparations: Creon, Panzinorm, Mezim;
• diet;
• antispasmodics: Papaverine, No-shpa.

Remember! Repeated vomiting leads to rapid dehydration of the body.

It differs from acute not only in duration, but also in the characteristics of its occurrence. The symptoms are not very pronounced, the disease lasts a long time, the exacerbation is replaced by a lull. When a child’s process of gastric secretion is disrupted and gastric motility is impaired, the mucous membrane begins to suffer from prolonged exposure large quantity gastric juice.

How it manifests itself:

• pain in the stomach area;
• belching, feeling of heaviness;
• heartburn, nausea;
• a sharp deterioration in the child’s health.

The chronic form may be accompanied by decreased and increased gastric secretion. When it decreases, gastric cells self-destruct, which is rare among children.

• antispasmodics: Papaverine, No-shpa;
• normalization of gastric motility: Motilium, Cerucal;
• antibacterial drugs (in the presence of Helicobacter): Clarithromycin, Metronidazole, De-Nol;
• enzyme preparations: Creon, Pancreatin, Mezim;
• decreased gastric secretion: ranitidine, famotidine;
• reducing stomach acidity: Phosphalugel, Almagel.

A prerequisite is to follow a gentle diet.

Important! The chronic form of the disease is an indication for constant adherence to the diet, and not just at the time of exacerbation of the disease.

In children, the predominant form is superficial gastritis; the atrophic process in children is a rare occurrence.

This type is characterized by the appearance of ulcers and erosions on the surface of the mucosa. Often occurs when a child swallows a chemical.

How it manifests itself:

• pale skin;
• lethargy, anxiety, tearfulness, sleep problems;
• pain in the stomach area;
• vomiting, chills, high fever;
• increased or decreased salivation.

Treatment is carried out exclusively in a hospital setting under the supervision of a doctor. After discharge, the child needs to maintain a calm atmosphere in the home, follow a diet and eating regimen.

Infectious causes of gastritis were identified not so long ago; previously, stressful situations and nutritional problems were considered the trigger mechanism.

Infectious pathogens:

• dysentery;
• syphilis;
• tuberculosis;
• viral hepatitis;
• bacterium Helicobacter pylori.

How it manifests itself:

• constant nausea, vomiting;
• severe pain in the stomach, especially upon palpation;
• fever, lethargy, lack of appetite, poor health.

Treatment is carried out using antibiotics: De-Nol, Metronidazole, Clarithromycin. The following sorbents are used: Enterosgel, Smecta, Polysorb. The diet is being followed.

Diet

Dietary nutrition is one of the fundamental points medical procedures. The duration of therapeutic procedures depends on compliance with the diet.

A few rules of proper nutrition:

1. Eat small and regular meals 5-6 times a day in small portions.
2. Avoid spicy, fried, salty and fatty foods. Do not use spices during cooking. Eliminate from diet confectionery, fresh white flour bread, legumes, raw vegetables.
3. Boil or steam food.
4. The menu should consist of dietary soups, vegetable broths, chicken and rabbit meat, mashed potatoes, porridges (oatmeal, buckwheat, rice) with added butter, steam cutlets from lean fish and meat, cottage cheese casseroles, steamed egg omelet. You can drink weak tea, dried fruit compotes. It is allowed to eat honey, day-old baked goods (white bread), and crackers.

Important! The most strict diet at the beginning of the disease, then it can be expanded to restore strength and nutrient reserves.

Disease prevention

It is better to prevent any disease than to treat it, and gastritis is no exception.

What rules should you follow:

• adherence to a strict daily routine: sleep and meals according to schedule;
• a calm, homely atmosphere: do not swear in front of the child, do not shout at him;
• strict adherence to the norms for introducing complementary foods to children under one year of age;
• eliminate food from the entire family's diet instant cooking(fast food);
• do not rush the child while eating, do not play with him, do not turn on cartoons. Ensure that the child chews food thoroughly;
• eliminate any pockets of infection (do not forget to visit the dentist and treat caries in a timely manner).

The children's diet should be as dietary as possible. The diet of all family members must be adjusted so that the child does not have access to prohibited foods.

Parents should pay attention to any complaint from the child about deterioration in health, pain, etc., in order to consult a doctor in time and avoid the development of the disease.

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