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Chronic duodenal ulcer in children: clinical observation and response to treatment
B L Chiang1, M H Chang, M I Lin
1Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Republic of China.
Insights
Chronic duodenal ulcer in children is more common in males and linked to stress. While short-term treatments are effective, sucralfate shows superiority for long-term maintenance therapy in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Disorders
Background:
- Chronic duodenal ulcer diagnosis in children has increased due to advanced panendoscopy.
- A study identified 33 pediatric cases between 1976 and 1986.
Purpose of the Study:
- To evaluate treatment efficacy for chronic duodenal ulcer in children.
- To compare different therapeutic regimens for long-term maintenance.
Main Methods:
- Retrospective analysis of 33 pediatric patients diagnosed with chronic duodenal ulcer.
- Patients were treated with antacids, sucralfate, or cimetidine.
- Outcomes were assessed over 1-10 years, with a focus on recurrence and maintenance therapy.
Main Results:
- A male predominance (4.5:1) and positive family history (36%) were noted.
- Short-term (8-week) therapy showed similar efficacy (83-94%) across all groups.
- Sucralfate demonstrated superiority over antacids for ongoing maintenance therapy.
Conclusions:
- Chronic duodenal ulcer in children requires long-term maintenance therapy due to frequent recurrence.
- Sucralfate is a preferred agent for maintaining remission in pediatric patients.
- Emotional stress and family history are significant factors in pediatric duodenal ulcers.
Abstract:
Chronic duodenal ulcer is diagnosed more frequently in children since recent advances in panendoscopy techniques. From 1976 to 1986, chronic duodenal ulcer was diagnosed in 33 children in this hospital. There was a marked male preponderance (male: female = 4.5:1). Family history for peptic ulcer was positive in 36% of the patients. The important element of emotional stress was identified in 39% of the patients. Thirty patients received medical treatment, and 26 were observed for more than 1 year (1-10 years). In 11 children, medication was changed because of symptom recurrence and change in the mode of treatment. The patients were divided into three groups with different treatment regimens: antacid (12 cases), cytoprotective agent (sucralfate, 17 cases), and histamine H2-receptor antagonist (cimetidine, eight cases). The response to short-term (eight-week) therapy was similarly good (83-94%) in the three treatment groups. However, sucralfate is superior to antacid in the ongoing maintenance therapy of chronic duodenal ulcer in childhood. Because chronic duodenal ulcer recurred frequently, it is crucial to give long-term maintenance therapy.