Ulcers & Acid Reflux in Children

Acid reflux and ulcers are typically thought to be diseases that occur in adults only. However, many children suffer from either acid reflux or ulcers and sometimes from both. Most children suffer from ulcers due to medications, though some cases are caused by helicobacter pylori bacteria. Acid reflux can start as early as infancy and continue through childhood and into adulthood.

Acid Reflux

• The backward flow of stomach acid into the esophagus is called acid reflux. Acid reflux is also known as gastroesophageal reflux. During an acid reflux episode, stomach content and acid are moved up through the esophagus and may be tasted in the back of the throat. Frequent vomiting by infants and children could be caused by either acid reflux or gastroesophageal reflux disease (GERD). Acid reflux and GERD are very similar but the conditions are not necessarily the same. In most cases, acid reflux begins and later progresses into GERD. Acid reflux in children is most commonly treated with over-the-counter antacids, doctor-prescribed acid suppressors and acid blockers.

Gastroesophageal Reflux Disease (GERD)

• Michael Picco, a gastroenterologist with the Mayo Clinic, states that GERD is a chronic digestive disease that occurs when stomach acid or bile flows back into the esophagus. The reflux of acid agitates the stomach lining and symptoms of GERD occur. Heartburn and acid reflux are both symptoms most commonly associated with GERD. If these symptoms occur more than twice a week or begin to hinder daily life, then the condition is labeled GERD. Medications are used such as over-the-counter antacids, H2 receptors Tagamet HB and Pepcid AC, and proton pump inhibitors like Prilosec. A surgery referred to as the Nissen fundoplication can be performed for children with GERD when necessary. Often, a pyloroplasty can be performed during the same surgery to improve gastric emptying.

Pyloroplasty and Nissen Fundoplication

• Pyloroplasty is performed while under general anesthesia. An incision is made near the navel or in the top right area of the belly. The incisions will be smaller if pyloroplasty is performed laparascopically. Nissen fundoplication surgery is done through the stomach or chest. The chest incision is typically used when the patient is overweight or has a short esophagus. Nissen fundoplication is performed using a laparoscopic incision or through larger surgical incisions. If the patient also has GERD or hiatal hernia it can be fixed during this surgery. Nissen fundoplication is also performed under general anesthesia.

Ulcers

• Though spicy foods are believed by many to be the cause of ulcers, the bacteria helicobacter pylori (H. Pylori) is the main culprit. Many believe that high-stress jobs are also a factor in the development of ulcers, but even children can develop ulcers. An ulcer is an open, painful sore. Peptic ulcers form in the upper stomach and in the duodenum (part of the small intestine). Ulcers in the stomach are called gastric ulcers and ones that form in the duodenum are called duodenal ulcers.

Helicobacter Pylori Infection

• Both gastric and duodenal are caused by H. pylori bacteria and are contracted when exposed to food, water or close contact with another individual infected by the bacteria. H. pylori is usually contracted during childhood. H. pylori infection does not typically cause any problems, but when left untreated it can lead to gastritis, stomach cancer later in life and peptic ulcer disease. Gastritis is inflammation and irritation of the stomach lining.