Pediatric gastritis

　　1, Improper medication: Some children often take drugs such as消炎痛 (Metamizole), hormones, Aspirin, and antibiotics that irritate the stomach due to illness, which can easily damage the gastric mucosa and trigger antral gastritis.

　　2, Lack of physical exercise, overfatigue, and stress in children's daily life.

　　3, Picky eating or preference: Long-term picky eating in children can easily lead to a lack of various vitamins, essential minerals, and other nutrients, which can affect the normal function of the gastric antrum and may eventually lead to antral gastritis.

　　4, Poor eating habits: Some parents give children oil-stick and fried buns, which are difficult to digest, for breakfast, or drink cold drinks and eat cold food on an empty stomach, or eat snacks all day long, which can lead to the imbalance of gastric juice and gastric acid secretion, affecting the nutrition of the gastric antrum mucosa, and eventually leading to antral gastritis.

　　5, Poor hygiene habits: such as not brushing teeth, not washing hands before and after meals, not cutting nails, food is easily contaminated by bacteria, and if infected with Helicobacter pylori, it can lead to antral gastritis.

　　6, Helicobacter pylori (HP) infection: In 1983, an Australian scholar discovered the pathogen, and in the 1990s, step-by-step in-depth research was conducted in children, finding that 50% of patients with children's gastritis have a positive Helicobacter pylori test result. There is also a certain genetic factor, and there is a family aggregation phenomenon: if both parents are positive for HP, the positive rate of HP tests in children is significantly increased. In addition, patients with poor gastrointestinal function such as chronic diarrhea and malnutrition have a significant HP infection.

　　Acute gastritis in children has an acute onset and is often caused by chemical substances, physical factors, microbial infections, or bacterial toxins. Chemical substances include drugs such as sodium salicylate, corticosteroids, and certain antibiotics; physical factors include eating cold, hot, and rough foods, which can damage the gastric mucosa and cause inflammation. In addition, eating food contaminated by bacteria can cause children's gastritis. The symptoms of acute gastritis include abdominal discomfort, nausea, or decreased appetite. If not treated thoroughly, symptoms may recur due to improper diet, leading to chronic inflammation.

　　Research has found that chronic gastritis in children is related to decreased immune function, decreased defensive function of the gastric mucosa, hormone regulation, and Helicobacter pylori infection. If acute gastritis persists, it can become chronic. Long-term stimulation of the gastric mucosa, such as eating too quickly, irregular and unrestricted diet, preference for hot, cold, rough, and spicy foods, frequent use of drugs such as aspirin and potassium chloride, may cause congestion and edema of the gastric mucosa, leading to gastritis. The main symptoms of chronic gastritis in children are discomfort or dull pain in the upper abdomen or below the xiphoid process, and even fatigue, poor spirits, and inability to concentrate, which can affect growth and development.

　　The occurrence of children's gastritis is very detrimental to the growth and development of children, and it greatly hinders their digestion and nutrient absorption, which may lead to nutritional deficiencies in children. These are all obstacles to the intellectual development of children that parents should pay attention to.

　　The most common symptom of chronic gastritis in children is recurrent abdominal pain, which is often persistent dull pain or spasmodic pain, and can occur before or after meals, or at night or without regularity.

　　Parents should be aware that due to the concealed onset and atypical symptoms, in addition to the fact that children cannot accurately describe the characteristics of the illness, it is easily overlooked by family members and doctors, or misdiagnosed as enterobiasis, indigestion, and other conditions.

　　Children with gastritis generally have good general condition, but may have bowel movements less than 10 times a day, which are yellow or yellow-green, with a small amount of mucus or white soap-like lumps, and not much fecal matter. Sometimes the stool appears like 'egg flower soup'. Nausea and vomiting, decreased appetite, and sometimes vomiting coffee-like substances. If hypokalemia occurs, there may be abdominal distension and systemic symptoms of poisoning; if there is irregular low fever or high fever, restlessness and then depression, drowsiness, and even coma may occur.

　　Acute gastroenteritis in children is easy to prevent. As long as parents understand the causes of the disease, regulate their children's diet reasonably, pay attention to changes in weather conditions, and prevent infection, they can prevent their children from getting this disease.

　　1. Medications for children should be used with caution and avoid drugs that damage the gastric mucosa. Long-term abuse of such drugs can damage the gastric mucosa, causing chronic gastritis and ulcers.

　　2. Always pay attention to the child's health, actively treat oral and pharyngeal infection foci, and do not swallow sputum, mucus, and other pathogenic secretions to prevent chronic gastritis infection.

　　3. Avoid giving children overly acidic, spicy, and other irritating foods, as well as raw and cold, hard-to-digest foods. Chew food slowly and thoroughly to mix it with saliva, which is beneficial for digestion and reduces stomach irritation. The diet should be regular, with a fixed amount, rich in nutrition, and high in vitamins A, B, and C. Avoid drinking strong tea and coffee, which are irritating beverages.

　　1. Gastrin is secreted by G cells in the gastric antrum. Literature reports that the serum gastrin level is 88pg/ml after birth, which increases to 119pg/ml in the second week after birth. Another author reported that the serum gastrin levels of 148 children were detected by radioimmunoassay, with a level of 264.92pg/ml in the first week after birth, 250.07pg/ml from the second to fourth week, reaching a peak of 300.7pg/ml at 3 years of age, and gradually decreasing to adult levels (130.84±8.34)pg/ml after 3 years. The serum gastrin levels measured by different laboratories are not consistent, and the reasons need to be further explored.

　　2. Helicobacter pylori detection includes direct smearing and staining of gastric mucus under gastroscopy, tissue section staining to find Hp, Hp culture, and urease detection. The next method is a non-invasive method that utilizes the biological characteristics of bacteria, especially the ability of Hp to hydrolyze urea with urease, forming a breath test (13C-urea breath test) to detect Hp. The determination of Hp IgG antibodies in serum cannot provide evidence of the current presence of bacteria and therefore cannot be used for the diagnosis of current infections, but is mainly used for screening or epidemiological surveys. Among the above methods, the urease method is the simplest and fastest, often completed in one step. The 13C-urea breath test is expensive, and its clinical popularization is limited.

　　3. The fetal stomach already contains intrinsic factor after 1 week of gestation, and the amount of intrinsic factor in the stomach reaches adult levels within 3 months after birth. The normal secretion amount of intrinsic factor in adults is 77.00U/h. Checking the content of intrinsic factor is beneficial for the diagnosis of atrophic gastritis and pernicious anemia. Some people have found that some children have congenital intrinsic factor secretion defects. The presence of 400 to 600U of intrinsic factor in gastric juice can maintain the normal absorption of vitamin B12. Therefore, even patients with atrophic gastritis are not prone to develop pernicious anemia.

　　4. Pepsinogen Pepsinogen is secreted by chief cells and activated into pepsin with digestive function in an acidic environment. Its secretion amount is consistent with gastric acid, but the number of chief cells is more than that of parietal cells, so it is not as obvious as gastric acid when affected by disease.

　　5. Gastric acid determination Gastric acid in superficial gastritis is normal or low, while in atrophic gastritis it is significantly reduced, even lacking acid. The gastric content of newborns is acidic, and the pH value measured after the baby clears the alkaline amniotic fluid swallowed is less than 4. The concentration of hydrochloric acid reaches its peak from 7 to 10 days after birth, and then gradually decreases, reaching adult levels 2 to 3 months after birth. This hospital conducted fasting gastric acid and gastric mucosal histological examination on 64 children aged 11 to 14 years and found that the gastric acid results of most chronic superficial gastritis children were similar to those of normal children, consistent with literature reports, only a small number of chronic superficial gastritis children had reduced gastric acid, the cause was unknown. Theoretically, superficial gastritis lesions do not invade glands and should not appear low gastric acid. This phenomenon indicates that some children may have functional changes before the structural changes occur, which needs further investigation.

　　6. Gastroscopy is the most important diagnostic method for chronic gastritis, and it can also take mucosal living tissue for pathological examination. Chronic gastritis appears as congestion, edema, increased reflectivity, obvious gastric pits, fragile mucosa prone to bleeding; increased mucus, formation of small nodules, localized or large patches with fresh or old bleeding points and erosion. When the gastric mucosa has atrophic changes, the mucosa loses its normal orange-red color, the color becomes gray, the folds become finer, the mucosa becomes thinner, and the submucosal blood vessels become visible. Pathological histological changes include epithelial cell degeneration, hyperplasia of pit epithelial cells, infiltration of inflammatory cells in the lamina propria, atrophy of glands, and inflammatory cells are mainly lymphocytes and plasma cells.

　　7. Barium meal X-ray examination is not very helpful in the diagnosis of chronic gastritis. According to foreign data, X-ray examination shows that only 20% to 25% of patients with chronic gastritis diagnosed by gastroscopy have gastric mucosal inflammation. Although most radiologists in the past believed that the disorder of gastric tension, changes in motility, and gastric juice in the空腹 stomach could be used as the basis for diagnosing gastritis, recent gastroscopy has found that this phenomenon is due to abnormal gastric motility rather than gastritis.

　　Dietary adjustment is important for the cure of children's chronic gastritis, and the general principle is that food should be 'fine, soft, tender, and well-cooked'. Children are in the stage of growth and development, so the food should also be rich in nutrition. Therefore, some milk, braised fish, eggs, dairy products, noodles, congee, fresh vegetables, and fruits should also be added. In addition, some foods that are beneficial to the digestive function of the stomach can also be eaten, such as yam, mung beans, lotus seeds, gizzard, pork stomach, and Job's tears. Foods that should not be eaten too much include celery, bamboo shoots, fatty meat, and various fried foods. For children with different symptoms, different dietary therapies can be tried:

　　1. Radish and honey

　　Ingredients: 500 grams of white radish, 150 grams of honey

　　The method involves cutting radish into pieces, boiling them in boiling water, then removing and drying them for half a day. After that, place them in a pot with honey and boil on low heat, mix well, cool, and then bottle. Take 3 tablespoons a day.

　　Characteristics: Suitable for children with bloating pain and acid regurgitation in the stomach.

　　2. Milk Honey Quail Egg

　　Materials: 220 milliliters of milk, 30 grams of honey, 1 quail egg

　　Method: Boil milk first, beat in quail eggs, then cook for a few minutes and add honey to finish. Take it every morning.

　　Characteristics: Suitable for children with stomachache, thirst, and constipation.

　　3. Molasses Soy Milk

　　Materials: 20 grams of molasses, 250 milliliters of soy milk

　　Method: Dissolve molasses in 250 milliliters of soy milk, boil, and drink on an empty stomach.

　　Characteristics: Suitable for children with hidden pain in the stomach, cold hands and feet, and fear of cold.

　　4. Lotus Seed and Glutinous Rice Porridge

　　Materials: Lotus seeds, glutinous rice, glutinous rice flour each 50 grams, 15 grams of brown sugar

　　Materials: Soak lotus seeds in boiling water until they swell, peel and remove the core, add them to the pot after boiling for 30 minutes, then add glutinous rice and glutinous rice flour and boil, simmer with low fire until soft, and add brown sugar before eating.

　　Characteristics: Suitable for children with upper abdominal pain, weight loss, poor appetite, and greasy tongue.

　　Nutritional Therapy for Childhood Gastritis:

　　1. White Peony Dendrobium Lean Pork Soup

　　Ingredients: 200 grams of lean pork, 10 grams of white peony, 10 grams of Dendrobium, 1 Hericium erinaceus, 1 carrot.

　　Preparation: Cut lean pork and carrots into pieces, wash white peony, Dendrobium, and Hericium erinaceus. Put all the ingredients in the pot, add an appropriate amount of clear water, boil for 1 to 2 hours, and season to taste.

　　Effect: Benefit the stomach, nourish yin, and relieve pain. Suitable for children with irritability, weight loss, poor appetite, and constipation, this recipe is suitable for the treatment of childhood gastritis.

　　2. Crucian Carp Soup

　　Ingredients: 2 crucian carp, 3 grams of galangal, 3 grams of tangerine peel, 60 grams of Coix seed, 2 slices of ginger.

　　Preparation: Crush the galangal, put it in the cleaned fish belly, and put the fish, tangerine peel, Coix seed, and ginger together in the pot. Add an appropriate amount of clear water, boil with strong fire, then simmer with low fire for 1 hour.

　　Effect: Eliminate dampness and invigorate the spleen. Suitable for children with gastritis who have upper abdominal pain, weight loss, poor appetite, and greasy tongue.

　　3. Pig Stomach and Pepper Soup

　　Ingredients: 1 pig stomach, 9 to 15 grams of pepper.

　　Preparation: Clean the pig stomach, add ground pepper to the inside of the pig stomach, tie the mouth of the pig stomach with thread, add an appropriate amount of clear water, boil with strong fire, then simmer with low fire for 1 to 2 hours, and season to taste.

　　Effect: Warm the stomach and dispel cold. Suitable for children with gastritis who have hidden pain in the stomach and cold hands and feet.