A stomach ulcer is an open sore in the lining of the stomach. A duodenal (doo-uh-DEE-nul) ulcer is an open sore in the lining of the duodenum (doo-uh-DEE-num). The duodenum is part of the small intestine that is connected to the stomach. 

Most ulcers form when H. pylori bacteria (a type of germ) cause an infection in the stomach or duodenum. Ulcers can also happen from taking certain pain medicines or having a serious illness.

Kids with an ulcer usually have burning pain in the belly above the breast bone. Other symptoms may include nausea, vomiting, burping or hiccupping a lot, and not wanting to eat. 

Treatment for an ulcer usually includes antibiotics to treat H. pylori and medicine to lower acid in the stomach. Although it takes a few months for the ulcer to heal, most kids feel better soon after starting treatment.

Follow your health care provider's recommendations for:

• Taking any medicines as prescribed. If your child is taking antibiotics for H. pylori, it is important that they get all of the doses, even if they are feeling better. This is the best way to kill the harmful germs. 
• Taking medicines for pain, such as acetaminophen (Tylenol^® or a store brand). Follow the package directions for how much to give and how often. 
• Any medicines to avoid, including aspirin, ibuprofen (brand names include Advil^® and Motrin^®), or naproxen (brand names include Aleve^® and Naprosyn^®). Don't give any other medicines without checking with your health care provider first.
• Making any follow-up appointments for your child.

Other reminders:

• Help your child avoid things that may make symptoms worse, including:
  • Caffeine — found in coffee, tea, colas, chocolate, and energy drinks.
  • Spicy or fatty foods.
  • Alcohol.
  • Cigarettes. For help quitting, call 800-QUIT-NOW (800-784-8669) or visit smokefree.gov.
• Stress may make symptoms from ulcers worse. Help your child manage stress by encouraging them to:
  • Get plenty of physical activity every day.
  • Get enough sleep.
  • Balance school and work activities with enough time to relax/recharge.

Your child:

• Has continued symptoms (like belly pain, nausea, or decreased appetite) that don't get better after being on the medicine about a week or two
• Seems to be losing weight
• Seems very tired or weak

Your child:

• Is vomiting and cannot keep any liquids down
• Has sudden, sharp belly pain
• Has bloody vomit or vomit that looks like coffee grounds
• Has bloody or black bowel movements (poop)

These could be signs of a serious problem, such as the ulcer bleeding, breaking through the stomach or duodenal wall, or blocking the path of food from going through the intestines.

What causes ulcers? Most ulcers are caused by H. pylori bacteria. Using nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen regularly can also cause ulcers. The ulcers happen because the bacteria or medicine weakens the mucus that coats the stomach and duodenum. This lets acid get through to the sensitive lining beneath, which can cause ulcers. 

Sometimes kids who are very sick, for example a child with a serious burn or a baby with a serious bacterial infection, can get ulcers. This likely happens from the body's stress response, which makes too much acid in the stomach, and the body's weakened ability to heal.

Can ulcers caused by H. pylori be prevented? Protecting kids from H. pylori infection may lower their risk of getting an ulcer. Kids should:

• Wash their hands well and often
• Eat food that has been safely prepared 
• Drink water from a safe source