Sores form in the lining of the stomach or duodenum.
Symptoms in children include gnawing pain in the abdomen and vomiting.
The diagnosis is based on endoscopy and sometimes imaging tests.
Treatment includes drugs to reduce stomach acid and sometimes antibiotics.
(For adults, see Peptic Ulcer Disease Peptic Ulcer Disease A peptic ulcer is a round or oval sore where the lining of the stomach or duodenum has been eaten away by stomach acid and digestive juices. Peptic ulcers can result from infection with Helicobacter... read more 
.)
Ulcers penetrate into the lining of the stomach or duodenum (the first part of the small intestine). Ulcers develop when the normal defense and repair mechanisms of the lining of the stomach or duodenum are weakened, making the lining more likely to be damaged by stomach acid.
Peptic ulcers are much less common among children than adults. As with adults, use of nonsteroidal anti-inflammatory drugs (NSAIDs) and infection with Helicobacter pylori Helicobacter pylori Infection Helicobacter pylori (H. pylori) infection is a bacterial infection that causes stomach inflammation ( gastritis), peptic ulcer disease, and certain types of stomach cancer. The... read more bacteria can lead to the formation of peptic ulcers Peptic Ulcer Disease A peptic ulcer is a round or oval sore where the lining of the stomach or duodenum has been eaten away by stomach acid and digestive juices. Peptic ulcers can result from infection with Helicobacter... read more . In children, Helicobacter pylori is not as common a cause as in adults. Children whose parents have peptic ulcers are more likely to have ulcers especially if their parents are infected with Helicobacter pylori. Exposure to secondhand smoke is another risk factor for ulcers in children. Adolescents who drink alcohol or smoke are also more likely to develop ulcers. Children of any age can develop ulcers when they are extremely sick, such as after severe burns, injuries, and illnesses. These ulcers are referred to as stress ulcers.
Symptoms of Peptic Ulcer
The typical symptoms occur in the upper abdomen and include
Gnawing pain
Burning pain
Aching
Soreness
An empty feeling
Feeling of hunger
However, young children may not have the typical symptoms but may have abdominal pain and vomiting. Infants with ulcers may be fussy and irritable during and after feedings.
Complications of peptic ulcer
In children of any age, peptic ulcers can tear (perforate Perforation A peptic ulcer is a round or oval sore where the lining of the stomach or duodenum has been eaten away by stomach acid and digestive juices. Peptic ulcers can result from infection with Helicobacter... read more ), bleed Bleeding A peptic ulcer is a round or oval sore where the lining of the stomach or duodenum has been eaten away by stomach acid and digestive juices. Peptic ulcers can result from infection with Helicobacter... read more , or cause swelling leading to blockage of the stomach (obstruction Obstruction A peptic ulcer is a round or oval sore where the lining of the stomach or duodenum has been eaten away by stomach acid and digestive juices. Peptic ulcers can result from infection with Helicobacter... read more ).
Diagnosis of Peptic Ulcer
Endoscopy
For complications, imaging tests
Doctors diagnose peptic ulcer based on the results of an endoscopy Endoscopy Endoscopy is an examination of internal structures using a flexible viewing tube (endoscope). In addition to examinations, doctors can use endoscopy to do biopsies and give treatment. Endoscopes... read more . During this test, a flexible viewing tube (endoscope) is inserted through the child's mouth and down the esophagus into the stomach and first part of the duodenum. With an endoscope, a doctor can also do a biopsy (removal of a tissue sample for examination under a microscope) to determine whether an ulcer is caused by Helicobacter pylori bacteria. Stool tests and breath tests can also be done to detect Helicobacter pylori.
If a complication, such as perforation, is suspected, doctors may do imaging tests such as x-rays X-Ray Studies of the Digestive Tract X-rays often are used to evaluate digestive problems. Standard x-rays ( plain x-rays) can show some blockages or paralysis of the digestive tract, or abnormal air patterns in the abdominal cavity... read more , computed tomography Computed Tomography and Magnetic Resonance Imaging of the Digestive Tract Computed tomography (CT) and magnetic resonance imaging (MRI) scans are good tests for assessing the size and location of abdominal organs. Additionally, cancerous (malignant) or noncancerous... read more (CT), or magnetic resonance imaging Computed Tomography and Magnetic Resonance Imaging of the Digestive Tract Computed tomography (CT) and magnetic resonance imaging (MRI) scans are good tests for assessing the size and location of abdominal organs. Additionally, cancerous (malignant) or noncancerous... read more (MRI).
Treatment of Peptic Ulcer
Reduction of stomach acid
For Helicobacter pylori infection, antibiotics and drugs to reduce stomach acid
The main goal of peptic ulcer treatment is to reduce stomach acid. Drugs that reduce acid include proton pump inhibitors, histamine-2 (H2) blockers, and antacids ( see Table: Drugs Used to Treat Stomach Acid Drugs Used to Treat Stomach Acid 
). It is also important to reduce things that increase acid production. For example, children should be kept away from caffeine and secondhand smoke.
Children who are infected with Helicobacter pylori are given antibiotics to eliminate the bacteria and a proton pump inhibitor to reduce stomach acid.
Surgery may be needed if a complication is present or if the ulcers return.
