Can Childhood Gastric Ulcers Heal on Their Own?

In most cases, childhood gastric ulcers do not heal on their own without proper medical intervention. The two most common causes of gastric ulcers in children are Helicobacter pylori (H. pylori) infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Without appropriate treatment, these ulcers can lead to complications and significantly affect a child's health. Below is a detailed overview of both causes and their respective treatment approaches:

1. H. pylori Infection as a Cause of Gastric Ulcers

When a gastric ulcer is caused by an H. pylori infection, the primary goal of treatment is to completely eradicate the bacteria and allow the stomach lining to heal. This involves a two-phase approach:

H. pylori Eradication Therapy: This typically involves either triple or quadruple therapy. Triple therapy includes a proton pump inhibitor (PPI) combined with two antibiotics, while quadruple therapy adds a bismuth compound to the PPI and two antibiotics. The full course of eradication therapy usually lasts between 10 to 14 days.

Acid Suppression Therapy: After completing the eradication phase, children continue with acid suppression therapy using PPIs for at least 8 weeks. This helps promote ulcer healing and reduces the risk of recurrence.

Following treatment, it's important to assess whether the ulcer has fully healed. If the ulcer was large or severe, a follow-up endoscopy may be recommended. If the ulcer hasn't fully healed, the acid suppression therapy may need to be extended to prevent relapse.

2. NSAID-Induced Gastric Ulcers

Children who take NSAIDs such as ibuprofen or aspirin regularly may develop gastric ulcers as a side effect. These types of ulcers require careful management to ensure complete healing.

Treatment Duration: Most NSAID-induced ulcers require 4 to 8 weeks of treatment, depending on their size and severity.

Follow-Up Evaluation: Smaller ulcers, especially those related to stress or occasional NSAID use, may resolve on their own without specific treatment. However, the majority of ulcers will require medical attention to ensure proper healing and prevent complications such as bleeding or perforation.

In summary, while some small ulcers might show improvement without treatment, they should not be left unaddressed. Proper diagnosis and timely treatment are essential to avoid long-term complications and support a full recovery. Parents should consult a pediatric gastroenterologist if they suspect their child has a gastric ulcer, especially if symptoms like abdominal pain, nausea, or loss of appetite persist.