John W., 13

John is a 13-year-old Grade 8 pupil and the eldest of six children. His family of eight lives in a two-room mud house with a leaking roof, no electricity and water obtained from a stream over 30 minutes away. His father, the sole breadwinner, works as a cane cutter earning about KSh 2,500 monthly. Despite these hardships, John is hardworking, enjoys reading and football, and dreams of becoming a lawyer. John had experienced worsening weakness, dizziness, easy fatigue and recurrent burning upper abdominal pain for two weeks. Despite previous treatment with omeprazole for suspected peptic ulcer disease, his condition deteriorated. Five days before admission, he developed black stools (melena) and vomiting of blood (haematemesis), accompanied by poor appetite and increasing pallor. At hospital, he was critically ill, markedly weak and pale and was diagnosed with severe anaemia secondary to blood loss from a bleeding peptic ulcer. He required urgent admission to control the gastrointestinal bleeding and correct the anaemia. As his family could not afford the necessary inpatient care and medication, he was referred to Helpster Charity Foundation for financial support.

John, a 13-year-old, presented with severe anaemia secondary to bleeding peptic ulcer disease. He was admitted to hospital, where his condition was assessed through physical examination, blood tests, and upper gastrointestinal endoscopy to identify the source of bleeding. Initial treatment focused on stabilising him with intravenous fluids, blood transfusions to restore haemoglobin levels, and high-dose proton pump inhibitor (PPI) therapy to reduce stomach acid and control the bleeding. Following stabilisation, endoscopic treatment was performed to stop the ulcer bleeding using appropriate haemostatic techniques. John was closely monitored for signs of recurrent bleeding, and his haemoglobin levels and vital signs were checked regularly. If Helicobacter pylori infection was confirmed, eradication therapy with antibiotics and a PPI was prescribed. He also received iron supplementation and nutritional advice to aid recovery from anaemia. John responded well to treatment, with no further episodes of gastrointestinal bleeding. His haemoglobin levels gradually improved, his symptoms of fatigue and weakness resolved, and he was able to resume normal daily activities. At follow-up, the ulcer showed signs of healing, and he was advised to continue PPI therapy for the recommended duration, avoid ulcer-causing medications such as non-steroidal anti-inflammatory drugs (NSAIDs), and attend regular medical reviews to prevent recurrence.

John presented critically unwell with haematemesis, melena, marked pallor, weakness and severe anaemia from a bleeding peptic ulcer. This is a serious condition requiring urgent admission to control the bleeding, correct anaemia, stabilize circulation and treat the underlying ulcer. Significant untreated bleeding may lead to shock and organ injury. With prompt treatment, appropriate monitoring and control of the ulcer and bleeding, John’s prognosis is favourable, although follow-up is essential to prevent recurrence.