Red flags & when to go in person for Peptic Ulcer (Suspected) - Triage

Audience: pediatric

A peptic ulcer is a sore that can form in the lining of the stomach or the upper part of the small intestine. In children, symptoms may include stomach pain, nausea, or vomiting. While many cases can be managed with advice and treatment through telemedicine, some signs mean your child needs to see a healthcare provider in person quickly. These include severe belly pain, vomiting blood, or black, tarry stools. This guide helps you understand when to seek urgent care and what telemedicine can and cannot do for suspected peptic ulcers in children. Remember, this information is educational and does not replace a medical diagnosis or treatment plan.

Red flags — go in person / ER

• Vomiting blood or material resembling coffee grounds — go to emergency care immediately.
• Black, tarry stools indicating possible bleeding — seek urgent in-person evaluation.
• Severe, sudden stomach pain or signs of shock (weakness, pale skin, rapid heartbeat) — call emergency services or go to the hospital.

What telemedicine can do

• Initial symptom assessment and history taking.
• Providing education about peptic ulcers.
• Prescribing and managing medications for mild symptoms.
• Monitoring symptom changes and advising on lifestyle adjustments.

What telemedicine cannot do

• Physical examination and diagnostic testing.
• Managing severe bleeding or complications.
• Emergency treatment for life-threatening symptoms.
• Performing invasive procedures or imaging studies.

What is a Peptic Ulcer?

A peptic ulcer is a sore in the stomach lining or the first part of the small intestine. It happens when stomach acid damages the protective lining. In children, it may cause stomach pain, especially when the stomach is empty, nausea, or vomiting. Sometimes, ulcers can cause bleeding or other serious problems.

Common Symptoms to Watch For

Children with peptic ulcers often have:

Symptoms may come and go. Mild symptoms can often be checked through telemedicine.

Red Flags: When to Seek In-Person Care Immediately

Certain signs mean your child needs urgent medical care:

These symptoms may indicate serious bleeding or complications.

What Telemedicine Can Do

Telemedicine can help by:

It can be a safe first step for mild or unclear symptoms.

What Telemedicine Cannot Do

Telemedicine cannot:

In these cases, in-person evaluation is necessary.

Preparing for a Telemedicine Visit

Before the visit, prepare:

This helps the healthcare provider give the best advice.

After the Telemedicine Visit

Follow these steps:

Keep communication open with your healthcare provider.

How to prepare for your tele-visit

• Write down all symptoms your child is experiencing, including when they started.
• List any medications, supplements, or treatments your child is currently using.
• Note any allergies or previous health conditions.
• Prepare questions or concerns to discuss during the visit.
• Ensure a quiet, private space for the telemedicine appointment.
• Have a way to record or remember the provider's instructions.

After your tele-visit

• Follow the healthcare provider's instructions carefully.
• Administer any prescribed medications as directed.
• Watch for any worsening symptoms or new red flags.
• Keep scheduled follow-up appointments or telemedicine check-ins.
• Seek immediate in-person care if red flags develop.

FAQs

Can a peptic ulcer in children heal on its own?

Some mild peptic ulcers may improve with lifestyle changes and avoiding irritants like certain foods or medications. However, medical evaluation is important to confirm the diagnosis and guide treatment to prevent complications.

What causes peptic ulcers in children?

Peptic ulcers can be caused by infection with a bacteria called Helicobacter pylori, certain medications like nonsteroidal anti-inflammatory drugs (NSAIDs), or other factors that increase stomach acid or damage the stomach lining.

Is it safe to use telemedicine for stomach pain in my child?

Telemedicine can be a safe way to discuss mild or unclear stomach pain and get advice. However, if your child has severe symptoms or red flags like vomiting blood, telemedicine is not a substitute for urgent in-person care.

What should I do if my child vomits blood?

Vomiting blood is a medical emergency. You should seek immediate in-person care at an emergency department or call emergency services right away.

How can I help prevent peptic ulcers in my child?

Preventive steps include avoiding unnecessary use of NSAIDs, managing stress, ensuring good hygiene to prevent infections, and following medical advice if your child has stomach complaints.

Sources

1. Peptic Ulcer Disease — MedlinePlus, U.S. National Library of Medicine.
2. Peptic Ulcer — Mayo Clinic.
3. Peptic Ulcer Disease: Symptoms and Causes — Centers for Disease Control and Prevention (CDC).
4. Peptic Ulcer Disease — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or red flags, seek emergency or in-person evaluation promptly.