A teen who complains of gnawing pain under the breastbone just might have what's called a peptic ulcer.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
According to the American Academy of Pediatrics (AAP), ulcers are not an adults-only condition — teenagers can develop them, too 24. Gastric ulcers form in the stomach, and duodenal ulcers form in the first part of the small intestine. They're both peptic ulcers 24.
“Peptic ulcers in teens are less common than in older adults, but the causes are largely the same and so is the diagnosis and treatment,” says Brooks Cash, MD, chief of gastroenterology at the University of Texas Health Science Center in Houston 14.
What Causes Peptic Ulcers in Teens?
It was once believed that peptic ulcers, in people of any age, were caused by stress or diet 4. However, the majority of peptic ulcers are now known to be caused by bacteria known as Helicobacter pylori (H. pylori), by the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or by a combination, says AAP 34.
“The reason peptic ulcers are less common in teens is that they are less likely to be taking an NSAID than older people, and they have had less lifetime to be exposed to an H. pylori infection,” says Dr. Cash 4.
It’s not exactly clear what causes the H. pylori infection, according to the Mayo Clinic, but most people who have it acquire it in childhood, and many people never have any symptoms 3. It may be caused by contact with contaminated food or water or an infected person’s saliva, feces or vomit, it says. The bacteria cause the ulcer by breaking down the protective coating of the stomach lining, allowing stomach acid to irritate the tissues underneath.
NSAIDs are a category of medicines often used to treat headaches or muscle aches. Common NSAIDs include aspirin, ibuprofen (Advil or Motrin), and naproxen (Aleve). They are also found in many common cold and flu remedies, like Alka-Seltzer, according to the American College of Gastroenterology 1. NSAIDs cause ulcers by interfering with the ability of the stomach or duodenum to protect itself from stomach acid.
According to KidsHealth.org, some doctors think young people get more medication-related gastric ulcers than other types of peptic ulcers 4. Even with moderate use, NSAIDs can cause GI problems and bleeding in some kids, it notes. Although such cases are rare, a recent report in the January 2014 issue of the Journal of Pediatric Surgery Case Reports illustrates the risk 5. Researchers describe GI complications in a teenage male athlete whose "deeply penetrating ulcer" was traced to NSAID use.
- It was once believed that peptic ulcers, in people of any age, were caused by stress or diet 4.
- “ The reason peptic ulcers are less common in teens is that they are less likely to be taking an NSAID than older people, and they have had less lifetime to be exposed to an H. pylori infection,” says Dr. Cash 4.
Ulcer Symptoms in Teenagers
The Best Food to Eat for a Stomach Ulcer
“The most common symptom is epigastric pain, which is a gnawing pain under the breastbone,” says Dr. Cash. “The pain of a gastric ulcer may get worse after eating because the stomach produces more acid in response to food intake. Duodenal ulcer pain may get better because eating triggers release of bicarbonate from the pancreas into the duodenum, and bicarbonate is a natural antacid.”
According to AAP, other signs and symptoms of ulcers in teens can include:
- Loss of appetite
- Nausea or vomiting
- Blood-tinged vomit or bloody stool, which may look black
Without treatment, complications from peptic ulcers can be dangerous for children and teens, as they can be for adults, according to Dr. Cash 4. The main complications are bleeding, perforation and obstruction. Bleeding can cause weakness and anemia. Perforation can lead to a life-threatening infection. Obstruction of the digestive tract can occur from swelling caused by the ulcer, which can also be dangerous.
“Many people have ulcers and do not have serious symptoms,” says Dr. Cash. “Dangerous ulcers are called ‘clinically significant ulcers.’ Those are the ones that cause bleeding, perforation or obstruction.”
- “The most common symptom is epigastric pain, which is a gnawing pain under the breastbone,” says Dr. Cash.
- “ Duodenal ulcer pain may get better because eating triggers release of bicarbonate from the pancreas into the duodenum, and bicarbonate is a natural antacid.”
Diagnosing and Treating Peptic Ulcers in Teens
“Treatment may include:
- avoiding NSAIDs
- treating the ulcer with a medicine to decrease gastric acid production — called a proton pump inhibitor — for eight weeks and
- if H
pylori infection is diagnosed
* treating with antibiotics,” says Dr. Cash.
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- American College of Gastroenterology: “Peptic Ulcer Disease”
- American Academy of Pediatrics: “Peptic-Ulcers”
- Mayo Clinic: “Helicobacter Pylori (H. pylori) Infection”
- KidsHealth.org: "Peptic Ulcers"
- Journal of Pediatric Surgery Case Reports: "Hepatic Abscess Following NSAID Use in an Adolescent"
- Testerman TL, Morris J. Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment. World J Gastroenterol. 2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781
- Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Physician. 2007;76(7):1005-12.
- Epelboym I, Mazeh H. Zollinger-Ellison syndrome: classical considerations and current controversies. Oncologist. 2014;19(1):44-50. doi:10.1634/theoncologist.2013-0369
- Lim YJ. Genetic susceptibility of gastroduodenal disease in ethnic and regional diversity. Gut Liver. 2014;8(6):575-6. doi:10.5009/gnl14313
- Li L, Chan R, Lu L, et al. Cigarette smoking and gastrointestinal diseases: The causal relationship and underlying molecular mechanisms (Review). International Journal of Molecular Medicine. 2014;34(2):372-380. doi:10.3892/ijmm.2014.1786
- Bang CS, Baik GH, Kim JH, et al. Peptic ulcer disease in liver cirrhosis and chronic hepatitis: impact of portal hypertension. Scand J Gastroenterol. 2014;49(9):1051-7. doi:10.3109/00365521.2014.923501
- American College of Gastroenterology. Peptic Ulcer Disease.
- Peptic Ulcer Disease. American College of Gastroenterology.
- Definition & Facts for Peptic Ulcers (Stomach Ulcers). National Institute of Diabetes and Digestive and Kidney Diseases.
- Lim YJ. Genetic Susceptibility of Gastroduodenal Disease in Ethnic and Regional Diversity. Gut Liver. 2014;8(6):575–576. doi:10.5009/gnl14313