Peptic Ulcer Disease

Peptic Ulcer Disease (PUD) in children, though less common than in adults, is a significant gastrointestinal condition characterized by the formation of ulcers in the stomach or duodenum. The primary cause in pediatric populations is Helicobacter pylori (H. pylori) infection accounting for 50-70% of cases, followed by the use of non-steroidal anti-inflammatory drugs (NSAIDs) and stress-related mucosal damage. The pathophysiology involves an imbalance between aggressive factors (acid, pepsin, H. pylori) and defensive factors (mucosal barrier, blood flow, prostaglandins), leading to mucosal erosion and ulceration. Clinical presentation in children can be atypical, with symptoms ranging from epigastric pain and nausea to non-specific complaints like irritability or failure to thrive. Diagnosis relies on a combination of clinical history, non-invasive H. pylori testing (e.g., stool antigen or urea breath tests), and upper gastrointestinal endoscopy, which remains the gold standard for definitive diagnosis and biopsy. Treatment focuses on eradicating H. pylori (using triple or quadruple therapy), reducing acid secretion (with proton pump inhibitors or H2-receptor antagonists), and promoting mucosal healing. Complications such as hemorrhage, perforation, or gastric outlet obstruction require urgent intervention. Prevention strategies include improving sanitation to reduce H. pylori transmission, judicious use of NSAIDs, and early detection of symptoms. Despite its challenges, PUD in children has a favorable prognosis with timely and appropriate treatment. Ongoing research into vaccine development, antibiotic resistance, and non-invasive biomarkers holds promise for improving diagnosis, treatment, and prevention in the future. This comprehensive review highlights the importance of a multidisciplinary approach to managing PUD in pediatric populations, ensuring optimal outcomes and quality of life for affected children. This abstract provides a concise yet detailed summary of the key aspects of PUD in children, including etiology, pathophysiology, clinical presentation, diagnosis, treatment, and future directions.