Duodenal Ulcers in a child
Posted: Wed Feb 17, 2016 8:55 pm
Hi,
I have a son, who is 6 years old, who has been suffering from Gastro Oesophageal Reflux Disease for years. He had reflux from birth but it got worse at about 7 months old when weaning. He is very underweight, has struggled to eat for several years and has been taking a PPI, Omeprazole, since 18 months old.
His sister also has milder reflux. I have had reflux/indigestion since a childhood and have had severe morning sickness during both pregnancies (just in case it is relevant).
Last year they suggested he had CMPI and we have eliminated cows milk from his diet but he still struggles.
Our health system in the UK, the NHS, performed an Endoscopy on him in January and found shallow ulcers and inflammation on his Duodenum.
We stopped PPI’s 7 days before the Endoscopy. He took Mebendazole for thread worms approximately 4 weeks before the Endoscopy and was on Movicol when he had the Endoscopy done.
The paediatric gastroenterologist performing the Endoscopy really thought it looked like H Pylori.
However, the H Pylori Rapid Urease Test came back negative. The histology results came back negative.
The other test results (blood/stool) suggested no other reason why he would have duodenal ulcers. They did not test for H Pylori in stool test.
So I have been asked to increase his PPI and give him an iron supplement. No further medical advice or investigation suggested.
I found a paper ‘Evidence-based Guidelines From ESPGHAN and NASPGHAN for Helicobacter pylori Infection in Children’ which suggests PPI’s be ceased 14 days prior to testing.
Can I ask if this is correct or if 7 days is sufficient ?
From my research it seems that the guidelines regarding how long to stop the PPI for is unclear. Especially for children as the test is less reliable for children.
Secondly, is there any other bacteria other than H Pylori that can cause the same symptoms ?
Many thanks.
I have a son, who is 6 years old, who has been suffering from Gastro Oesophageal Reflux Disease for years. He had reflux from birth but it got worse at about 7 months old when weaning. He is very underweight, has struggled to eat for several years and has been taking a PPI, Omeprazole, since 18 months old.
His sister also has milder reflux. I have had reflux/indigestion since a childhood and have had severe morning sickness during both pregnancies (just in case it is relevant).
Last year they suggested he had CMPI and we have eliminated cows milk from his diet but he still struggles.
Our health system in the UK, the NHS, performed an Endoscopy on him in January and found shallow ulcers and inflammation on his Duodenum.
We stopped PPI’s 7 days before the Endoscopy. He took Mebendazole for thread worms approximately 4 weeks before the Endoscopy and was on Movicol when he had the Endoscopy done.
The paediatric gastroenterologist performing the Endoscopy really thought it looked like H Pylori.
However, the H Pylori Rapid Urease Test came back negative. The histology results came back negative.
The other test results (blood/stool) suggested no other reason why he would have duodenal ulcers. They did not test for H Pylori in stool test.
So I have been asked to increase his PPI and give him an iron supplement. No further medical advice or investigation suggested.
I found a paper ‘Evidence-based Guidelines From ESPGHAN and NASPGHAN for Helicobacter pylori Infection in Children’ which suggests PPI’s be ceased 14 days prior to testing.
Can I ask if this is correct or if 7 days is sufficient ?
From my research it seems that the guidelines regarding how long to stop the PPI for is unclear. Especially for children as the test is less reliable for children.
Secondly, is there any other bacteria other than H Pylori that can cause the same symptoms ?
Many thanks.