Chronic duodenal ulcer in children: clinical observation and response to treatment.

Chronic duodenal ulcer is diagnosed more frequently in children since recent advances in panendoscopy techniques. From 1976 to 1986, chronic duodenal ulcer was diagnosed in 33 children in this hospital. There was a marked male preponderance (male: female = 4.5:1). Family history for peptic ulcer was positive in 36% of the patients. The important element of emotional stress was identified in 39% of the patients. Thirty patients received medical treatment, and 26 were observed for more than 1 year (1-10 years). In 11 children, medication was changed because of symptom recurrence and change in the mode of treatment. The patients were divided into three groups with different treatment regimens: antacid (12 cases), cytoprotective agent (sucralfate, 17 cases), and histamine H2-receptor antagonist (cimetidine, eight cases). The response to short-term (eight-week) therapy was similarly good (83-94%) in the three treatment groups. However, sucralfate is superior to antacid in the ongoing maintenance therapy of chronic duodenal ulcer in childhood. Because chronic duodenal ulcer recurred frequently, it is crucial to give long-term maintenance therapy.