Gastritis in children

Inflammation of the inner shell of the stomach( gastritis) refers to the frequent pathology of the digestive system, which occurs in pediatric practice. Morbidity has "peaks" of recovery in 5-6 years and in adolescents 14-15 years. During these periods the children's body grows most intensively. Some authors still distinguish the "wave" of early school age from 6 to 8 years.

Gastritis in children also, as in adults, has an acute and chronic course, is accompanied by morphological changes in the mucosa and various degrees of impaired functions with hyper- or hypoacid state of the stomach.

What features of children affect the incidence of gastritis?

It is important to take into account the physiological characteristics of children, which are associated with the underdevelopment of the digestive system before the age of seven:

• reduced concentration of hydrochloric acid in gastric juice;
• inadequate enzyme activity;
• prolonged movement of food from the stomach into the intestines due to a weak tonus of the muscle layer.

These conditions are very beneficial for infection with microorganisms, the negative effects of any food. Therefore, preschool children often have signs of food poisoning, and the treatment of gastritis in children begins with a check on bacteria and parasites.

The nervous system of the child, unprepared for overloads, reacts much more intensively to overloads in the school, additional activities. For her, stress is any change in the regime and the situation. Disruption of digestion arises from the uncoordinated synthesis of enzymes.

Chronic flow often acquires an incomplete acute process. Cells of the epithelium of the stomach undergo gradual destruction, the secretory glands are atrophied. Children's gastritis quickly causes violations of the entire digestive system, metabolism.

Reasons for

Given the age physiology, you can form a risk group, which includes children who are likely to develop gastritis. The most common cause is malnutrition:

• irregular feeding, increasing intervals between meals up to 5 or more hours;
• lack of proper control, permission to eat junk food of fast food, cooked in doubtful conditions by roasting or smoking( hamburgers, French fries, chips), drinking of crackers with spices, sweet carbonated drinks, which use harmful dyes;
• the use of poor quality food, bought in kiosks, in shops with the broken term of storage;
• feeding infected dishes in public canteens if the process of cooking and storing food is improperly handled.

Children do not realize that the delicious can be dangerous

This proves that as a child grows up, the child needs control over nutrition, learning rules for self-selection and hygiene. Psycho-emotional overloads with the beginning of school classes contribute to increasing the sensitivity of children to aggression surrounding environments. The regulatory function of the nervous system of producing gastric juice, appetite is disturbed.

The result may be inflammation in the stomach. Equally harmful are both increased physical activity and insufficient mobility. They break blood circulation, tear off immune protection. Infection with Helicobacter pylori is important in the onset of chronic gastritis.

The microorganism reproduces well enough in conditions of high acidity. Children with hypersecretion of gastric juice are most sensitive. The cause of acute gastritis can be:

• any food products, nutritional formulas in the infant;
• infected meals for older children;
• accidental ingestion by small children of medicines, cleaning products, pesticides.

The children's organism hardly perceives meetings with toxic substances, infection. He is not able to confine himself to a local response. Causes pronounced autoimmune inflammation, in which one's own cells are taken for alien and destroyed. Thus, chronic atrophic gastritis develops in children.

Among the causes of chronic gastritis, one should not forget about the possibility of a primary lesion in a child of the liver, gall bladder, pancreas( hepatitis, cholecystitis, pancreatitis), intestines. To a sluggish gastritis lead:

• allergy to food;
• endocrine disorders;
• chronic infections( tonsillitis);
• long-term use of drugs;
• infection with helminths.

How do symptoms of gastritis appear in childhood?

Symptoms of gastritis in children depend on the form and stage of the disease. The first signs are often unclear discomfort in the abdomen. The child can not accurately describe what is bothering him. On leading questions it turns out that he constantly feels tired, wants to sleep, in the stomach - heaviness and bursting after any meal, no appetite.

Usually unpleasant sensations appear 30 minutes or an hour after eating

Pain syndrome is felt in the epigastric region, the intensity can range from aching pain to a strong cramping. Children refuse to eat because they do not want to worsen their condition. Heartburn is described by patients as a burning sensation "in the throat and below" when leaning forward, physical exercises. Acid is felt in the mouth.

Belching - an indicator of increased fermentation and stagnation in the stomach, appears with an unpleasant odor or a long-eaten food. Nausea occurs due to irritation of the emetic center of the brain with signals from the inflamed surface of the stomach. Disturbs constantly or is accompanied by increased salivation and vomiting.

In older children with increased acidity after vomiting, there comes an improvement. Signs of gastritis are violations of general digestion: bloating, diarrhea or constipation, anemia caused by impaired absorption of vitamin B12, other symptoms of avitaminosis( brittle hair, pallor, acne in teenagers, weak muscles, decreased vision).

Babies grow poorly and do not gain weight. Upon examination, the doctor observes the lagging of the tongue, palpation is sometimes determined by a spasmodic, painful stomach.

Methods of diagnosis

It is important to find out the causes of the child's complaints by examining. Under gastritis, other diseases are sometimes masked. Fibrogastroduodenoscopy is the best way to examine the stomach mucosa, to assess its condition, but in pediatrics it is used heavily, only for older children.

Babies spend it technically difficult. Therefore, they are first assigned a standard treatment according to the scheme and the condition is monitored. If the signs of the disease do not decrease, then fibrogastroduodenoscopy is considered absolutely shown. Ultrasound and X-ray examination in children are not used because of low informativeness.

They may be needed to exclude chronic pancreatitis, hepatitis, cholelithiasis. In the laboratory, the child is tested for signs of anemia( hemoglobin, the number of red blood cells in a general blood test), diastase in the urine, tests for hepatic biochemical indicators in the blood serum.

Necessarily appoint a study of feces on scatology, latent blood and detection of infection with worms

How does acute inflammation occur in children?

The gastric mucosa in acute gastritis comes into contact with an irritant and gets irritated or burned. Damage is of a different nature:

• superficial inflammation;
• is a deep process with the capture of the mucous membrane over the entire thickness;
• formation of erosion( cracks, scratches) against the inflamed mucosa;
• destructive changes with destruction of cells of the gastric membrane.

Acute gastritis is different:

• frequent vomiting, which rarely becomes indomitable( with destructive changes);
• with constant pain in the upper abdomen;
• increase in temperature during bacterial contamination;
• weakness and lethargy of the child, caused by the loss of fluid and electrolytes.

With timely proper treatment, superficial gastritis results in complete recovery of the patient. In the case of gross destructive disorders, the child is threatened by gastric bleeding, inflammation becomes chronic, and it needs to be treated for a long time.

Chronic form in children

Chronic inflammation of the stomach - a rather rare diagnosis for children. It takes time to develop. This means that by the time the symptoms appear, a small child will become a teenager. All changes in secretory function and gastric motility occur against a background of reduced local immunity.

If an excessive amount of gastric juice is synthesized, the unprotected mucosa does not have the ability to withstand severe aggression. The inflammatory process is provoked by the destruction of epithelial cells. The disease is exacerbated with every error in the diet, unrest, exercise.

To exacerbate chronic hyperacid gastritis,

• is characterized by severe local epigastric pain, which is aggravated after eating or motor activity;
• belches sour and heartburn.

Refusal of milk porridge can not be considered a whim of

In chronic atrophic gastritis( a rare form in children), the main problem is not pain in the stomach, but a pronounced dyspeptic syndrome, manifested by broken digestion, incomplete absorption of nutrients from the intestines, diarrhea. Significantly disrupted the general condition of the child due to anemia and hypovitaminosis.

It is impossible to determine in advance how the disease will develop in the child. Children need to observe the gastroenterologist, rigorous implementation of recommendations for nutrition and treatment. The tactics of treatment of gastritis in a child depends on the form of the disease.

Treatment for acute gastritis

Treatment of gastritis in children with acute course involves the rapid withdrawal of irritant and an infectious agent from the digestive tract. To do this, use:

• gastric lavage probe, less often give copious drinking of a weak solution of potassium permanganate and cause vomiting by pressing the root of the tongue;
• inwardly appointed enterosorbents( Smecta, Sorbeks atoksil, activated carbon, Enterosgel).

On the first day only a plentiful drink of boiled water, a broth of a dogrose is allowed. From the second day the child is allowed to eat liquid porridge on the water, slimy soup with soaked white breadcrumbs. Further, the expansion of the diet depends on the state of digestion.

With prolonged flow, you may need:

• antispasmodics intramuscularly( No-shpa, Papaverin) for pain relief;
• preparations, enveloping and protecting the gastric mucosa( Almagel, Fosfalugel, Maalox);
• with increasing secretion - drugs that block the glands( Ranitidine, Famotidine);
• antibacterial agents if a gastritis is associated with an infection.

How is the chronic form treated?

Children with chronic gastritis should be on a diet for a long time in order to exclude the intake of irritating substances in the stomach. Of course, it is very difficult for working parents to establish proper nutrition and control over the baby, so they often ask the pediatrician how much to diet.

Theoretically, it can be assumed that after 16-17 years the digestive system will be prepared for the influence of adulthood. But who will guarantee that, after breaking the connection with the pediatrician, the adult who has matured will be completely cured?

Knowing about the predisposition of a child's stomach to breakdown, it is better to tell him in advance about the limitations in nutrition and accustom them to

In gastritis with high acidity, the following medicamental treatment is prescribed:

• Drugs that suppress the function of the secreting glands( famotidine, ranitidine, kwamatel).Inhibitors of proton pump are contraindicated. Protective agents( Phosphalugel, Gastromax, Maalox, Almagel) act better.
• With reduced secretion, Plantaglucid, Acidin pepsin, gastric juice are recommended.
• The course of eradication against Helicobacter pylori infection includes a combination of antibiotics and bismuth preparations.
• Of antispasmodics are more often appointed No-shpu, Riabal.

At atrophic form of gastritis for elimination of hypovitaminosis and strengthening of immunity are shown vitamins of group B, in the presence of iron deficiency anemia preparations Totem, Ferrum-lek, Aloe in injections, Actovegin. To compensate for the loss of pancreatic enzyme production, Creon, Mezim, Pancreatin are used.

The drug inhibits the stimulating effect of histamine, gastrin, on acid production

How can I feed a child?

A diet for children with gastritis is no less important than medications. It helps to protect the surface of the stomach from additional irritation, to facilitate digestion, to achieve a long period of remission in a chronic process.

Basic nutritional requirements:

• Regular feeding 5-6 times a day in small portions. Observance of the regime will allow to "accustom" the secretory glands of the stomach to work actively.
• All products must be benign, sparing the gastric mucosa. Dishes of the planned menu should be prepared before meals, not stored for a long time in the refrigerator. Categorically contraindicated sharp, fatty meat products and pastries, smoked sausages, canned food, marinades, fresh bread, sauces and spices, sweets( chocolate, jam, candies, cakes and cake), legumes, salads from raw vegetables.
• The cooking technology must be observed. Do not fry, you can stew, boil, bake or use a steamer. Suitable dishes are crispy, crushed, not hot.
• Vegetables or mashed potatoes, soups with lean meat or fish broth, cereals with butter( oatmeal, buckwheat, rice), steam cutlets, meatballs, meat balls, casserole with cottage cheese are recommended. From the drinks shows a weak tea, coffee with milk, decoctions of dried fruits. You can add honey to sweeten.

Can I use folk remedies?

Applying medicinal plants in broths for the treatment of gastritis in children, you need to know exactly their effect on the acidity and type of disorder in the child. The most safe are herbal teas with chamomile, calendula, hips( anti-inflammatory and soothing effect), decoction of flax seeds( envelops and protects the mucous membrane).

Propolis tincture, mint and plantain increase acidity, so they are used strictly according to the indications of

. The child is more often than adults exposed to bacterial contamination with subsequent inflammation of the stomach. The lack of adult control over the nutrition and habits of children leads to the detection of chronic gastritis in schoolchildren. How will the next generation grow? Will our children suffer the consequences of neglect of adults? Let everyone ask themselves this question.