Causes and Management of Gastric and Duodenal Ulcer in Adolescents

Many etiological hypotheses have been suggested to explain the development of peptic ulcers during the last 300 years (including gastric ulcer and duodenal ulcer). In the last two decades, significant progress has been made in understanding the pathophysiology of peptic ulcer disease, particularly with regard to the involvement of Helicobacter pylori and nonsteroidal anti-inflammatory medications (NSAIDs). This study will attempt to review literature on etiology and management of gastric and duodenal ulcers among adolescents.

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Prevalence of Helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy

Asian Journal of Health Sciences ◽

10.15419/ajhs.v3i1.405 ◽

2015 ◽

Vol 3 (1) ◽

Author(s):

Vudumula Vijaya Lakshmi

Keyword(s):

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Normal Population ◽

Gastric Ulcers ◽

Upper Gastrointestinal Endoscopy ◽

Contributing Factors ◽

Duodenal Ulcers ◽

Female Ratio ◽

Ulcer Disease ◽

H Pylori

Helicobacter pylori (H. pylori) has a role in the multifactorial etiology of peptic ulcer disease. A link between H. pylori infection and duodenal ulcer disease is now established. Other contributing factors and their interaction with the organism may initiate the ulcerative process. The fact that eradication of H. pylori infection leads to a long-term cure in the majority of duodenal ulcer patients and the fact that the prevalence of infection is higher in ulcer patients than in the normal population are cogent arguments in favor of it being the primary cause of the ulceration. This study was under taken at the Department of surgery, Narayana medical college, Nellore from January 2007 to July 2008. A total of 150 patients with duodenal ulcers, gastric ulcers, antral gastritis, gastric carcinoma and dyspepsia of any kind were studied. Maximum number of cases were in the age group of 31 years to 50 years among both sexes and number of cases gradually decreased after 50 years of age in males and females. Males were more in number and male to female ratio is (2.75:1) approximately 3:1.

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DUODENAL ULCER IN CHILDHOOD

PEDIATRICS ◽

10.1542/peds.45.2.283 ◽

1970 ◽

Vol 45 (2) ◽

pp. 283-286

Author(s):

Mary Loretta Rosenlund ◽

C. Everett Koop

Keyword(s):

Duodenal Ulcer ◽

Common Symptom ◽

Peptic Ulcers ◽

Older Children ◽

Duodenal Ulcers ◽

X Ray ◽

Ulcer Disease ◽

The Past ◽

Younger Age ◽

The Central Nervous System

There has been some disagreement concerning the admittedly rare incidence of duodenal ulcer disease in children. Because of conflicting reports from other pediatrics centers, we have reviewed the records of all patients admitted to The Children's Hospital of Philadelphia in the past 20 years (1948 through 1967) in whom duodenal ulcer was diagnosed by x-ray, at operation or on postmortem examination (Table I). There were 27 children between the ages of 15 days and 15½ years, with well established duodenal ulcers. Six of these were female (22%). The age at presentation was scattered, but the majority were between 2 and 11 years of age. Presenting complaints were varied: gastrointestinal bleeding was most common in the younger age group, while abdominal pain, usually persistent and intermittent, was the most common symptom in the older children. The diagnosis of duodenal ulcer was made by x-ray examination in 22 patients and at operation in 2; and the ulcers were discovered only at autopsy in 3 children. All the ulcers were duodenal; the precise location was not specified in 9, but 11 were bulbar and 7 were postbulbar. Complications of the ulcer were noted in 9 patients. Perforation occurred in 7 patients, leading to death in 4 (all had disease of the central nervous system) and repeated bleeding in 2. Etiology of the ulcer disease was determined in 15 of the children, but the cause was unknown in 12. Our series is concerned only with duodenal ulcers which, admittedly, comprise the greatest percentage of peptic ulcers.

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RECURRENCE RATE OF HELICOBACTER PYLORI IN PATIENTS WITH PEPTIC ULCER FIVE YEARS OR MORE AFTER SUCCESSFUL ERADICATION

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032016000300006 ◽

2016 ◽

Vol 53 (3) ◽

pp. 152-155 ◽

Cited By ~ 2

Author(s):

Yuri Costa Farago FERNANDES ◽

Gabriel da Rocha BONATTO ◽

Mauro Willeman BONATTO

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Recurrence Rate ◽

Early Recurrence ◽

Peptic Ulcers ◽

Ulcer Disease ◽

Gastroduodenal Mucosa ◽

H Pylori

ABSTRACT Background Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. Objective This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Methods Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. Results During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. Conclusion The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.

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ETIOPATHOGENESIS OF PEPTIC ULCER: back to the past?

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032014000200016 ◽

2014 ◽

Vol 51 (2) ◽

pp. 155-161 ◽

Cited By ~ 7

Author(s):

Mariana Barbosa ARAÚJO ◽

Paulo BORINI ◽

Romeu Cardoso GUIMARÃES

Keyword(s):

Peptic Ulcer ◽

General Population ◽

Peptic Ulcers ◽

Data Bases ◽

Duodenal Ulcers ◽

The Past ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

H Pylori ◽

Made In

ObjectivesTo review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation withHelicobacter pylori (H. pylori).MethodsA search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries.ResultsIt was observed that the prevalence of H. pyloriinfection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylorishows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries.DiscussionThe observations might be suggestive of H. pyloribeing only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum.

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Peptic Ulcer Disease in Children: Etiology, Clinical Findings, and Clinical Course

PEDIATRICS ◽

10.1542/peds.82.3.410 ◽

1988 ◽

Vol 82 (3) ◽

pp. 410-414

Author(s):

Brendan Drumm ◽

J. Marc Rhoads ◽

David A. Stringer ◽

Phillip M. Sherman ◽

Lynda E. Ellis ◽

...

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Emergency Surgery ◽

Clinical Course ◽

Clinical Findings ◽

Gastric Ulcers ◽

Peptic Ulcers ◽

Duodenal Ulcers ◽

Ulcer Disease ◽

Initial Symptoms

The records of all children with peptic ulcer disease at the Hospital for Sick Children were retrospectively evaluated, excluding neonates, throughout a 5-year period. Only cases with a definite ulcer crater identified either at endoscopy or at surgery were included. There were 36 patients, 20 boys and 16 girls. Duodenal ulcers were more common than gastric ulcers (2.8:1). Ages ranged from 3 months to 17 years, with a mean age of 10 years. Patients were reviewed with respect to etiology of peptic ulcer disease, age when first examined, initial symptoms, and clinical course. Patients were divided into two groups, those with primary (n = 19) and those with secondary (n = 17) peptic ulcer disease. All peptic ulcers in patients younger than 10 years of age were secondary in nature. Secondary ulcers occurred generally in association with a severe underlying illness (11/17), and many ulcers necessitated emergency surgery because of perforation and/or severe hemorrhage (8/17). None of these patients had chronic or recurrent symptoms. In contrast, in children with primary peptic ulcer disease, initial symptoms were more benign. Most patients had abdominal pain and only one required emergency surgery. Children with primary duodenal ulcer disease had a high incidence of recurrent symptoms (67%), however, with surgery for intractable disease necessitated in 40%. Single-contrast barium meals were found to be unreliable in establishing a diagnosis of peptic ulcer disease, particularly cases of gastric ulcer disease.

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Update on Peptic Ulcers in the Pediatric Age

Ulcers ◽

10.1155/2012/896509 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Graziella Guariso ◽

Marco Gasparetto

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Immunosuppressive Drugs ◽

Stressful Events ◽

Peptic Ulcers ◽

Pediatric Age ◽

Adequate Treatment ◽

Medline Search ◽

Ulcer Disease

Background. Peptic ulcer disease (PUD) in children is reported worldwide, although it is relatively rare as compared with adults. Helicobacter pylori (HP) infection is a common cause of PUD in the pediatric age. Other risk factors include the use of nonsteroidal anti-inflammatory agents (NSAIDs), steroids, immunosuppressive drugs, and stressful events. Aim. To critically review the evidence on epidemiology, diagnostic management, and available treatments for PUD in the pediatric age. Methods. A MEDLINE search was performed indicating keywords as “Peptic Ulcer Disease,” “Epidemiology,” “Pediatric,” “Helicobacter pylori,” “Gastric ulcer,” “Bulbar Ulcer,” and “Upper Gastrointestinal Bleeding.” A selection of clinical trials, systematic reviews, and meta-analyses within the time period 2002–2012 was performed. Results. PUD in children is reported worldwide with an estimated frequency of 8.1% in Europe and of 17.4% in the US. When the underlying cause of PUD is addressed, the prognosis is excellent. Standard triple therapy, bismuth-based quadruple therapy, and the sequential therapy represent the current recommended treatments for HP related ulcers. NSAIDs related ulcers are treated by stopping the causative medications and by administration of proton-pump inhibitors or antisecretory drugs. Conclusions. PUD still represents a major concern in the paediatric age. A careful differential diagnosis and an adequate treatment constitute an excellent prognosis.

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Peptic Ulcers and their Complications

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v10i3-s.4082 ◽

2020 ◽

Vol 10 (3-s) ◽

pp. 256-261

Author(s):

Akhilesh Kumar ◽

Dhanesh Kumar ◽

Rajendra Kumar ◽

Jhakeshwar Prasad ◽

Mahendra Kumar ◽

...

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Head Injury ◽

Peptic Ulcer Disease ◽

Early Life ◽

Acute Stress ◽

Peptic Ulcers ◽

Ulcer Disease ◽

Number Of Children ◽

H Pylori

Peptic ulcer disease (PUD) is an uncommon disorder of early life. Peptic ulceration of the stomach or duodenum is usually associated with abnormalities of the gastric mucosa such as gastritis and/or gastropathy. Gastritis and ulcers of the stomach and duodenum can be classified into either primary or secondary depending on their aetiologies. The majority of primary or unexplained peptic ulcers are the result of chronic inflammation caused by Helicobacter pylori infection. However, an increasing number of children with PUD without evidence of H. Pylori infection are now being seen. Rarely PUD is caused by hypersecretory states. Secondary ulceration occurs in response to acute stress from severe systemic illnesses such as sepsis, head injury, burns, and as sequelae to use of certain drugs. The prognosis for recovery from peptic ulcers is good as most patients will respond to treatment. Keywords: Peptic ulcer disease, Complication, Helicobacter pylori, NSAIDs, Management.

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Prevalence of Helicobacter pylori in patients with peptic ulcer disease

International Surgery Journal ◽

10.18203/2349-2902.isj20181011 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1315

Author(s):

Mrutyunjay I. Uppin ◽

Kapildev K. Hannurkar

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Histopathological Examination ◽

Rapid Urease Test ◽

Duodenal Ulcers ◽

Ulcer Disease ◽

Urease Test ◽

H Pylori ◽

Upper Gastrointestinal

Background: Prevalence of Helicobacter pylori (H. pylori) emerges throughout the world and instigates peptic ulcer disease (PUD). The study was conducted with the aim to determine the prevalence of H. pylori in patients with PUD undergoing upper gastrointestinal endoscopy.Methods: This prospective study was conducted on 150 cases of PUD from August 2009 to February 2011. Endoscopy was done in all cases. Biopsy was done and sent for histopathological examination and rapid urease test for confirmation of presence of H. pylori.Results: Out of 150 patients with mean age of 45.76 years, 109 patients were diagnosed to have been infected with Helicobacter pylori (72.66%). Out of 89 patients with gastric ulcer, 61 patients were infected with Helicobacter pylori (68.53%). Forty two out of 51 patients (82.35%) with duodenal ulcers and 06 of 10 patients (60%) with carcinoma of stomach were positive for H. pylori. The remaining patients were found to be negative for the H. pylori infection.Conclusions: The findings of the study conclude that H. pylori was consistently associated with PUD.

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Helicobacter pylori: Basic Mechanisms to Clinical Cure

Canadian Journal of Gastroenterology ◽

10.1155/1995/210176 ◽

1995 ◽

Vol 9 (2) ◽

pp. 91-95 ◽

Cited By ~ 1

Author(s):

ABR Thomson ◽

CN Williams

Keyword(s):

Gastric Cancer ◽

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Clinical Cure ◽

Eradication Therapy ◽

Dual Therapy ◽

Quadruple Therapy ◽

Ulcer Disease ◽

H Pylori

Since its rediscovery 10 years ago,Helicobacter pylorihas reshaped our thinking about the course of peptic ulcer disease. Our approach to the patient with a duodenal ulcer has become one of attempting eradication therapy at the time of first diagnosis, in the hope of curing the ulcer disease. Gastric and duodenal ulceration are only two of the manifestations of this chronic antral infection; other complications ofH pyloriinclude gastritis, gastric cancer and possible maltomas. Therapy ofH pyloriinfection is complicated and involves dual therapy with an antibiotic plus a protein pump inhibitor, such as omeprazole 20 mg bid plus amoxicillin 1 g bid for two weeks, triple or quadruple therapy with bismuth, two antibiotics and an H2-receptor antagonist. Vaccination againstH pyloriis on the far horizon.

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Helicobacter pylori cag pathogenicity island genes: clinical relevance for peptic ulcer disease development in Brazil

Journal of Medical Microbiology ◽

10.1099/jmm.0.46824-0 ◽

2007 ◽

Vol 56 (1) ◽

pp. 9-14 ◽

Cited By ~ 30

Author(s):

Rejane Mattar ◽

Sergio Barbosa Marques ◽

Maria do Socorro Monteiro ◽

Anibal Ferreira dos Santos ◽

Kiyoshi Iriya ◽

...

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Gastric Ulcers ◽

Disease Development ◽

Duodenal Ulcers ◽

Ulcer Disease ◽

Significant Difference ◽

H Pylori ◽

The Right

The purpose of this study was to verify whether the presence of any of the Helicobacter pylori cagPAI genes or segments – cagA, cagA promoter, cagE, cagM, tnpB, tnpA, cagT and the left end of the cag II (LEC) region – would be a useful marker for the risk of peptic ulcer disease development. H. pylori DNA extracted from positive urease tests of 150 peptic ulcer patients and 65 dyspeptic controls was analysed by PCR. Duodenal ulcers were present in 110, gastric ulcers in 23 and both gastric and duodenal ulcers in 17 patients. A significant association (P <0.001) was found between a conserved cagPAI and peptic ulcer disease (34 %). The positivity of the cagA gene varied according to the region of the gene that was amplified. The region near to the promoter was present in almost all of the H. pylori isolates (97.2 %). The segment from nt 1764 to 2083 and the extreme right end were frequently deleted in the isolates from the controls (P <0.01). The positivity of the promoter region of cagA and cagT, cagE, cagM and LEC showed a significant difference between the isolates from peptic ulcer patients and from the controls (P <0.01). Patients usually had moderate gastritis; however, the intensity of the active inflammation was higher in the peptic ulcer group (P <0.001). cagT, cagM, LEC and the right end terminus of the cagA-positive H. pylori isolates were associated with a 27-fold, 8-fold, 4-fold and 4-fold risk of peptic ulcer disease, respectively, and may be useful markers to identify individuals at higher risk of peptic ulcer disease development in Brazil.

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