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The Dyspepsia Educational Tool As a Novel Aid in Dyspepsia Management
Published on: June 29, 2019
[Peptic ulcer]
1Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Insights
Peptic ulcer disease in children, often linked to H. pylori, requires accurate diagnosis and treatment. Eradicating H. pylori is key to preventing recurrence of primary duodenal ulcers.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Internal Medicine
Background:
- Peptic ulcer disease (PUD) is common in adults but less frequent in children.
- Advancements in optical fibroendoscopy have increased PUD diagnosis in pediatric populations.
- PUD is categorized as primary (no underlying disease) or secondary (related to disease or drugs).
Purpose of the Study:
- To review the pathogenesis, pathophysiology, diagnosis, and treatment of PUD in children.
- To synthesize findings from recent publications and clinical experience.
- To highlight the role of H. pylori in pediatric PUD.
Main Methods:
- Comprehensive review of relevant articles on pediatric peptic ulcers published in the last 20 years.
- Analysis of clinical presentation, etiology, and therapeutic approaches.
- Integration of author's personal experience.
Main Results:
- Primary duodenal ulcers are most common, with strong evidence implicating H. pylori.
- Clinical presentation varies by age and ulcer type; secondary ulcers are often acute, while primary ulcers present chronically.
- Acid antisecretory agents effectively manage symptoms and lesions, but H. pylori eradication prevents recurrence.
Conclusions:
- Multiple factors contribute to primary PUD pathogenesis, with H. pylori being the most significant.
- Accurate diagnosis and treatment, including H. pylori eradication, are crucial for managing pediatric PUD.
- Antibiotics play a vital role in PUD management, necessitating further research into H. pylori.
Abstract:
OBJECTIVE: To present a current review about pathogenesis, pathophysiology, diagnosis, and treatment of peptic ulcer disease in children, based on the reviewed publications and the author personal experience. METHODS: We revised the most relevant articles about peptic ulcer in children, published from the last 20 years. RESULTS: The gastroduodenal peptic ulcer is very common in adults, mostly in the developing countries. Although it is less frequent in children, the optical fibroendoscopy has improved the number of diagnosed cases. The peptic ulcer is classified as its etiology in primary and secondary. The secondary peptic ulcer is related to a subjacent disease or use of drugs, while the primary ulcer happens in the absence of underlying systemic diseases The primary duodenal ulcer is the most common presentation, and there are strong evidences of the H. pylori association in the etiology. Clinical presentation changes with age and ulcer type. Secondary ulcers are mostly acute and sometimes dramatic, while the primary ones have a chronic evolution mostly similar to patients with functional recurrent abdominal pain, but the presence of epigastric pain, feeding-related pain, vomiting, bleeding, familiar history for peptic ulcer, nocturnal pain, and male gender are strongly related to peptic ulcer. The acid antisecretory agents have great efficacy on relieving symptoms and solving ulcerate lesion, although the H. pylori eradication itself prevents primary duodenal ulcer recurrence. CONCLUSIONS: The primary peptic ulcer involve many factors in Its etiopathogenesis, being H. pylori the most important of them Although there isn t yet a ideal therapeutic course. The antibiotics play an important role in peptic ulcer and the H. pylori research must be done for na accurate diagnosis and treatment.
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