Recurrent Abdominal Pain in Children: Endoxcopic Findings and Helicobacter pylori Infection

Chang, Cheol Ho; Chung, Churl Young

Abstract

OBJECTIVE
Recurrent abdominal pain (RAP) in children is similar to nonulcer dyspepsia of adult. Recently, microscopic inflammation and Helicobacter pylori (H. pylori) infection have been suggested as possible causes of nonulcer dyspepsia in adults. The aim was to know the clinical significance of encoscopic findings and H. pylori infection in children with RAP.
METHODS
128 children with RAP underwent upper gastrointestinal endoscopy. CLO tests were performed in 51 of 128 children for identification of H. pylori. Clinical findings were compared according to the presence or absence of mucosa abnormalities and H. pylori infections. We inquired about the improvement of abdominal pain throught OPD follow-up or phone interview.
RESULTS
Upper gastrointestinal endoscopy showed abnormal macroscopic findings in 80(62.5%) of 128 children with RAP. Patients with endoscopic abnormality had the longer duration of pain than those without abnormal findings. The mean age was similar in both groups. And none of the symptoms associated with RAP correlated significantly with the endoscopic abnormality. H. pylori was confirmed in 16 of 51(31.4%) children with RAP. The mean age of children positive for H. pylori was significantly higher than that of those without H. pylori infection. Micronodularity in the antrum was found more frequently in H. pylori-poslsitive patients than in those without H. pylori infection(p=0.001). Of 128 children with RAP, 74(67.9%) showed complete loss or improvement of abdominal pain after gastrofiberscopy. The sex, age of oneset, duration of pain, gastrofiberscopic findings, and medication did not influence the outcome of children with RAP.
CONCLUSIONS
Abnormal endoscopic findings are common in children with RAP and do not influence the outcome of them. H. pylori infections are not more common among children with RAP than asymptomatic children.