Helicobacter pylori and associated duodenal ulcer

Article Abstract:

The presence of the bacterium Helicobacter pylori in the mucosal tissue lining the stomach is associated with the development of gastritis, the inflammation of the stomach, in adults and children. Other studies have shown that infection with H. pylori also contributes to the development of duodenal ulcers, which are lesions in the mucosa of the small intestine. The characteristics of duodenal ulcer disease associated with H. pylori infection were examined in 23 affected children. The children were treated with either two weeks of the antibiotic amoxicillin and six weeks of the histamine antagonist cimetidine, or with cimetidine alone. Endoscopy was performed to obtain a biopsy or tissue sample of the stomach and small intestine for biochemical and tissue microscopic tests. This procedure involves the examination of a body cavity using a tube-like device fitted with an optical system that is inserted through a natural opening or small incision. Biopsies were obtained at the start of the study, and six weeks, 12 weeks, and six months thereafter. Amoxicillin was given for two weeks to children with H. pylori infection persisting for six weeks. Infection with H. pylori persisted in all children treated with cimetidine alone, but was cleared in 6 of 13 children treated with both amoxicillin and cimetidine. In patients with H. pylori infection persisting for six months, the duodenal ulcers healed in two of six children and recurred in 50 percent of cases. The ulcers healed and did not recur in children who remained free of H. pylori infection. Continual H. pylori infection was associated with persistent gastritis and duodenitis (inflammation of the small intestine), despite healing of the ulcer. These findings show that treatment of duodenal ulcers in children should include detection and elimination of H. pylori infection of the gastric mucosa. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Helicobacter infections

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Investigation of rectal bleeding

Article Abstract:

Rectal bleeding in children is often transient, benign, and simply treated. The age at which rectal bleeding occurs is important in determining the cause of the bleeding. Rectal bleeding is often associated with necrotizing enterocolitis (a disorder characterized by inflammation of the intestines and colon associated with tissue death) in premature and newborn infants Structural abnormalities of the anus, such as fissures or invagination, are often the cause of rectal bleeding in young infants. Lymphoid hyperplasia (the overgrowth of lymphoid tissue) and inflammatory bowel disease may be responsible for this symptom in older child. The patient's medical history is important in determining the diagnosis. The consistency of the stool, pain, defecate patterns, diet, the amount and color of blood, family medical history, and drug history provide important clues. The abdomen, areas surrounding the anus, and the rectum should be examined thoroughly. The examination of the anus and rectum and important physical findings are discussed in detail. Stool samples should be analyzed if rectal bleeding is associated with infection. Imaging methods used to assess rectal bleeding include X-rays; sonography, which involves the use of sound waves; and endoscopy, the insertion of a tube-like structure with an optical system into the intestinal cavity. Although endoscopy is often difficult to perform and uncomfortable for the child, it can be used to obtain a biopsy and examine any changes in tissue structure. More radical medical methods to assess rectal bleeding include use of radioactive technetium-labelled red blood cells that accumulate at sites of bleeding in the intestine; angiography, X-ray of blood vessels; and laparotomy, the surgical opening of the abdomen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical examination, Gastrointestinal bleeding, Gastrointestinal hemorrhage, Demographic aspects, Colorectal diseases, Intestinal diseases, Rectum, Rectal examination, Necrotizing enterocolitis, Enterocolitis, Neonatal necrotizing

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Perforated duodenal ulcer: an unusual complication of gastroenteritis

Article Abstract:

Acute peptic ulcer is a lesion in the lower esophagus, stomach, or small intestine. The occurrence of acute peptic ulcer in childhood is not rare, but may be overlooked. Children may have symptoms of vomiting or bleeding from the gastrointestinal tract, or the ulcer may be detected at autopsy. Perforation or rupture of the ulcer rarely occurs. A case is described of a seven-year-old boy who was admitted to the hospital with gastroenteritis, the inflammation of the stomach and small intestine. The boy had symptoms of diarrhea and vomiting over the past 48 hours. The gastroenteritis was complicated by an acute perforated ulcer in the duodenum, a portion of the small intestine. The perforated ulcer was repaired and the boy recovered without complications. The delayed diagnosis of peptic ulcer in childhood leads to a delay in the management of this disorder, which is associated with severe illness and viral infections but rarely with perforation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Gastroenteritis, Gastroenteritis in children

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