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Dyspepsia in children: organic or functional? Experience in a tertiary care hospital
Erick M Toro-Monjaraz1, Karen Ignorosa-Arellano1, Karen Raya-Aguirre1
1Department of Gastroenterology and Pediatric Nutrition, Instituto Nacional de Pediatría, Mexico City, Mexico.
Insights
In children with dyspepsia, organic causes like esophagitis and H. pylori infection are common. A stepped diagnostic approach is crucial before diagnosing functional dyspepsia.
Area of Science:
- Pediatric Gastroenterology
- Digestive Health
Background:
- Dyspepsia presents with varied symptoms, stemming from organic or functional origins.
- Understanding pediatric dyspepsia is key for effective diagnosis and management.
Purpose of the Study:
- To identify the primary causes of dyspepsia in children.
- To describe the clinical progression of pediatric dyspepsia.
Main Methods:
- Retrospective analysis of 100 children diagnosed with dyspepsia.
- Diagnostic procedures included endoscopy with biopsy, rapid urease testing for H. pylori, and hydrogen breath tests.
- Follow-up assessments monitored symptom evolution.
Main Results:
- Esophagitis or erosive gastropathy affected 54% of patients.
- Helicobacter pylori infection and small intestinal bacterial overgrowth each occurred in 12% of cases.
- Functional dyspepsia was diagnosed in 20% of the children.
Conclusions:
- Organic etiologies for pediatric dyspepsia must be excluded before considering functional causes.
- A systematic diagnostic pathway involving endoscopy, H. pylori testing, and breath tests is recommended.
Introduction:
Dyspepsia comprises a group of symptoms that can have organic or functional origin. The purpose of this study was to describe the main causes of dyspepsia and its clinical evolution in children cared for in a tertiary care hospital.
Material And Methods:
Retrospective study in children with dyspepsia. Patients underwent endoscopy with biopsy and rapid urease test to detect the presence of Helicobacter pylori. In case of normal endoscopy and biopsy, hydrogen breath test was performed. In all cases, follow-up was provided in order to evaluate symptom improvement.
Results:
One hundred children were included, out of whom 52 were girls; mean age was 8.59 years. Esophagitis or erosive gastropathy were found in 54% of the cases (n = 54), H. pylori infection in 12% (n = 12), small intestinal bacterial overgrowth in 12% (n = 12), and functional dyspepsia in 20% (n = 20).
Conclusion:
In children with dyspepsia, organic causes should first be ruled out before dyspepsia being characterized as functional. In general terms, we consider that a stepped approach that includes endoscopy with biopsy, search for H. pylori and hydrogen breath test is necessary.
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