Acute gastritis in children

　　The causes of acute gastritis in children are not fixed and can be caused by various factors.

　　I. Microbial or bacterial infection

　　In acute gastritis caused by the ingestion of contaminated food with microorganisms and bacterial toxins, Salmonella, halophilic bacteria, and certain viruses are often seen, with staphylococcal toxins being the most common, occasionally botulinum toxin. In recent years, Helicobacter pylori has also been found to be a pathogen that can cause acute gastritis.

　　II. Chemical factors

　　1. Medications: salicylate drugs such as aspirin, indomethacin, and others.

　　2. Accidental ingestion of corrosive agents: strong acids (such as sulfuric acid, hydrochloric acid, nitric acid) and strong bases (such as sodium hydroxide, potassium hydroxide) can cause corrosive damage to the gastric wall.

　　3. Accidental ingestion of toxic substances: toxic mushrooms, arsenic, insecticides, rodenticides, and other chemical toxins can stimulate the gastric mucosa and cause inflammation.

　　III. Physical factors:Consuming cold, hot, or rough foods can damage the gastric mucosa, causing inflammation.

　　IV. Stress state:Certain severe diseases such as neonatal asphyxia, intracranial hemorrhage, sepsis, shock, and large-area burns can put children in a severe stress state, which is a major cause of acute erosive gastritis.

　　V. Protein allergy:Exogenous protein allergy can cause gastritis, which is particularly common in infants fed with milk or milk products.

    In addition to its clinical manifestations, acute gastritis in children can also cause other diseases. Acute gastritis in children can lead to dehydration and acidosis, such as severe bleeding can lead to anemia or shock, acute corrosive gastritis can lead to stenosis of the esophagus or pylorus, and obstruction.

　　Acute gastritis in children often has an acute onset, manifested as upper abdominal fullness, pain, belching, nausea, and vomiting. The vomitus may contain blood and appear coffee-colored, or there may be more bleeding, manifested as hematemesis and melena, which can even be the initial manifestation. Stress gastritis, gastritis caused by aspirin, and infectious gastritis accompanied by diarrhea are called acute gastroenteritis. Some patients may have symptoms such as fever and infection中毒, severe vomiting can lead to dehydration, acidosis, and blood loss can cause shock.

　　1. Acute simple gastritis:The onset is relatively acute, usually occurring several hours after eating contaminated food or within 24 hours, with varying degrees of symptoms, such as discomfort, pain, or even severe abdominal colic in the upper abdomen, anorexia, nausea, vomiting. If accompanied by enteritis, diarrhea may occur. If caused by drugs or刺激性 food, the symptoms are usually mild, limited to the upper abdomen, and physical examination may show tenderness in the upper abdomen or around the umbilicus, and increased bowel sounds.

　　2. Acute erosive gastritis:It often occurs in a state of severe disease stress, onset is acute, often manifested as prominent symptoms such as hematemesis or melena, and massive bleeding can cause syncope or shock, accompanied by severe anemia.

　　3. Acute corrosive gastritis:History of accidental ingestion of strong acid or alkali, in addition to oral mucosal erosion and edema, there is severe pain in the upper abdomen,绞窄感, nausea, vomiting, hematemesis, and melena. Complications may include gastric dysfunction. After the acute phase, there may be stenosis of the esophagus or pylorus, leading to vomiting and other obstructive symptoms. Acute gastritis has no characteristic clinical manifestations, and diagnosis mainly relies on medical history, symptoms, and endoscopic examination.

     The prevention of acute gastritis in children should start from the etiological aspect, avoid contacting factors that can cause the disease, develop good eating habits, pay attention to dietary hygiene; drugs that are irritating to the gastric mucosa should be taken after meals, and in case of necessity, the dosage should be reduced or the medicine should be changed, manage corrosive agents and toxic substances well, prevent children from accidentally taking them; avoid cold and刺激性 food, etc.

　　Acute gastritis in children is diagnosed clinically through gastroscopy.

　　1. Blood routine

　　For those caused by infectious factors, the peripheral blood white blood cell count increases, and the proportion of neutrophils increases.

　　2. Routine stool examination

　　Stool examination shows a small amount of mucus, red and white blood cells, and positive occult blood.

　　3. Detection of vomitus

　　4. Endoscopic examination

　　This examination is safe and reliable. It can directly observe obvious congestion and edema of the gastric mucosa. The mucosal surface is covered with thick, tenacious inflammatory exudate. In cases of erosive gastritis, there are spots, round, patchy, linear, or irregular erosions on the basis of the above lesions. The center is red fresh bleeding or brownish old bleeding, accompanied by white fur or yellow fur. During gastroscopy, it is necessary to take the lesion tissue for pathological examination and Helicobacter pylori detection at the same time.

　　Acute gastritis patients should eat more of the following foods in their diet:

　　1. Drink plenty of water to replenish the water and salt lost due to vomiting and diarrhea. The specific method is to alternate drinking warm dilute salt water (boiled water, coarse salt), dilute black tea water, and cooked vegetable water. Generally, once an hour, 150-200 milliliters each time. Drinking plenty of water is also beneficial for eliminating toxins.

　　2. After the patient stops vomiting and the frequency of diarrhea decreases, drink a small amount of millet porridge or konjac powder, and then gradually eat some congee, soft thin noodles, etc. Continue to drink plenty of water, and do not eat meat, eggs, and other foods rich in protein and fat and foods that are easy to cause bloating and foods rich in dietary fiber, such as milk should not be consumed temporarily.

　　3. After the condition improves, such as when the pain stops, the frequency of defecation decreases, and the body temperature approaches normal, you can start eating egg soup, steamed egg custard, yogurt, congee, soup, soda biscuits, dried bread, steamed or braised fresh fish, minced lean meat, tender leaf vegetables, etc. The amount of food per meal should be small.

　　4. During the recovery period, eat easily digestible, low刺激性, and low-bloating foods, and try to make them soft and light.

　　Acute gastroenteritis is also suitable for eating the above foods, and pay attention to eating light foods.

　　To avoid gastrointestinal fermentation and bloating, avoid eating easily gas-producing foods such as beef during the acute stage, and try to reduce the intake of sucrose. Pay attention to food hygiene. Avoid high-fat fried, grilled, and smoked fish, vegetables and fruits with high fiber content, drinks with strong刺激性, food and spices, etc.

　　The treatment principle for pediatric acute gastritis is to eliminate the cause first, and then treat separately according to different symptoms.

　　1. Eliminate the cause

　　For patients with acute gastritis caused by drugs, stop using the relevant drugs; actively treat the primary disease for stress gastritis; appropriate antibiotics can be selected for gastritis caused by infection.

　　2. General treatment

　　Children should rest in bed, eat light fluid or semi-liquid food, and eat small amounts frequently. Stop 1-2 meals if necessary, and avoid eating刺激性 and indigestible foods.

　　3. For dehydration, oral rehydration salts can be taken to correct dehydration and electrolyte imbalance.

　　4. In case of severe bleeding, rest in bed, monitor respiration, heart rate, and blood pressure.Increase blood volume and transfuse blood cells and plasma if necessary. Intravenous infusion of cimetidine, ranitidine, or proton pump inhibitor omeprazole.