Role of Gastrointestinal Endoscopy and Biopsy in Children with Functional Abdominal Pain Disorders
Year: 2021
Type: article
Study design: Observational Study
Abstract: Background: Rome 4 criteria have classified pediatric functional abdominal pain (FAP) disorders into four variants, that is, functional dyspepsia (FD), FAP not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS), and abdominal migraine (AM).However, there is lack of information on Endoscopy and Histo-pathological findings in this subset of children.Objective: The objective of the study was to evaluate the endoscopic and histopathological findings in children with FAP disorders especially FD and FAP NOS. Materials and Methods:This was a prospective observational study.110 children (aged 4-17 years) with diagnosis of FAP according to Rome 4 criteria were enrolled from pediatric outpatient department, after written consent underwent gastrointestinal endoscopy and biopsy.Results: Majority of children were girls (n = 62, 56.4%).Most of them belonged to age group of 6-12 years (52.7%).Fifty-eight (52.7%) children were suffering from FD, 42 (38.2%)children suffering from FAP NOS, nine (8.2%) had IBS, and one child had AM.Endoscopic assessment showed 28 (42.3%)children with FD had either gastritis, duodenitis, or esophagitis while it was seen only in two (4.8%) children with FAP NOS (P < 0.001) and none in IBS or AM.Rapid Urease Test for Helicobacter pylori was positive in 30 (51.7%) of children with FD, while only 1 in FAP NOS (P < 0.001).Histopathological assessment collaborated with endoscopic assessment in both the categories.Thirty-five children of FD had evidence of gastritis, duodenitis, esophagitis, or mixed while only four children of FAP NOS and one child of IBS had abnormal histology (P < 0.001).On follow-up 96.6% children with FD improved when given treatment with PPI and H. pylori (in positive cases).Conclusion: Children with FD have significant high incidence of organic causes including H. pylori infection.Hence, we recommend that children with FD should be subjected to both upper Gastrointestinal endoscopy and H. pylori evaluation while FAP-NOS usually do not require the same.
Authors: Saba Ekta, Bhatnagar Shrish, Shamsi Sumaiya, Mohd Shahid
Institutions: Jamia Hamdard, Era's Lucknow Medical College and Hospital
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3205418991