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.

CAUSES

• 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

SYMPTOMS

• 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.

DIAGNOSIS

• 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

TREATMENT

• 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.