Causes of stomach inflammation in children
The leading cause of chronic gastritis in childhood is Helicobacter pylori infection. The bacterium is transmitted within a family through shared utensils, kissing, and poor hygiene, and is often detected in several family members. The second significant reason is the use of non-steroidal anti-inflammatory drugs, especially long-term and without a doctor’s prescription. Less common are autoimmune and eosinophilic gastritis, lesions in Crohn's disease, and a reaction to bile. Eating dry food, fast food and soda by themselves usually do not cause gastritis, but they can intensify symptoms and interfere with the healing of the mucous membrane.
- Helicobacter pylori infection
- Taking painkillers and anti-inflammatory drugs
- Autoimmune and eosinophilic gastritis
- Reflux of bile into the stomach
- Chronic bowel diseases
- Stress and irregular diet as aggravating factors
Symptoms
Most often, children complain of pain or heaviness in the upper abdomen, in the pit of the stomach, which appears after eating or, conversely, on an empty stomach. Nausea, belching, rapid satiety, loss of appetite, and sometimes vomiting occur. Young children cannot pinpoint the location of the pain and simply point to their stomach or become capricious and refuse to eat. It is important to remember that similar complaints include functional dyspepsia, constipation, helminthic infestations, urinary tract inflammation and anxiety disorders, so a doctor’s assessment is required.
- Pain and heaviness in the upper abdomen
- Relationship between pain and food intake
- Nausea, belching, early satiety
- Decreased appetite
- Sometimes vomiting
- Children are moody and refuse to eat
How to examine
The examination begins with an examination and exclusion of other causes: a blood test to detect anemia and inflammation, a general urine test, a stool test, and, if necessary, an ultrasound of the abdominal cavity. It is important to understand that an ultrasound scan of the stomach does not evaluate or confirm gastritis: it is done to rule out problems with the gallbladder, pancreas and kidneys. The main method remains gastroscopy, in which the doctor sees the mucous membrane and can take a biopsy. In children, it is performed according to indications, often with medicated sleep. H. pylori infection is detected by a breath test or stool antigen test; A blood test for antibodies is not suitable for monitoring treatment.
- Examination by a pediatrician and assessment of warning signs
- Complete blood count, urine test, stool test
- Ultrasound of the abdomen to rule out other causes
- Gastroscopy with biopsy according to indications
- Breath test or H. pylori antigen in stool
- Refusal of blood testing for antibodies to monitor treatment
Treatment
If H. pylori infection is confirmed, a multi-drug regimen including antibiotics and an acid reducer is prescribed. The course is completed in its entirety, and a control test is performed a certain time after completion. Self-administration of antibiotics is unacceptable: this leads to bacterial resistance and treatment failure. For gastritis associated with painkillers, the drug is discontinued or replaced in consultation with the doctor. Symptomatically, acid-reducing agents are used in a course and in an age-specific dose. Enzymes, choleretic, herbal preparations and bifid drugs for gastritis are not the main treatment and are not always prescribed.
- H. pylori eradication scheme as prescribed by a doctor
- Post-course test
- Stopping or replacing medications that irritate the stomach
- Acidity reducing agents, course
- Examination and, if necessary, treatment of family members
- Avoiding self-medication with antibiotics
Nutrition and regimen
Strict diets with pureed food are not supported by the modern approach, but the regimen is really important. It is good for a child to eat regularly, 4-5 times a day, not to skip breakfast, not to overeat at night and not to replace food with dry snacks. During the period of exacerbation, limit spicy, fried, very fatty drinks, carbonated drinks, strong tea, coffee and energy drinks, which teenagers often drink regularly. It is worth paying attention to the psychological side: in schoolchildren, abdominal pain often worsens with anxiety and academic stress. Return to normal diet occurs gradually as symptoms disappear.
- Regular meals 4–5 times a day
- Mandatory breakfast, no food at night
- Limiting spicy, fried, soda and energy drinks
- Enough drinking and vegetables in the diet
- Paying attention to stress levels and sleep patterns
- Gradual expansion of the diet after an exacerbation
- Separate utensils and hygiene in case of identified infection in the family