Upper gastrointestinal endoscopy in children with abdominal pain

Abdominal pain is a common gastrointestinal symptom in children. The purpose of this paper is to determine the upper gastrointestinal mucosal pathology in a group of children with abdominal pain. 48 consecutive children referred to the authors with the problem of abdominal pain were studied. These were divided into 2 groups. Those with only one episode of pain and lasting for less than 2 weeks were considered to have acute abdominal pain. Those with repeated episodes of pain and lasting for more than 2 weeks were considered to have recurrent abdominal pain. Careful clinical examination was done to exclude an acute surgical abdomen. Other common causes of abdominal pain in our population such as urinary tract infection, lactose intolerance, hepatitis and choledochal cyst were excluded by clinical examinations and laboratory investigations. Upper gastrointestinal endoscopy was done by one of the authors. Five out of the 16 children with acute abdominal pain had macroscopic features of acute gastritis and another 2 had duodenitis. In the other 32 children with recurrent abdominal pain, 5 had duodenal ulcers and 3 had reflux oesophagitis. It was concluded that upper gastrointestinal endoscopy was a useful means of identifying the upper gastrointestinal pathology in children with abdominal pain. 43% and 25% of the children with acute and recurrent abdominal pain respectively had a cause identified by gastroscopy.