Romanian Journal of Pediatrics (Dec 2020)

Recurrent or chronic abdominal pain of digestive cause. What is useful in the diagnostics?

  • Daniela Pop,
  • Sofia Psarrou,
  • Dorin Farcau

DOI
https://doi.org/10.37897/RJP.2020.4.7
Journal volume & issue
Vol. 69, no. 4
pp. 305 – 309

Abstract

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The objective of this study was to find out which are the most frequent diseases diagnosed in our medical unit in patients presenting with recurrent or chronic abdominal pain as the main symptom and to assess the usefulness of the investigations performed to make a final diagnosis. Material and method. We included in the study group children admitted in our medical unit between January 2019 and December 2019 for chronic or recurrent abdominal pain and who were diagnosed with organic or functional digestive disorders. It was a retrospective, descriptive study. The study group included 86 children, aged between 2 and 18, mean age±standard deviation (SD) = 10.4±3.8 years, 49 girls (57%). Results. Twenty-nine (34%) patients were diagnosed with organic and 57 (66%) with functional digestive disorders. Alarm signs or symptoms were present in 16/29 (55%) patients diagnosed with organic digestive disorders and 14/57 (37%) of those with functional disorders. Gastritis or gastroduodenitis and gastroesophageal reflux disease were the most frequent organic gastrointestinal disorders, in 16% and 14 % of the cases, respectively. Functional abdominal pain-not otherwise specified (23%) and functional dyspepsia (20%) were the most frequently diagnosed functional gastrointestinal disorders. Abdominal ultrasound was performed in 80% of the patients, but the findings lead to a final diagnosis in only 7% of these cases. Anti-tissue transglutaminase antibodies (IgA) and fecal calprotectin were indicated only in a small number of cases (7% and 6%, respectively). Conclusions. The clinical peculiarities of abdominal pain and associated alarm signs or symptoms are not enough to differentiate between organic and functional gastrointestinal disorders. Many of the investigations performed in children with recurrent or chronic abdominal pain are not helpful in finding a cause for abdominal pain.

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