Gastritis In Children - Symptoms, Signs And Treatment Of Acute Gastritis In Children

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Symptoms, causes and treatment of gastritis in children

Content:

• Symptoms of gastritis in children
• Causes of gastritis in children
• Diagnosis of gastritis in children
• Acute gastritis in children
• Chronic gastritis in children
• Treatment of gastritis in children
• Diet of gastritis in children

Gastritis in children most often occurs at school age. The disease is a different type of inflammation of the gastric mucosa. This feature underlies the clinical manifestations of gastritis. But the most important factor that determines the symptoms of the disease is its specific type. Knowing these subtleties, it is possible by symptoms to suspect not only the presence of gastritis, but also to determine its type.

Symptoms of gastritis in children

Common symptoms of all types of gastritis:

• Painful sensations. Most often, with gastritis, children complain of pain in the upper abdomen (in the area of the stomach). The intensity of the pain syndrome depends on the severity of the inflammatory process and the perception of pain by a particular child. Therefore, pain in the epigastric region can be both mild, non-intense, and excruciatingly strong;
• Discomfort and heaviness in the stomach. It happens both as an isolated symptom and is combined with pain, arising when it subsides or in the interictal period;



• Heartburn. Children note its strengthening with torso bending and physical exertion. This symptom manifests itself as a burning sensation in the upper stomach and behind the sternum. Some children may notice the spread of burning sensation along the entire course of the esophagus to the level of the pharynx. In this case, there is a feeling of sourness in the mouth;
• Belching of air or a small amount of food eaten. In this case, the child may have an unpleasant smell from the mouth;
• Poor appetite and child refusal to eat;
• Nausea and vomiting. Both of these symptoms can either accompany each other or arise in isolation;
• Digestive disorders. Inflammation in the stomach disrupts one of the first stages of food processing, which leads to a failure in all parts of the digestive process. Children have bloating, loose stools or constipation, anemia, vitamin deficiencies, and other symptoms of malabsorption of nutrients;
• Palpation pain in the epigastric region. Sometimes in children with thinned subcutaneous fatty tissue, a spasmodic stomach in the form of a strand is determined;
• External changes. Indirectly, the presence of gastritis with impaired digestion can be judged by pallor of the skin, lining of the tongue with a grayish or whitish coating.

Features of the manifestations of chronic atrophic gastritis:

• It rarely occurs in children;
• It is not pain that comes to the fore, but dyspeptic syndrome in the form of heaviness in the stomach, impaired digestion and absorption of nutrients;
• Atrophic gastritis causes a violation of the general condition of the child, anemia and hypovitaminosis.

Symptoms of chronic hyperacid gastritis, in which there is excess gastric secretion, are as follows:

• Pain is the main manifestation. It is provoked by the child's food intake or physical activity;
• Heartburn and sour belching;
• The general condition of the child is rarely disturbed. Local soreness and gastric disturbances predominate.

Acute gastritis is characterized by the following symptoms:

• Vomiting predominates. Sometimes she becomes indomitable;
• Persistent stomach pain;
• Violation of the general condition of the child, lethargy with prolonged vomiting.

Causes of gastritis in children

The risk group for the development of gastritis among the child population consists of children who are in a period of active growth and transitional changes in the body. Therefore, gastritis mainly occurs in children of early school age (6-10 years old), as well as in adolescents in transitional age (from 12-13 to 16-17 years old). These age-related prerequisites for childhood gastritis create favorable conditions for the implementation of the negative action of causal factors. These include:

• Improper nutrition. Refers to the most common cause of both acute and chronic gastritis. Malnutrition means the child's consumption of unhealthy fast food products (hamburgers, fries, fried pies, etc.), chips, crackers, carbonated drinks (Coca-Cola, Sprite, any colored liquids), spicy foods and foods with excessive spices, smoked meats, excessively fatty foods;
• Violation of the process and regularity of food intake. If a child eats irregularly with large intervals between meals or portion sizes, this creates a high risk of developing gastritis;
• Poor quality food. If a child eats, even healthy food, but at the same time they are either spoiled or infected with pathogenic microorganisms, this will cause acute gastritis;

• Mental and psycho-emotional overload. Modern children are overloaded with school responsibilities. A child who does not have free time becomes very sensitive to any aggressive environmental factors. At the same time, the regulation of the synthesis of gastric juice is disturbed, appetite decreases, and as a result, the inflammatory process in the stomach;
• Physical overload and lack of exercise. Both an excess of physical activity and its lack lead to disruption of blood circulation processes in a growing body and disruption of the mechanisms of autoregulation of protective and secretory processes in the stomach;
• Helicobacter pylori infection. In the origin of chronic gastritis, the role of Helicobacter is clearly proven. These microorganisms can exist only in the stomach cavity under conditions of high acidity. Therefore, they cause chronic gastritis only in conditions of hypersecretion of gastric juice and hydrochloric acid. There can be no Helicobacter pylori inflammation against the background of a reduced secretory activity of the stomach;
• Infectious-toxic and systemic autoimmune-allergic reactions. This means that the child's body is not able to limit pathological processes only to the diseased organ. Therefore, any inflammation or infection in the body can result in an allergic reaction and reactive inflammation in the stomach. In this case, atrophic gastritis often occurs.

Diagnosis of gastritis in children

The clinical signs and complaints of a child can only prompt the doctor or parents to suspect gastritis. The diagnosis must be either confirmed or refuted. Indeed, under the guise of banal gastritis, more dangerous diseases, both of the stomach and any other systems and organs, can be hidden. Therefore, such children are subject to careful observation and diagnosis.

The diagnosis can only be confirmed using one diagnostic method. This is fibrogastroduodenoscopy - an endoscopic examination, during which a direct visual examination of the gastric mucosa is performed to assess its condition. But this procedure is fraught with great difficulties and inconveniences of a technical nature, which limits the indications for its implementation in pediatric practice. Therefore, it is much easier to prescribe a preventive (general prophylactic) treatment for gastritis to a child and monitor the dynamics of the process. If the manifestations of the disease do not decrease, there are direct indications for performing fibrogastroduodenostcopy. It is important to remember that the younger the child is, the more difficult it is to complete it.

In confirming the diagnosis of gastritis in children, neither an ultrasound study, nor X-ray methods, which are practically not used, are informative. Ultrasound examination is necessarily prescribed in order to exclude other problems with the digestive system (biliary dyskinesia, chronic pancreatitis). Laboratory research methods in the form of a clinical study of blood and urine, the level of diastase and liver function tests are carried out to determine the severity and complications of gastritis or concomitant problems with the liver and pancreas. The feces are necessarily examined as part of the general analysis and the presence of helminthic invasion.

Acute gastritis in children

Any child who does not feed on breast milk, but on food can develop acute gastritis. This type of disease is an inflammation of the gastric mucosa caused by the action of harmful environmental factors. First of all, these are food products consumed by the child. In relation to older children, gastritis can be caused by any substandard or infected with pathogenic microbes, dishes. Young children, in addition to these products, accidentally swallow toxic substances (potassium permanganate, rat poison, medications, household chemicals). With their direct contact with the surface of the stomach, either a burn of the mucous membrane of varying degrees occurs, or its irritation with the development of an acute inflammatory process.

Acute gastritis can have primarily different degrees of severity and manifestation, which depends on the severity of damage to the mucous membrane:

• Superficial inflammatory process in the upper layers;
• Deep inflammation with spread to the entire thickness of the mucous membrane;
• The formation of superficial small eroded changes against the background of inflammation;
• Gastritis with deep destructive and inflammatory changes in the gastric mucosa.

The specific type of pathological changes determines the severity of the clinical manifestations of acute gastritis in a child:

• Vomiting. It can be single with a superficial inflammatory process, or be indomitable in the case of deep destructive changes;
• Pain syndrome. Almost always with acute gastritis, gastric spasm occurs, which is manifested by severe pain in the projection of the stomach (upper abdomen);
• General weakness and violation of the general condition. More common for severe acute gastritis with repeated vomiting and dehydration. The appearance of these symptoms is an alarming signal and requires special attention from parents and professionals to such children.

If acute gastritis is represented by superficial inflammatory changes, then it does not pose any threat to the health of the child. After a short-term deterioration, against the background of proper treatment, the child's condition improves and the disease passes without a trace. The situation is quite different with acute gastritis against the background of gross morphological changes in the gastric mucosa. Such children require specialized help, since there is an immediate threat not only to health, but also to the child's life. After all, they can result in gastric bleeding, intoxication or dehydration.

On the subject: prevention of gastritis

Chronic gastritis in children

Chronic gastritis differs from an acute inflammatory process in the gastric mucosa not only by the duration of its course, but also by the mechanism of its occurrence. This means that the chronic process is characterized by a long course, a relatively weak severity of symptoms, a tendency to periodic exacerbations and subsidence of inflammation and symptoms. If acute gastritis is always a sudden onset and rapid course, then chronic gastritis, on the contrary, is a gradual onset and prolonged inflammation. These features are based on the cause of each of these types of gastritis.

Chronic gastritis in children occurs as a result of a violation of the secretory and motor activity of the stomach against the background of a decrease in the protective properties of its mucous membrane. In this case, a situation arises when an excess amount of gastric juice is synthesized with its prolonged stagnation. The unprotected mucous membrane is unable to withstand such aggressive environments. The consequence of this imbalance between protective and irritating mechanisms is a kind of self-digestion of the mucous membrane of the gastric contents, accompanied by an inflammatory process.

The described pathogenetic bases of chronic gastritis underlie its clinical manifestations and the course of the disease. This suggests that the disease becomes a kind of companion in the life of the child and reminds of itself with another exacerbation with every error in the diet.

This undulating course is characterized by symptoms:

• Pain in the stomach;
• Heaviness and belching;
• Heartburn with nausea;
• A rare violation of the general condition of the child.

All these features underlie the treatment program for chronic hypersecretory gastritis. It is radically different from that of its acute variety. But we must not forget about other variants of chronic gastritis, which are accompanied not by hypersecretion, but, on the contrary, by its decrease. They are based on atrophic changes in the mucosa, in which the gastric cells irreversibly self-destruct, losing their function. Such forms of the disease in childhood are rare.

Treatment of gastritis in children

The complex of therapeutic measures for gastritis in children depends on the type of this disease. Differentiated tactics are presented in the form of a table.

Gastric lavage with a probe or drinking plenty of fluids, followed by vomiting; Sorbents: smecta, activated carbon, sorbex atoxil, enterosgel; Gastrocytoprotective drugs: Venter, Almagel, Maalox, Phosphalugel; With a prolonged course of the inflammatory process, a decrease in the secretory activity of the stomach is shown (famotidine, ranitidine); Enzyme preparations: festal, panzinorm, creon, mezim; Diet food. Means gentle food that will not irritate the stomach lining; For severe pain, antispasmodics: no-shpa, papaverine, baralgin, riabal;

Antisecretory therapy for hyperacid stomach conditions (famotidine, quamatel, ranitidine). Preparations from the group of proton pump inhibitors are contraindicated in children. If chronic gastritis is accompanied by a reduced secretion of juice, there is no need to use these funds; Helicobacter pylori therapy. It is carried out with the proven presence of Helicobacteria in the stomach cavity. Includes antibacterial drugs (metronidazole, ornidazole, clarithromycin, amoxicillin), bismuth preparations (de-nol, vikalin), histamine receptor blockers (ranitidine, quamatel); Antacids and gastrocytoprotectors: phosphalugel, maalox, gastromax, almagel; Means that normalize the motility of the stomach and intestines: cerucal, motilium; Antispasmodics if needed: riabal, no-shpa; Enzyme preparations: Creon, Pancreatin, Mezim; With atrophic gastritis, iron preparations (totem, ferum-lek), fortifying and vitamin agents (actovegin, aloe, mummy, neurobeks) are shown; Diet therapy, treatment with mineral waters (Borzhomi, Luzhanskaya, Truskavetskaya, Essentuki) and health resort improvement.

Diet of gastritis in children

Diet nutrition for any type of gastritis in children is of particular importance. The duration of acute treatment and the duration of the relapse-free course of chronic processes depend on the correctness of its characteristics.

Recommendations for the nutrition of children with gastritis consist of clear rules:

The first rule is fragmentation, regularity and evenness of meals. If the child eats not 2-3 times, but 5-6 times a day exclusively at the set time, this will accustom the secretory activity of his stomach to absolute self-regulation. The main thing is to make sure that the portions are not too large.

The second rule is the good quality of food and their gentle nature in relation to the gastric mucosa. All meals consumed by the child should be prepared before the appropriate meal. Foods of a spicy, smoked, fatty and fried nature, flavoring additives and spices, refined confectionery products, rich bakery products, fresh bread made from white flour, legumes, raw vegetables are excluded.

The third rule is the nature of the food. Proper nutrition for any gastritis implies the technology of cooking products by steaming or boiling them. Baked meals are allowed. All of them should be soft, mushy, brought to a uniform consistency, with a temperature corresponding to the body temperature of the child (slightly above room temperature).

Details about the diet: what can and can not be eaten with gastritis?

Rule four - the composition of the menu. The diet includes mashed potatoes, any dietary soups with broths from vegetables and meat of chicken, rabbit, beef, porridge (oatmeal, rice, buckwheat), seasoned with butter, steam cutlets from diet varieties of lean fish and meat, cottage cheese casseroles, drink based on cocoa with milk, weak teas, especially from medicinal plants, a decoction of dried fruits, honey, white flour bread, but only yesterday's pastries, crackers.

The fifth rule is that it is especially necessary to follow a diet in the initial stages of the disease. As symptoms and inflammation decrease, its volume expands, which is necessary to replenish lost energy and nutrients.

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Author of the article: Sokolova Praskovya Fedorovna, pediatrician