STOMACH AND DUODENAL ULCERS
- Also called the PEPTIC ULCER DISEASE
- The stomach produces acid constantly for digesting food.
- To protect itself from the acid, one of the mechanisms employed is, to produce a mucus lining that prevents harmful effects of acid. Occasionally this balance is disrupted. This leads to ulcers.
- The stomach acid is produced especially after meals.
- There are various factors, hormones that control acid production, hence more stress causes acidity and then ulcers.
- The stomach continues as intestine(Duodenum). Duodenum can also have the ulcers.
- Bacterial infections – one particular bacteria – (Helicobacter Pylori ). It spreads by ingesting them with dirty hands.
- Medications– common medications like painkillers irritate the stomach and decrease mucus production in the stomach.
- Stress Ulcers– when the body’s stress in conditions like burns, trauma
- Ulcers in stomach or duodenum cause bleeding from the wound. so they may vomit blood or may excrete is as dark coloured faeces.
- Babies may present with repeated vomiting, excessive crying, dark coloured stools
- Burning Tummy pain, tummy fullness, indigestion.
- The pain can be described as a dull ache that is going on for months and with periods of worsening and getting better.
- A tube( Endoscope) is inserted into the mouth( Under General anaesthesia) and passed to the stomach and the area is seen. If any suspicion of inflammation or peptic ulcers, a probable diagnosis is made.
- There are breath tests and stool test to detect the presence of the bacterial infection. Occasionally a small part of stomach may be biopsied to look for confirmation
- If bleeding is severe then the child is stabilised by intravenous fluids and constant monitoring of the blood pressure.
- A tube may be passed from nose to stomach to empty all contents( Acid and blood)
- Ulcers are treated with high dose antacids.
- Bacterial infections need to be treated with antacids( 1 month) and antibiotics( 2 weeks).Most children improve with this treatment. if no improvement, then changing the antibiotics may be considered.
- Endoscopically a tube may be inserted into the stomach to identify the bleeding site and locally stop it from bleeding.