When Your Child Has a Gastric or Duodenal Ulcer

An ulcer is a breakdown of tissue on the inside of the stomach or small intestine. This causes a sore to form. An ulcer can form in the stomach (a gastric ulcer). Or one can form in the first part of the small intestine (a duodenal ulcer). In children, ulcers are often caused by an infection with bacteria (such as Helicobacter pylori), certain medications (such as NSAIDs), or an increase in stomach acid. 

What Are the Symptoms of an Ulcer?

Common symptoms of a gastric or duodenal ulcer include:

  • Burning, cramping, or hungerlike pain in your child’s stomach area. This often happens 1 to 3 hours after a meal, or in the middle of the night.

  • Pain that gets either better or worse with eating.

  • Nausea or vomiting (blood may be present in vomit).

  • Black, tarry stools (this means the ulcer is bleeding).

How Are Ulcers Diagnosed?

Common tests for ulcer include:

  • Upper GI series, X-rays of the digestive tract to locate an ulcer.

  • Endoscopy, a test using a thin, flexible tube with a tiny camera attached (endoscope). The endoscope is inserted through your child’s mouth into the stomach. This allows the doctor to see the ulcer. This tube may also be used to do a biopsy (take a tiny tissue sample).

  • Blood or stool tests.

How Are Ulcers Treated?

Ulcers in children are most often treated with medication. The most common medications are H2 blockers and proton pump inhibitors (PPIs). They help by blocking stomach acid production. It may take 8 to 12 weeks of medication to relieve your child’s symptoms and heal the ulcer. 

Long-Term Concerns 

A child who has had an ulcer is more likely to have one again. So be sure you and your child watch for ulcer symptoms. If your child has any symptoms, contact your child’s doctor right away. If an ulcer is not treated, a serious problem called perforation (a hole through the stomach or intestinal wall) can occur. Emergency surgery will likely be needed to fix a perforation.

When to Call the Doctor

Watch for any signs that your child’s ulcer has worsened or perforated. These include:

  • Fever:

    • In an infant under 3 months old, a rectal temperature of 100.4°F  (38ºC) or higher

    • In a child of any age who repeatedly has a temperature of 104°F (40ºC) or higher

    • A fever that lasts more than 24 hours in a child under 2 years old or for 3 days in a child 2 years older.

    • A seizure caused by the fever 

  • Vomiting blood

  • Severe abdominal pain