Role of Upper Gastrointestinal Endoscopy in Diagnosis of Recurrent Abdominal Pain in Children

Abstract

BACKGROUND: In the pediatric population, recurrent abdominal pain (RAP) is one of the most frequent indications of upper gastrointestinal endoscopy. AIM: To evaluate the diagnostic role of upper gastrointestinal endoscopy (UGIE) in children with recurrent abdominal pain.

MATERIALS AND METHODS: A three year prospective study was conducted on 100 consecutive children with recurrent abdominal pain who had UGIE. Baseline sociodemographic data, dyspepsia and any alarm symptoms were recorded. Other investigations such as stool analysis for ova, parasites, occult blood and fecal antigen for Helicobacter pylori as well as an abdominal ultrasound were also registered

RESULTS: Our children were 47 (47%) males and 53 (53%) females with mean ±SD age of 10.9 ±4.2. Red flag symptoms were seen in 39(39%) of the subjects, and dyspepsia was seen in 52(52%). Endoscopy was diagnostic in 75 patients with the following endoscopic findings were: Esophagitis & hiatus hernia in 7%, gastritis in 39% of cases, nodularity in 25% of cases, 6% had gastric erosion, gastric ulcer was present in 5 %, 14% had hyperemia& erythemic membrane in the duodenum, and duodenal ulcer was seen in 2%. Significantly greater diagnostic yield of UGIE was determined in patients with alarm symptoms (66.6%) compared to those without (OR = 6.7, 95% CI: 2.5-23.3, p = 0.03).

CONCLUSION: Upper gastrointestinal endoscopy is a helpful tool for determining the reason of recurrent abdominal pain in children because it provides an accurate assessment of gastrointestinal etiology.