Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Frequently Asked Questions
Stomach ulcers, also known as peptic ulcers, are less common in children than adults but occur more frequently than one might imagine. According to 2011 research published in the medical journalUlcers, as many as 8.1% of children in Europe and 17.4% in the United States will experience a stomach ulcer before the age of 18.
Diagnosing stomach ulcers in children is slightly different than it is in adults, as some tests are less able to deliver reliable results. Usually, uncomplicated cases are easily treated with antibiotics and drugs that reduce stomach acid and protect the stomach lining.
Unless there is a serious underlying cause, the risk of complications from a stomach ulcer is low (between 1% and 2%) and the mortality rate is approximately one death every 100,000 cases.
Verywell / Brianna Gilmartin
Stomach Ulcer Symptoms
A stomach ulceris simply an open sore that develops on the lining of the stomach. A sore in the stomach itself is referred to as a gastric ulcer, while one that develops further along toward the small intestine is called a duodenal ulcer.
The common signs of a stomach ulcer include:
The pain is often most noticeable when the stomach is empty, but pain that occurs after eating can often distinguish a gastric ulcer from a duodenal one. Gastric ulcers will usually cause pain soon after food is eaten, while the pain from a duodenal ulcer will usually develop two or three hours later.
Fever, chills, vomiting, and difficulty swallowing are all signs of a condition requiring urgent medical care.
What Causes Stomach Ulcers in Children?
H. pyloriis a corkscrew-shaped bacterium commonly linked to chronic gastritis and stomach ulcers. Around 50% of the world’s population is believed to haveH. pylori.According to one study, over 30% of these people will develop upper gastrointestinal symptoms.
WhileH. pyloriis a common cause of stomach ulcers in children, other factors may either cause or contribute to their development. Among them are:
While generalized stress, anxiety, and spicy foods do not cause ulcers, they can exacerbate existing ones.
Uncommon causes includehypersecretorydisorders in which excessive stomach acids are produced. Examples includecystic fibrosis, basophilic leukemia,Zollinger-Ellison syndrome, andmultiple endocrine neoplasias.
Similarly, any condition that causes increased intracranial pressure (pressure in the skull) can trigger the excessive production of stomach acids, causing what is known as aCushing ulcer. In rare cases, a stomach ulcer may be a sign of blood cancer known aslymphoma.
Diagnosis of Stomach Ulcers
Diagnosing a stomach ulcer in children can be a challenge. Some of the tests used for adults, such as theH. pyloriantibody blood test, are less accurate in children.
Unless the symptoms are severe, a healthcare provider usually will start the investigation with minimally invasive tests. Among these are:
A negative result from these tests would allow your healthcare provider to rule out digestive disorders as the cause before moving on to more invasive procedures.
Imaging Tests
If the tests are positive and the symptoms severe, a procedure known as anupper endoscopywould be the preferred next step to diagnose a stomach ulcer in the child. An endoscopy involves the insertion of a flexible fiberoptic scope down the throat to view the lining of the stomach.
It is performed under mild sedation and can be used to pinch off tissue samples (called a pinch biopsy) for evaluation in the lab.Side effects may include:
Abarium X-ray, also called a barium swallow or upper-GI series, is far less invasive but also less accurate. This is especially true if the stomach ulcer in a child is small.
For this test, they would swallow a chalky liquid containing barium, which coats the stomach and helps to better identify abnormalities on X-ray. Side effects include upset stomach, nausea, vomiting, and constipation.
Stomach Ulcer Treatment
If your child’s stomach ulcer is related toH. pylori, the healthcare provider will treat the infection with a combination of drugs meant to normalize gastric acid levels so that their stomach can heal.
Keep in mind that eradicatingH. pylorihas proven difficult in recent years due to antibiotic resistance. To this end, healthcare providers often now take a more aggressive approach.
In many cases, your child’s stomach ulcer may be treated with two or more antibiotics together, along with an acid-reducing drug known as a proton pump inhibitor (PPI). They also may take bismuth subsalicylate tablets (such as chewable Pepto-Bismol) that are able to coat and protect the stomach.
If this treatment fails, other drug combinations will be used until all signs of the infection are gone. Treatment usually lasts 14 days and typically involves the antibiotics clarithromycin and amoxicillin. Subsequent therapies may include tetracycline or metronidazole.
These antibiotics need to be taken as directed—and to completion—to avoid the development of antibiotic resistance. NSAIDs should be avoided to reduce gastric stress, while Tylenol (acetaminophen) can instead be used to treat pain and fever in your child.
Diet
During treatment, you can focus on giving your child foods that are easy to digest and place little stress on the stomach. These include high-fiber fruits and vegetables, lean chicken and fish, and probiotics like yogurt. Avoid fried foods, spicy foods, acidic foods, carbonated drinks, or anything with caffeine (including tea and chocolate).
Foods Your Child Can Eat or Avoid With a Stomach Ulcer
Surgery and Other Procedures
Often, stomach ulcers in children can be treated at the time of their endoscopy. When an ulcer is spotted, various instruments can be fed through the endoscope to seal off a ruptured blood vessel. This may involve a laser or an electrocautery device to burn the tissue, or an injection of epinephrine (adrenaline) to rapidly dilate the blood vessel.
Surgery is rarely used to treat stomach ulcers in children. It is only indicated if there is a perforation, an obstruction, severe bleeding, or a high risk of a perforation. If needed, elective surgeries can often be performed throughlaparoscopy(with keyhole incisions), while emergency surgeries are usually performed as an open procedure.
A Word From Verywell
Finding out that your child has a stomach ulcer can be upsetting. Your first instinct may be to attribute the cause to stress at home or school, but more often than not there are underlying and treatable physical causes.
While your child is receiving care, though, it’s important to reduce stress. It will help for you to explain to your child what a stomach ulcer is and what to expect moving forward. But if your child needs to lose weight, now is not the time to start. Focus first on healing the ulcer and any underlying cause before moving forward with a diet and exercise plan.
A stomach ulcer can cause pain in the upper central region of your child’s abdomen. It is often described as a burning or gnawing sensation. If the ulcer perforates into an adjacent structure, it can cause pain to the rest of the abdomen and, in some cases, lead to referred pain to the shoulders.
Less common stomach ulcer symptoms include:BurpingFullness after only eating small amounts of foodNauseaNot feeling hungerStool that is bloody or blackRegular vomiting or vomiting bloodUnintentional weight lossSome of these symptoms can resemble many other health issues, but your healthcare provider can help determine their cause.
Less common stomach ulcer symptoms include:
Some of these symptoms can resemble many other health issues, but your healthcare provider can help determine their cause.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Guariso G, Gasparetto M.Update on peptic ulcers in the pediatric age.Ulcers. 2012. doi:10.1155/2012/896509Vakil N.Peptic ulcer disease. Merck Manual Professional Version.National Library of Medicine. MedlinePlus.Gastrointestinal perforation.Testerman TL, Morris J.Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.World J Gastroenterol. 2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781Suzuki H.Helicobacter pylori-associated upper gastrointestinal symptoms: FD or HpD?Dig Dis Sci. 2017;62(6):1391-1393. doi:10.1007/s10620-017-4556-4Geboes K, Geboes K, Jouret-Mourin A.Endoscopy and histopathology. In:Endoscopy [Internet]. 2013. doi:10.5772/52739The National Institute of Diabetes and Digestive and Kidney Diseases.Upper GI Endoscopy.Cancer Research UK.Barium X-Ray.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for peptic ulcers (stomach ulcers).Vomero ND, Colpo E.Nutritional care in peptic ulcer.Arq Bras Cir Dig. 2014;27(4):298-302. doi:10.1590/S0102-67202014000400017Tan S, Wu G, Zhuang Q, et al.Laparoscopic versus open repair for perforated peptic ulcer: A meta analysis of randomized controlled trials.Int J Surg. 2016;33 Pt A:124-32. doi:10.1016/j.ijsu.2016.07.077Harvard Health Publishing. Harvard Medical School.Peptic Ulcer.Johns Hopkins Medicine.Stomach and Duodenal Ulcers (Peptic Ulcers).
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Guariso G, Gasparetto M.Update on peptic ulcers in the pediatric age.Ulcers. 2012. doi:10.1155/2012/896509Vakil N.Peptic ulcer disease. Merck Manual Professional Version.National Library of Medicine. MedlinePlus.Gastrointestinal perforation.Testerman TL, Morris J.Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.World J Gastroenterol. 2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781Suzuki H.Helicobacter pylori-associated upper gastrointestinal symptoms: FD or HpD?Dig Dis Sci. 2017;62(6):1391-1393. doi:10.1007/s10620-017-4556-4Geboes K, Geboes K, Jouret-Mourin A.Endoscopy and histopathology. In:Endoscopy [Internet]. 2013. doi:10.5772/52739The National Institute of Diabetes and Digestive and Kidney Diseases.Upper GI Endoscopy.Cancer Research UK.Barium X-Ray.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for peptic ulcers (stomach ulcers).Vomero ND, Colpo E.Nutritional care in peptic ulcer.Arq Bras Cir Dig. 2014;27(4):298-302. doi:10.1590/S0102-67202014000400017Tan S, Wu G, Zhuang Q, et al.Laparoscopic versus open repair for perforated peptic ulcer: A meta analysis of randomized controlled trials.Int J Surg. 2016;33 Pt A:124-32. doi:10.1016/j.ijsu.2016.07.077Harvard Health Publishing. Harvard Medical School.Peptic Ulcer.Johns Hopkins Medicine.Stomach and Duodenal Ulcers (Peptic Ulcers).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Guariso G, Gasparetto M.Update on peptic ulcers in the pediatric age.Ulcers. 2012. doi:10.1155/2012/896509Vakil N.Peptic ulcer disease. Merck Manual Professional Version.National Library of Medicine. MedlinePlus.Gastrointestinal perforation.Testerman TL, Morris J.Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.World J Gastroenterol. 2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781Suzuki H.Helicobacter pylori-associated upper gastrointestinal symptoms: FD or HpD?Dig Dis Sci. 2017;62(6):1391-1393. doi:10.1007/s10620-017-4556-4Geboes K, Geboes K, Jouret-Mourin A.Endoscopy and histopathology. In:Endoscopy [Internet]. 2013. doi:10.5772/52739The National Institute of Diabetes and Digestive and Kidney Diseases.Upper GI Endoscopy.Cancer Research UK.Barium X-Ray.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for peptic ulcers (stomach ulcers).Vomero ND, Colpo E.Nutritional care in peptic ulcer.Arq Bras Cir Dig. 2014;27(4):298-302. doi:10.1590/S0102-67202014000400017Tan S, Wu G, Zhuang Q, et al.Laparoscopic versus open repair for perforated peptic ulcer: A meta analysis of randomized controlled trials.Int J Surg. 2016;33 Pt A:124-32. doi:10.1016/j.ijsu.2016.07.077Harvard Health Publishing. Harvard Medical School.Peptic Ulcer.Johns Hopkins Medicine.Stomach and Duodenal Ulcers (Peptic Ulcers).
Guariso G, Gasparetto M.Update on peptic ulcers in the pediatric age.Ulcers. 2012. doi:10.1155/2012/896509
Vakil N.Peptic ulcer disease. Merck Manual Professional Version.
National Library of Medicine. MedlinePlus.Gastrointestinal perforation.
Testerman TL, Morris J.Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.World J Gastroenterol. 2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781
Suzuki H.Helicobacter pylori-associated upper gastrointestinal symptoms: FD or HpD?Dig Dis Sci. 2017;62(6):1391-1393. doi:10.1007/s10620-017-4556-4
Geboes K, Geboes K, Jouret-Mourin A.Endoscopy and histopathology. In:Endoscopy [Internet]. 2013. doi:10.5772/52739
The National Institute of Diabetes and Digestive and Kidney Diseases.Upper GI Endoscopy.
Cancer Research UK.Barium X-Ray.
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for peptic ulcers (stomach ulcers).
Vomero ND, Colpo E.Nutritional care in peptic ulcer.Arq Bras Cir Dig. 2014;27(4):298-302. doi:10.1590/S0102-67202014000400017
Tan S, Wu G, Zhuang Q, et al.Laparoscopic versus open repair for perforated peptic ulcer: A meta analysis of randomized controlled trials.Int J Surg. 2016;33 Pt A:124-32. doi:10.1016/j.ijsu.2016.07.077
Harvard Health Publishing. Harvard Medical School.Peptic Ulcer.
Johns Hopkins Medicine.Stomach and Duodenal Ulcers (Peptic Ulcers).
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
