Stomach ulcer in children: how to recognize a dangerous disease. Features of the course, causes and tactics of treatment of peptic ulcer in children

stomach ulcer in children early age does not occur, for the first time such pathological disorders in the digestive system are found in adolescents. Since this disease is chronic, it is by this age that children suffering from gastritis or gastroduodenitis may develop a stomach ulcer or duodenum. The disease can occur with minimal symptoms and almost no discomfort during periods of remission, giving way to periodic exacerbations when the seasons change in autumn and spring.

The main symptoms of an ulcer are recurring pain in the upper abdomen, more often in its epigastric part, which is especially disturbing on an empty stomach. The child is often disturbed by pain at night, especially those of them who suffer from poor appetite and go to bed without a full dinner. It is noticed that after eating, the intensity of pain gradually decreases and completely disappears. Pain can also manifest itself in other places, radiating to the back or lower back.

Often the symptoms of peptic ulcer become similar to those of gastritis in chronic form and look like this:

the appearance of belching, often with a sour taste;
loss of appetite, children do not eat well and often refuse their usual dishes;
periodic bouts of nausea that can turn into vomiting;
flatulence of the intestine;
constipation with characteristic form feces in the form of balls;
sleep problems;
mental instability.

During the period of exacerbation, continuing long time, the child has noticeable visual changes in appearance. He loses weight dramatically, the skin loses elasticity, becomes pale and dry. Hair and nails lose their luster, becoming dull and brittle. On closer examination, there is a change in the color of the tongue, it looks thickly coated, with the formation of painful seizures at the corners of the mouth. With physical exertion, for example, when playing sports, the pain increases with the subsequent occurrence of complications during exacerbations. One of dangerous states are stomach bleeding.

It is noticed that the nature of pain attacks in case of peptic ulcer in a child increases in the morning after waking up and half an hour after eating. These features are one of characteristic features diseases, as well as bouts of nocturnal pain. Often it is possible to alleviate the condition by giving the child a drink of milk or plain water. The nature of the pain largely depends on the location. inflammatory process, with an exacerbation of the ulcer, the patient tries to change the position of the body to a more comfortable one, pulling the legs bent at the knees to the abdominal wall. With this forced posture, he tries to alleviate his well-being. In the case of the formation of an ulcer on the anterior surface of the stomach, relief can occur in the supine position and even leaning back far back, which allows at least a little reduction in pain symptoms.

The nature of the pain symptoms can also be different and appear in the form of attacks with cutting or stabbing pain.

What it looks like, photo

In the case of an ulcer formed during the diagnosis, the inflamed tissues of the gastric mucosa are clearly visible in the photo. If the size of the ulcer exceeds one centimeter, then it is already considered an ulcer. big size. On the sides of it, traces of inflammation are also noted, which can be regarded as gastritis.

Ulcer formation in upper divisions stomach is observed quite rarely and may be evidence of an exacerbation of the disease or oncology.

Well defined ulcer, located in the middle part of the stomach. In this case, patients experience pain immediately after food enters it, as there is an intensive production of gastric juice and mechanical irritation of the affected area. An ulcer in the stomach can also form in its distal section, in which case the child can feel the main painful symptom two to three hours after eating.

Via endoscopic examination It is possible to distinguish several stages of peptic ulcer, each of which has its own characteristics:

First stage. You can observe redness and swelling of the walls of the stomach, the ulcer has a rounded shape with clearly defined edges. A roller of inflamed tissue is formed around it, having a coating of gray or greenish tint.
Second stage. Observed initial signs healing of the ulcer with a decrease in redness and swelling of the walls and with the disappearance of fibrin at the bottom of the ulcer.
Third stage. There are symptoms of gastroduodenitis, a pink scar forms at the site of the ulcer.
Fourth stage. It implies a stage of remission, the existing scar is surrounded by a healthy mucosa without visible inflammation.

The conducted studies determine the nature of the damage and the stage of development of the disease. This allows to carry out timely treatment to prevent serious complications and further increase the duration of the remission period.

Causes

peptic ulcer in a child occurs under the influence of adverse endogenous or exogenous factors. External or exogenous factors include:

improper diet and illiterate diet;
absence full-fledged first dishes;
long breaks between meals or overeating;
eating poorly chewed food;
eating fatty, unhealthy food for children, hot spices;
acceptance of certain medicines.

Internal or endogenous factors are presented as follows:

penetration into the body of helicobacteria;
genetic predisposition inherited;
insufficient motility of the gastrointestinal tract with congestion accompanied by non-digestion of food;
complications resulting from other pathological processes such as gastritis and gastroenteritis.

There are also secondary factors that also contribute to the development of peptic ulcer:

prolonged or repetitive stressful conditions;
factors traumatizing the unstable child's psyche;
increased emotionality and nervous excitability of the child.

Symptomatic secondary gastric ulcers in children can be caused by the result of chronic diseases in various body systems in the form of pathologies in the cardiovascular, urinary and respiratory systems, and also be the result of a violation of the processes of blood supply to the walls of the duodenum or stomach. Some stages allergic reactions can also lead to ulcer formation.

According to scientists involved in the study of problems of gastroenterology, the mechanism of ulcer formation occurs due to violations of the relationship between aggressive factors and factors designed to protect against them. As aggressive reasons consider:

activity of helicobacteria;
the effect of acids and enzymes on the walls of the gastric mucosa.

The protective factors in this case should be presented as follows:

production of bicarbonate to neutralize acid;
the formation of mucus in the stomach in accordance with the norm;
sufficient blood circulation in the gastric mucosa;
regenerative processes in the cell epithelium.

Contribute to the formation of ulcers in the stomach in children and previous infections, as well as anomalies in the structure of the digestive tract, which are congenital.

Diagnostics

Diagnostics for the purpose of timely detection of stomach ulcers is of great importance for the child's body. You can determine the presence of the disease in the following ways:

Carrying out a visual examination by a doctor and using the method of palpation, as a result of which it is possible to determine the location of the site of intense pain, the presence muscle tension in the peritoneum, as well as the existing muscle spasm.
The use of laboratory tests that can identify possible complications in the early stages of development. Samples of feces and blood are used as the test material.
Usage instrumental diagnostics, which includes:
- fibroesophagogastroduodenoscopy - histological examination for the presence of a tumor;
- X-ray contrast study of the digestive tract;
- determination of the pH level of gastric juice and assessment of the acid-forming capacity of the stomach;
- the use of ultrasound to exclude background pathological processes.
Application of specific methods:
- computed tomography, performed when there is a possibility of spreading the pathology outside the stomach or in case of narrowing of blood vessels;
- laboratory analysis for the presence of helicobacteria;
Histological examination with evaluation of biopsy sections with cytological analysis of smears from the mucosa.
A non-invasive study of exhaled air can be used to determine the presence of helicobacteria waste products in it.
Differential diagnosis of older children with the study of liver function, duodenal sounding of gastric juice during remission.

A large number of diagnostic methods does not mean at all that all of them will be applied directly to one child. Most often, it is enough to use one or two methods that are most effective in relation to the child's body. Yes, one of accurate diagnostics an endoscopic examination is used, with the help of which the doctor can examine in detail the internal mucosa in the stomach and in the duodenum. The technique is used at any stage of the disease, regardless of the moment of remission or the stage with exacerbation. If necessary, they may resort to a biopsy with the collection of particles of the mucous membrane for histology. X-ray examination is usually not used for children because of its unwanted impact on the child's body.

Treatment

An ulcer formed in a child is treated with drugs with simultaneous application diets, and nutrition recommended by a doctor, a sick child should adhere to peptic ulcer disease at any stage, as well as during remission, no matter how long it may be. Holding surgical operation shown only in the most extreme cases, threatening severe complications.

As traditional methods treatment using the following complex methods:

diet therapy;
the use of drugs as proton inhibitors in the form of Omeprazole, Rabeprazole, Lansoprazole, Esomeprazole;
reception necessary for the body vitamins and nutrients;
use of alkaline mineral water (on the recommendation of a doctor).

The stage of exacerbation of the ulcer may require as additional ways treatment to use more effective antisecretory drugs as histamine H2 receptor blockers. Depending on the condition of the sick child and the severity of the pathology, the course of treatment can last from two to five weeks. When stomach bleeding, methods of hemostatic therapy are applied to the child, cold compresses are applied to the stomach area, the list of foods allowed for food is necessarily reviewed.

In especially difficult cases accompanied by severe course diseases, children may be prescribed a surgical operation. In this case, with perforation and the formation of a through ulcer, as well as with gastric bleeding that cannot be stopped, sparing methods of surgery are used for children. For example, with a through expression of one of the walls, a simple suturing of the wound is performed.

Folk remedies

A stomach ulcer that occurs in children is always accompanied by intense pain, most often in the abdominal region. To mitigate these symptoms and alleviate the condition of the child during periods of exacerbation of the disease, medications prescribed by the attending physician are capable. Folk remedies used for peptic ulcer disease will be of great benefit in eliminating painful symptoms. Most often, in this capacity, the most common and time-tested folk recipes with medicinal herbs and healing substances, for example:

Use of hot water. For pain caused by stomach ulcers, the most in a simple way get rid of it, serves plain water. This is a harmless method of treatment that can be applied to a child of any age and will not bring him any harm. To do this, when a sharp pain occurs, the child is given a glass of hot water to drink on an empty stomach. The course lasts at least six months, observing breaks every month of treatment.
Kefir and oil. A sick child is given to drink at least a glass of kefir with vegetable oil every day. With this method, you can get rid of pain, as the oil envelops the walls of the stomach and reduces irritation of its walls.
Clay. Clay is effective tool during treatment pathological changes in the condition of the stomach and intestines. In order for the child to agree to such treatment, you can sweeten the solution of clay in water with any fruit syrup. Treatment is carried out for a month, after a two-week break, the course is repeated.

It is possible to get rid of pain and relieve the painful manifestations of peptic ulcer in children with the help of honey or another natural antiseptic diluted with novocaine. This allows you to normalize the level of microflora in the stomach and intestines, and thereby reduce the site of inflammation and stop further destruction of the mucosa. Since honey is rich in organic acids and enzymes, due to which it has a detrimental effect on the pathological microflora that exists in the gastrointestinal tract. Due to its abrasive qualities, it does an excellent job of cleaning the ulcerative surface, and also turns out to be useful as an enveloping and analgesic agent. It is better to use honey on an empty stomach, before eating, and it is allowed to dilute it with water or milk.

Honey is also useful in combination with medicinal herbs, from which the infusion is prepared. For this purpose, use chamomile, fennel, Linden blossom. Crushed herbs are poured with boiling water, insisted and taken in a tablespoon on an empty stomach.
With a stomach ulcer, as a rule, there is an increase in the acidity of the stomach, in this case honey mixed with cottage cheese will help, as well as its addition to cereals, which will protect against heartburn. The healing of the affected area of the mucosa at the site of the formed ulcer and its speedy scarring occurs faster when daily use eating honey.

Often as an effective way traditional medicine used to treat peptic ulcer vegetable juices, most often in the form of potato, cabbage, beet or tomato. With the help of freshly prepared juice, which has enveloping, analgesic properties, it is possible to reliably protect the mucous membrane of the stomach and duodenum from the adverse effects of acid and bile. In addition, vegetable juices have a mild analgesic effect, so their use contributes to more successful treatment of ulcers.

The correct use of vegetable juices for stomach ulcers is as follows:

Potato juice is obtained from tubers, which are passed through a combine or, after rubbing them, squeezed through a gauze napkin. The resulting remedy is taken, starting with 25 ml before meals, with a gradual increase in dose.
Juice from potatoes with carrots is prepared similarly from 100 g of vegetables.
Showed the greatest effectiveness in the treatment of ulcers juice from fresh cabbage. It is used as a remedy for an ulcer for one and a half months, up to five glasses of the resulting remedy can be drunk per day.

There are no contraindications to the use of such prescriptions, and the use folk recipes as complex treatment with drugs can increase their effectiveness and accelerate the healing of lesions caused by ulcerative lesions. If applied correctly, then painful symptoms subside after a week.

Diet

The main condition for successful treatment peptic ulcer in children is a strict diet. Food that can harm the digestive system and stomach is completely excluded from consumption. First of all, these are all kinds of salty, spicy, fatty foods, drinks with gas, chocolate and cakes. The dishes eaten should be at a comfortable temperature, i.e. not too hot and not too cold.

Unlike adults, peptic ulcer in children is less often accompanied by serious complications. When choosing a diet, first of all, the stage of development of pathological changes is taken into account, as well as the existing accompanying illnesses. In the case of an uncomplicated form of the disease, a strict anti-ulcer diet is prescribed for the first five to seven days, after which, if there are positive results, an indulgence in the restriction is gradually introduced, the patient can eat dairy dishes, fish and minced meat, steamed, grated fruits in puree form. From the third week, in case of reduction clinical severity pathological disorders in the state of the stomach, the patient is transferred to five meals a day with the usual diet for peptic ulcer disease.

Prevention

It is better to prevent an ulcer in a child than to treat it later. To keep his stomach healthy, you must adhere to the following recommendations:

provide the child with adequate night sleep according to his age;
don't let him use junk food, which has an irritating effect on the gastric mucosa;
avoid long breaks between meals;
strict adherence to the daily regimen and diet;
prevent dental diseases;
if possible, avoid a negative psychological situation in the environment of the child;
avoid not only physical overwork, but also unbearable stress on the child's psyche;
ensure the child is adequately fresh air with the necessary physical activity for his age.

The state of the body with an already existing gastric ulcer in remission requires especially careful attention. Creating the necessary conditions for a favorable existence with the absence of factors provoking exacerbation can keep the child healthy for a long time.

Complications

Any ulcer becomes threatening possible complication, which is sometimes quite serious and requires immediate intervention doctor.

The most common threats are the following:

development of bleeding. With the formation of gastric bleeding, vomiting of an uncharacteristic black color appears, the child's stool also resembles tar. In addition to these symptoms, the state of blood loss is accompanied by dizziness, loss of strength, rapid heart rate, and a decrease in pressure.
Penetration formation. In this case, an ulcer formed in the stomach grows into nearby organs. A sick child feels prolonged painful manifestations that do not depend on food intake. An attack of vomiting does not relieve pain.
Perforation. There is a breakthrough of the wall of the stomach, its contents begin to come out into the abdominal cavity. The condition is characterized as very serious, requiring immediate surgery.

Fortunately, children this kind complications are rare, but nevertheless, it is not worth considering the possibility of such an outcome of peptic ulcer disease. No one can accurately predict how a stomach ulcer will behave in a particular case, so it is better to try to exclude such a result.

Gastric and duodenal ulcers in children and adolescence(“juvenile ulcers”) are not uncommon. This group of patients is in hospital medical institutions about 8-10% total number patients with peptic ulcer.

About ulcers in children are 3.5%, under the age of 25 - about 8-10%; the total number of operations for this disease.

Ulcers in children account for 2.7 to 5.7% of perforated ulcers in adults. Separate observations of perforations of the ulcer are found both in the early and in the older childhood.

Among the patients of adolescence, boys predominate. In childhood, in the intersex period, ulcer disease in children occurs equally often in boys and girls. Perforated ulcers occur almost exclusively in boys and are extremely rare in girls.

Ulcers in children are distinguished by a number of features.

The period from the moment of illness to surgery is very long. These patients are treated for many years under other diagnoses, since there is a misconception about the great rarity of ulcers in childhood and adolescence and they are the least thought about it. Correct Diagnosis ulcers are placed later than in adult patients.

Very often there is a disease with peptic ulcer and some other family members (most often the father and brothers).

The onset and long-term development of the disease, complications in adolescence during a crucial period of body formation and the associated restrictions and abnormalities in nutrition, forced abandonment of the normal regimen for adolescence (physical education) and living conditions, have a very negative effect on the general condition of the patient and often lead to to a sharp lag in development and a decrease in vitality.

The localization of the ulcer in children is mainly in the duodenum (about 60%) and near the pylorus (about 25%) and much less often in the stomach. There are also multiple ulcers.

Peptic ulcer in adolescence is characterized by the severity of pathological changes. There is an early development of massive cicatricial stenosis of the duodenum and pylorus, which leads to a sharp increase in the size and volume of the stomach, hypertrophy, etc. thickening of its walls. The stomach often occupies the entire abdominal cavity, located at its lower pole near the pubic bones. Stenosis is often caused or combined with extensive inflammatory infiltrates around unhealed callous ulcers of the pyloroduodenal zone, passing to the hepatoduodenal ligament.

Ulcers of adolescence often penetrate into adjacent organs, especially the pancreas, lesser omentum, lower surface of the liver, with the formation of deep craters in the organs. Bleeding ulcers with vascular erosion are not uncommon. More often than adult patients, an ulcer in childhood is complicated by perforation.

As an exceptionally great rarity, the occurrence of an ulcer in childhood and adolescence of carcinoma occurs.

Ulcer symptoms in children

Symptoms of ulcers have some significant features. The course of the disease is characterized by great severity, persistence and a tendency to frequent relapses and complications. Particularly pronounced pain syndrome, which at first most often has a character typical of a duodenal ulcer, with light intervals and apparent recovery. As the pain progresses, it loses its usual pattern and becomes permanent. Often the pains are unbearable, excruciating in nature, incapacitate patients and deprive them of their ability to work. Pain radiates most often posteriorly to the back, to the interscapular region. The nature of pain and their irradiation are associated with early and deep penetration, with the development of massive inflammatory infiltrates around them.

Vomiting is observed in almost all children of ulcers and for the most part are in the nature of congestive profuse vomiting as a result of early developing stenosis. Abundant development of gases in the stomach and rotten burps. Most young patients themselves wash their stomachs and systematically induce vomiting to alleviate their condition. More often than adult patients, during the course of the disease there is hematemesis, often repeated, and melena. Occasionally, the disease is detected for the first time by bloody vomiting.

Pays attention appearance children with ulcers. Many of them in their youth have the appearance of lagging behind in physical development people, infantile, weak, while others, on the contrary, appear to be suffering, prematurely aged people, with wrinkled facial skin, with reduced interest in the environment. All this - as a result of prolonged pain, starvation and dehydration. Almost all children with peptic ulcer have a splashing noise in the stomach on an empty stomach and gastric peristalsis and antiperistalsis are easily caused. The abdomen is often sharply enlarged in volume, which is evident already at the first examination.

In most children, an ulcer occurs with a significant increase in the total acidity of gastric juice and the content of free of hydrochloric acid. In a number of patients, the acidity of gastric juice reaches especially high numbers (150/80 and above). Normal and subnormal acidity is observed only in a third of young patients. This testifies to the special ability of the gastric mucosa to secrete highly active gastric juice and the stability of its glands even with a long course of the ulcer process and the development of stenosis. This fact is important for the indications for the choice of treatment method.

The blood picture shows high content hemoglobin and erythrocytes due to blood clotting due to frequent vomiting and fluid loss when the ulcer is complicated by deep penetration and inflammatory infiltrates, moderate leukocytosis is noted, an accelerated sedimentation reaction is erythrocytosis. These patients also have ulcerative fever.

Peptic ulcer in children more often than adults is first detected by acute perforation with an asymptomatic course of the disease or with a very short history of peptic ulcer.

Among the complications of an ulcer in children, in the first place there are narrowing of the duodenum and the pylorus, then penetration and the formation of ulcerative infiltrates. More rarely, there are perforations and bleeding. In children, a combination of a number of complications is not uncommon.

Diagnosis of ulcers in children

Diagnosis presents certain difficulties. This disease is most often confused with chronic, performing an appendectomy, which, of course, does not work. However, it should be remembered about the possible pathogenetic relationship between the disease of the appendix and peptic ulcer and common clinical symptoms for both of these diseases. From other diseases, helminthic invasion, chronic cholecystitis, mesenteric tuberculosis lymph nodes often occur with a symptom complex resembling an ulcer, especially in the initial periods of the disease.

Examination of the child, in particular X-ray examination, and especially knowledge of the possibility of peptic ulcer at this age, help in the diagnosis.

Treatment of ulcers in children

Treatment of peptic ulcer young age in the uncomplicated stage, it should be conservative, especially considering that most patients have duodenal ulcers, which usually generally respond well to this treatment. Long-term rational conservative treatment, in particular sanatorium-and-spa treatment in Truskavets, in most patients gives a positive effect. Indications for surgery in young patients should be especially strictly justified.

Surgical treatment is indicated only for complicated ulcers in children and for the failure of conservative treatment. Along with this, it must be emphasized that the restriction of indications for surgery, and even more so the refusal of this treatment for a complicated ulcer only in connection with the young age of the patients, is erroneous and unjustified.

The notion that in young patients, complicated peptic ulcer always and well responds conservative treatment and rarely accompanied by severe complications, wrong.

As for the nature of the operation in children, if the disease is complicated by stenosis, penetration, repeated bleeding the only one shown is . Gastroenteroanastomosis should not be used, except in extreme cases of exhaustion with forced indications. The long-term results after this operation are extremely unsatisfactory, especially considering that most young patients have increased acidity, which does not decrease after the fistula is applied and, therefore, remain favorable conditions for non-healing or recurrence of an ulcer and, especially, the occurrence of a peptic ulcer of the anastomosis or jejunum which occurs more often in younger patients. The anastomosis operation has known indications for completed cicatricial processes in children of younger age groups. Fears of development after resection in children with an ulcer of severe complications, in particular the so-called "agastric asthenia", and the refusal of resection surgery in complicated forms of an ulcer are unfounded.

The immediate results of gastric resection in patients of this age are no worse than in adults. According to the combined statistics, postoperative mortality is only 1.5%.

When perforating an ulcer in children, the method of choice should be suturing the hole, especially with a short history of the disease and, moreover, with an asymptomatic course of the disease, which is very often observed in them. Such fresh ulcers in children with soft edges without large infiltration in the circumference can heal without a trace and do not relapse. With callous old ulcers, resection is indicated. They do not heal after suturing, recur or stenose the duodenum and pylorus and require a second operation.

Long-term results of gastric resection in patients at this age are quite favorable. The operation in most patients has a good effect on their general condition and physical development, returns them to their usual way of life and work.

The article was prepared and edited by: surgeon

Every disease that appears in a child is a matter of concern for parents. Special place occupies peptic ulcer, since immunity in children is still not strong enough, and the appearance of an ulcer can adversely affect the formation of other organs and body systems.

It is very important not to miss the first symptoms of the disease, to identify the causes of its occurrence and begin appropriate treatment.

The appearance of a peptic ulcer in a child is not a sentence for the rest of his life. The child's body quickly responds to timely measures, and the likelihood of a complete cure for the ulcer is quite high.

However, it should be remembered that without the participation of a gastroenterologist, it is simply impossible to achieve a positive result.

Peptic ulcer is a violation of the integrity of the internal walls of the stomach or duodenum in the form of ulcers of various sizes. They are the result of acids, digestive enzymes, bacteria and many other factors acting on the walls of the stomach.

The localization of these ulcerations may be in various departments digestive tract. Such a disease is characterized by a long and persistent course, which is especially difficult for the child's body.

The appearance of ulcers on the lining of the stomach or duodenum in children (even very young ones) is no longer a rare occurrence. Therefore, parents should arm themselves with information regarding this pathology.

Classification

Treatment of any disease in a child requires a thorough examination. This is especially true of such a disease as an ulcer; her running form in children can become a serious problem in his later life. There is a medical classification of peptic ulcer according to various parameters.

By location:

stomach;
duodenum;
double localization (in both organs).

According to the phase of the course of the disease:

stage of exacerbation;
phase of incomplete clinical remission;
stage of clinical remission.

According to the course of the disease:

uncomplicated;
with complications.

When choosing a method of treatment, it is necessary to study and take into account each of these factors. The final result of the fight against the disease largely depends on this.

Causes of peptic ulcer in children

Identification of the causes of any disease is crucial in determining the method of its treatment. Is no exception and a stomach ulcer; The reasons for its appearance in children are similar to the reasons for its appearance in adults.

Even in the recent past, living conditions and diet (nervous strain and dry food) were considered the main factors in the development of chronic stomach ulcers. However, further medical research showed that there are many other reasons for the development of the inflammatory process in the gastrointestinal tract. They are:

Helicobacter pylori bacterium. It is a unique pathogenic microorganism that lives and multiplies in the digestive tract. The formation of most ulcers is associated with the effect on the walls of the stomach of this particular bacterium.
Chronic gastritis. The appearance of it in a child should not be left without attention and treatment. In the future, it can provoke a weakening protective functions stomach and, as a result, the appearance of peptic ulcer.
process disruption gastric secretion. Under certain circumstances in children's body there is a failure of the mechanisms involved in the formation of gastric secretion. In this case it starts increased excretion acid that irritates the walls of the stomach. The likelihood of an ulcer in this case is very high.
Irregular meals and long breaks between meals. Lack of diet disrupts the ability of the stomach to protect itself from the aggressive effects of digestive enzymes.
Non-steroidal anti-inflammatory drugs. Against the background of their uncontrolled use, a child often develops one or another pathology in the gastrointestinal tract. Continued unreasonable use of such drugs (Aspirin, Ibuprofen, Naproxen) can lead to the formation of an ulcer.
Chronic diseases. Diabetes, gallbladder disease can cause an increase or decrease in gastric motility. Such disorders of the gastrointestinal tract contribute to the appearance of peptic ulcer.

There are other factors that provoke a weakening of the mucous layer of the stomach. These may include smoking, drinking alcohol, caffeinated drinks, physical exercise, injury. In order to save child health, parents should exclude their appearance in the life of the child.

Symptoms

The main alarming symptom of a peptic ulcer in a child is pain in any area of \u200b\u200bthe abdomen (depending on the location of the ulcer). They are not permanent: for some time the pain may be absent.

Pain attacks, as a rule, have a cramping appearance, so the child tries to pull his legs up to his stomach. His desire to take the “fetal position” with such pains should be a reason for the attention of parents.

In most cases pain attacks appear immediately after eating (although there are options for "hungry" pains), especially if the food was inappropriate and eaten in a hurry.

Sometimes painful sensations in the presence of an ulcer in a child are not observed. This is typical for the latent course of the disease, which may be a risk factor for gastrointestinal bleeding or other complications.

In addition to the pain symptom, a stomach ulcer is accompanied by other signs; in children they may be:

heartburn;
sour belching;
bouts of nausea or vomiting;
coated tongue;
decrease in body weight and appetite;
bowel dysfunction (usually constipation);
black stool - with the development of complications.

The task of parents is not to disregard any of these factors if a child has it. In this case, in no case should you self-medicate. Only a consultation with a specialist and a survey will be able to confirm or refute their fears.

Complications

Among the most dangerous diseases is stomach ulcer; the likelihood of complications in children is quite high. They can provoke a violation of the further development of the child's body. Common complications are:

Bleeding (most often accompanied by vomiting). At the same time, general symptoms of blood loss are also observed: weakness, dizziness, low blood pressure, black stools of a liquid consistency. Against the background of this condition, the appearance of vomiting with an admixture of blood clearly indicates gastrointestinal bleeding The child has.
Penetration. With such a pathology, the ulcer grows into nearby organs. The appearance of pain in this case is not associated with any other cause, accompanied by severe heartburn and is permanent.
Perforation. There is a breakthrough of the walls of the stomach at the site of the localization of the ulcer. All contents are poured into the peritoneal cavity. In this case, urgent surgical intervention; every hour of delay can cost the life of a child.
Narrowing or obstruction. Swelling and scarring can narrow or completely close the patency of the intestine. This may necessitate surgery.

Parents should keep in mind that complications from such a disease can cause irreparable damage to the child's body.

Diagnostics

The first step in diagnosing gastrointestinal diseases in a child is to identify complaints (by interviewing parents and the child). Then a thorough examination of the small patient is carried out.

For the correct diagnosis, a study of the digestive organs is prescribed. The most accurate picture gives an examination using an endoscope. Others apply additional methods diagnostics:

pH-metry of gastric secretion per day;
blood tests (general and biochemistry);
coprogram feces;
fecal analysis for the detection of occult blood;
if necessary, an allergy test.

Comparison of all the diagnostic data will help you choose the right method for treating ulcers in children.

Treatment of peptic ulcer in a child

Provision of many factors requires treatment of peptic ulcer; when such a disease is detected in children, these conditions fall on the shoulders of the parents. They should remember that ignoring children's complaints and symptoms can provoke an exacerbation of the disease. Uncontrolled reception drugs can also make things worse.

In the presence of an ulcer in a child, only a pediatric gastroenterologist can choose and change the method of treatment. Patient and diligent following all medical advice gives a chance for a complete cure. Depending on the severity and type of disease, it can be cured by applying various methods treatment.

Adjustment of the diet in certain cases can give positive result. Basically, it is applicable at the initial stage of the disease. In this case, it can be used as an independent method, and as part of a complex treatment. A diet for an ulcer should take into account all the nuances of the disease and the characteristics of the child's body.

Parents should adhere to frequent (up to 6 times a day) meals, but in small portions. At the same time, products that cause bile secretion are excluded - all fatty, spicy, sour, salty. Preference should be given to boiled, stewed, steamed food. It is desirable for a child to eat food in a pureed form, especially during an exacerbation.

It is also important to follow temperature regime children's meals. Food should not be either hot or cold - to exclude any injury to the inflamed tissues of the mucous membrane.

An exact list of allowed products for each specific diet is given by the attending physician. The age and individual parameters of the child are reflected in the recommended diet.

Medications

In a more complex stage of the disease, drug therapy is prescribed. Its primary task is to stop the progression of the disease and all accompanying inflammation processes. The causes that caused the disease are established; drugs are used for this the following types actions:

antibacterial;
acid blockers;
H2 blockers;
enveloping (to protect the mucous membrane);
drugs that promote the regeneration of the mucosa and the healing of ulcers.

May be given as a supplement sedatives(motherwort, valerian).

In the final stage of the drug therapy process, drugs are used that can restore the functions of the digestive tract. Part complex therapy may also include:

physiotherapy;
herbal preparations for healing and scarring of ulcers;
medicinal mineral waters.

All these activities are prescribed, focusing on the degree of the disease, the age and characteristics of the child's body.

Surgical intervention

If a change in diet and drug treatment did not work, then doctors use surgical treatment. Depending on the situation, operations can be carried out:

vagotomy (done to reduce the formation of acid within the stomach and to heal ulcers);
resection (removal of the affected part of the stomach);
gastroenterostomy (artificial connection of the stomach and small intestine);
local excision (removal of ulcerative foci);
palliative suturing of the opening (performed with perforated ulcer; the hole in the wall of the stomach is sutured with absorbable suture).

In the event of certain complications, surgical intervention should be immediate, as it is the only way treatment.

Currently, surgical interventions are performed in most cases laparoscopic method- through several small punctures. In the absence of contraindications, it is recommended as a low-traumatic and effective method conducting operations.

Prevention

With a hereditary predisposition to this disease, parents should treat preventive measures with special attention. To do this, you must adhere to the following rules:

Baby food should be regular and balanced.
The diet is appropriate for the age of the child.
Proper lifestyle: exclude smoking, alcohol; get involved in sports.
A comfortable psychological atmosphere should reign in the family - without stress and conflicts.

Properly organized by the parents, the diet and life in general will help to avoid the appearance of a dangerous disease in the child.

One of the loud medical discoveries recent years associated with the cause of peptic ulcer disease. Scientists have determined that in children (as well as in adult patients) the development of peptic ulcer in the duodenum is provoked by a microbe Helicobacter pylori which has a spiral shape. However, this microbe is in the body of more than eighty percent of the inhabitants of our country. But not every one of these eighty percent suffers from the ailment under discussion.

A quite obvious conclusion suggests itself: in order for a representative of the younger generation to develop a duodenal ulcer, not only the presence of a microorganism is necessary, but also the presence in the life of a child of several (or at least one) provoking factors:

constant presence in an environment of total stress (if the child is in prolonged depression or is subject to serious experiences, then the functions of his autonomic nervous system are violated; for this reason blood vessels the stomach experiences a spasm together with the muscles of this organ; as a result, there is a shortage in the body good nutrition, stomach and duodenum become vulnerable to negative impact hydrochloric acid, which simply corrodes the walls of these organs);
bad heredity;
the abuse of too spicy and rough food, due to which the volume of acid production in the child's stomach increases significantly (this is another reason why the younger generation should eat right);
smoking (unfortunately, this bad habit has become increasingly common in children);
uncontrolled intake of pharmacological agents.

Symptoms

The first complaints that a baby with a duodenal ulcer will voice to parents will be as follows:

heartburn,
burp,
vomit,
constipation,
nausea.

As a rule, symptoms worsen immediately after breakfast or dinner. This occurs in the second or fourth hour after eating. Another characteristic symptom disease in question pain that do not give the little patient peace. Doctors call this phenomenon “hunger pains.” This pain syndrome occurs in the baby's body at night, that is, when the child's stomach is completely empty. The pain goes away almost immediately after the child eats something.

What else distinguishes a baby who has a duodenal ulcer?

stable appetite.
Availability white coating around the entire circumference of the tongue.
The inability to feel the abdomen, as the child begins to actively resist in tandem with his abdominal muscles.
Headaches.
Irritability.
Bad dream.

Diagnosis of duodenal ulcer

Most Popular instrumental method, which is actively used to diagnose duodenal ulcers, is fractional probing. During this study, doctors not only consider the internal structure of the stomach and intestines of a small patient. They also determine the acidity of the juice in the stomach. This procedure can hardly be called pleasant. Often a child has to be persuaded for a long period of time to swallow the probe. However, endoscopy is the most informative method.

In addition to endoscopic examination, doctors prescribe:

examination of feces, vomit and blood for the presence of a pathogen;
x-ray (in most modern clinics from x-ray examination as diagnostic method with the disease under discussion, they have long been abandoned; but if the hospital does not have modern equipment, an x-ray can be ordered - for lack of anything else).

Complications

Complications that a duodenal ulcer brings to a child's life occur in about nine percent of children with the disease. Twice as often, complications encroach on the body of boys. Girls are less susceptible to the consequences of peptic ulcer than their peers - representatives of the opposite sex.

Peptic ulcer disease is very dangerous for its bleeding. With a stomach ulcer, bleeding occurs much less frequently than with a similar lesion of the duodenum.
Perforation of the ulcer is manifested by severe abdominal pain in a child.
Penetration is a term that refers to the penetration of an ulcer into other internal organs of a small patient. This complication is very rare. As a rule, it takes place where the child has been treated for the wrong thing for a long time.

Treatment

A duodenal ulcer is a disease that during the period of exacerbation should be treated in the inpatient department of the clinic. In other periods drug therapy The child can also be treated at home.

What can you do

Parents whose baby suffers from a duodenal ulcer should take care of his diet. Food should be sparing. Ideally, food should be in a semi-liquid state. Mom and dad are required to give up foods that provoke an intense secretion of gastric juice and irritate the gastrointestinal tract. A sick child should have at least five or six meals a day.

What can a doctor do

An ulcer is treated with complex methods. The first and most important thing that the doctor takes into account is the age of the little patient. Second, the period

the development of the disease. If the ulcer worsens, the baby is sent to the hospital. He will receive the following treatment:

antibacterial drugs,
antisecretory pharmacological agents,
anthocytes,
painkillers.

Prevention

home preventive recommendation, which will help to avoid the development of duodenal ulcer in a child, is the correct and balanced diet. And since the ulcer - chronic illness, then for the purpose of prevention, doctors prescribe their patients taking antiulcer drugs during the off-season. That is, when the disease worsens.

peptic ulcer- This chronic illness, occurring with periods of exacerbations and temporary well-being (remission), characterized by the formation of ulcers in the stomach and duodenum.

Children usually have duodenal ulcers, and stomach ulcers are extremely rare (except in adolescents). And stomach ulcer in children - acute illness and not chronic.

The causes of ulcers do not differ from those with gastroduodenitis. Medicine is not yet aware of why some children, when exposed to adverse factors, get off with mild gastritis, while others develop an ulcer in similar situations. For now, there are only speculations. It is believed that special psycho-traumatic factors and the individual susceptibility of the child play a role in the formation of an ulcer. However, direct evidence of this does not exist today, and the fact remains: some children are lucky, others are not.

Symptoms of peptic ulcer in children

Symptoms of peptic ulcer in a child the same as with gastritis (heartburn, nausea), only more pronounced and more persistent. A characteristic feature of pain in the abdomen with an ulcer is their occurrence at night, often closer to the morning. Therefore, sleep is disturbed in children.

The child is suffering from constant pain, and over time general state deteriorating: increasing emotional lability, fatigue, asthenia develops, the patient loses weight. Often, in children with peptic ulcer, the heart rate is also reduced, sweating and other reactions from the autonomic nervous system appear.

Complications of peptic ulcer

Bleeding. Typical signs:

Help with complications.

1. Cold on the stomach.

2. Drinking, eating, taking medicine is prohibited.

3. Immediately call an ambulance or take the child to the nearest hospital.

Treatment of peptic ulcer in children

For the first time, an ulcer of the stomach and duodenum was diagnosed and treated in the hospital.

General rules:

Meals 5-6 times a day in small portions. Eating in bed every 2-3 hours.
The last meal should be no later than 3 hours before bedtime.
Food during an exacerbation of the ulcerative process is liquid or semi-liquid, during the remission period - puree.
Food should be warm (not cold and not hot).
Excluded fried, smoked, spicy, fatty food, pickles, irritating the gastric mucosa.
You can't eat dry food.
It is necessary to force the child to chew thoroughly.
Salt is limited to 8 g per day.

Products excluded:

It is strictly forbidden: Cola (Pepsi-Cola, Coca-Cola, etc.), chips, Maconalds, noodles fast food type "Rolton", croutons ("Emelya", "Three crusts", etc.), mayonnaise, ketchup, alcohol (beer), tobacco smoke and chewing gum.
With peptic ulcer, you can not take foods that increase the secretion of gastric juice:

Concentrated meat broths,

Fresh pastries and dough

fresh white cabbage,

Dry wine.

Persimmon. Forms indigestible rough conglomerates in the stomach, damaging the mucosa.

With an exacerbation of the ulcerative process, baby food is best suited: mashed potatoes in jars, porridge. Products for baby food are well mechanically processed and fortified, which is optimal for children with a sick stomach.

During an exacerbation children with peptic ulcer appoint:

Table No. 1a according to Pevzner for 5-7 days.
Next - table number 16 for 7-14 days.
Next - table number 1 for 1 - 1.5 months.

After that, the child's diet can be expanded. With a long absence of exacerbations, the child is transferred to table number 5.

Phytotherapy and folk recipes.

During treatment, it is necessary to change the composition of herbal preparations every 2-3 weeks, and every 2 months it is necessary to take breaks for 2-3 weeks so that there is no addiction, otherwise the effectiveness of therapy decreases. Herbal treatment is prescribed during the period when the exacerbation will pass and for prevention in the autumn and spring.

Herbal preparations:

Sea buckthorn oil. Rosehip oil.

Biogastron (Germany). Preparation from licorice root.

Likviriton (Russia). Phytopreparation based on licorice roots.

Flakarbin (Russia). The drug contains bioflavonoids (quercetin, licuraside).

Alanton (Russia). Contains elecampane roots.

Plantaglucid (Russia, Ukraine). The drug from the leaves of plantain in the form of a powder.

Phytocollection No. 1:

fireweed leaves - 2 parts,

linden flowers - 2 parts,

fennel fruit - 1 part,

chamomile flowers - 1 part.

2 tsp collection pour 1 cup boiling water. Leave for 30 minutes, strain. Take 1 glass 2-3 times a day.

Phytocollection No. 2:

chamomile flowers - 1 part,

marshmallow root - 1 part,

fennel fruits - 1 part.

2 tsp collection pour 1 cup boiling water. Boil for 5-7 minutes, strain. Take 1 glass before bed. Phytocollection No. 3:

licorice root naked - 1 part,

chamomile flowers - 1 part,

fennel fruits - 1 part.

1 st. l. collection pour 1 cup boiling water. Heat in a water bath for 20 minutes. Cool at room temperature for 20 minutes. Strain. Take 1/4 cup 3 times a day after meals.

Phytocollection No. 4:

marshmallow root - 3 parts,

mint leaves - 1 part,

elecampane root - 1 part.

1 st. l. collection, drink 1 glass of boiling water. Insist in a warm place for 30 minutes, strain. Take 1/4 cup 3-4 times a day.

Phytocollection No. 5:

chamomile flowers - 1 part,

calendula flowers - 1 part.

1 st. l. collection pour 1 cup boiling water. Heat in a water bath for 15 minutes. Cool at room temperature for 45 minutes, strain. Take 1/2 cup 3-4 times daily before meals.

Phytocollection No. 6 (with increased acidity of gastric juice):

plantain leaves - 3 parts,

chamomile flowers - 4 parts,

cudweed herb - 3 parts,

rose hips - 4 parts

yarrow herb - 1 part,

licorice root - 1 part.

2 tsp collection pour 500 ml of boiling water. Leave for 30 minutes, strain. Take 1/2 cup before meals.

Phytocollection No. 7 (with reduced acidity of gastric juice):

plantain leaves - 4 parts,

wormwood grass - 2 parts,

yarrow herb - 2 parts,

centaury herb - 2 parts,

licorice root - 3 parts,

rose hips - 4 parts,

mint leaves - 2 parts.

Brew 1 tsp. collecting 1 cup boiling water. Leave for 30-60 minutes. Take 1 teaspoon - 2 tablespoons 3-4 times a day before meals.

With severe pain and heartburn: Phyto-collections No. 1 and No. 2 alternate every 10 days for 2-3 months. Prepare an infusion of herbs: 1 tsp. collection pour 1 cup boiling water. Take 1 teaspoon - 1 tablespoon 3 times a day 15-20 minutes before meals.

Honey. After taking honey, the acidity of the stomach normalizes, heartburn disappears, abdominal pain stops, erosions and ulcers heal. Treatment is possible only in the absence of an allergy to honey. Take 40 g ( adult dose) pure flower honey, dissolved in 1/3 cup of warm boiled water, 1.5-2 hours before meals or 3 hours after.

Infusions of cudweed marsh with honey. Pour 1 tbsp. l. herbs 1 cup boiled water, leave for 30 minutes, add 1 tbsp. l. honey and drink 1 tbsp. l. 3 times a day before meals.

Propolis with rosehip or sea buckthorn oil. Pour 20 g of peeled and crushed propolis crumbs with 200 ml of rosehip oil or sea buckthorn oil. Keep in a boiling water bath for 30-40 minutes with constant stirring, then filter through 2 layers of gauze. Take 1 tsp. 4-5 times a day. The course of treatment is 4-8 weeks.

Physiotherapy.

In the absence of bleeding from the ulcer, prescribe paraffin applications, UHF, EHF, diathermy, etc. Physiotherapist prescribes.

Therapeutic lavage of the duodenum with solutions of furailin, trichopolum, decoctions of chamomile, St. John's wort, etc.
Physiotherapy.

Mineral water.

Use water of weak and low mineralization without gas (Essentuki No. 4, Slavyanovskaya). Water is heated to 40-45 °C. Water intake begins with small doses (from half the dose for the first 2-3 days) 1-1.5 hours before meals 3 times a day. The course of treatment is 30-45 days. During an exacerbation of peptic ulcer, mineral water should not be drunk.

The dose of mineral water per reception is calculated as follows:

Child's age x 10.

For example, a child of 9 years old needs 9 x 10 = 90 ml of water to receive.

Aromatherapy.

Aromatic Blend:

lavender oil - 4 drops,

sage oil - 4 drops,

mint oil - 3 drops,

fennel oil - 5 drops,

transport oil - 100 ml.

(sesame)

Usage:

Belly massage. With light massaging movements, rub the aroma mixture into the stomach in a clockwise direction and into the lower back 1-2 times a day until the condition improves.
Microclysters in the rectum, 5 ml. Course - 21 days.

Tactics and dispensary observation patient with peptic ulcer

Children with peptic ulcer must be under the supervision of a doctor. Periodically, they are examined by a pediatrician, gastroenterologist, and other specialists, gastroscopy is performed. From time to time, for the prevention of exacerbations, children are prescribed courses drug treatment, herbal medicine, mineral water, physiotherapy. Shown sanatorium treatment.

In carrying out preventive measures to prevent exacerbations, the seasonality of the disease must be taken into account: the ulcer worsens, as a rule, in spring (March), autumn (September) and late autumn. Therefore, prevention should be carried out in advance, so that by the expected time of exacerbation, all treatment has already been completed.