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The Etiologies and Characteristics of Chronic Abdominal Pain in Children and Adolescents in Korea
Hyun Joo Lee1, Anh Duy Nam Nguyen2, Jeong Hoon Jeong2
1Department of Pediatrics, Jeju National University Hospital, Jeju, Korea.
Insights
Functional abdominal pain disorders are the primary cause of chronic abdominal pain in children. Identifying causes and clinical features aids in developing structured diagnostic approaches for pediatric abdominal pain.
Area of Science:
- Pediatric Gastroenterology
- Clinical Medicine
Background:
- Chronic abdominal pain (CAP) is a common and challenging condition in children.
- Understanding the diverse etiologies of CAP is crucial for effective management.
Purpose of the Study:
- To identify the causes and subtypes of organic and non-organic chronic abdominal pain in children.
- To analyze the association between CAP etiologies and clinical features.
Main Methods:
- Retrospective observational study of 384 pediatric patients (ages 1.9-18 years) with abdominal pain lasting ≥2 months.
- Data collected from a tertiary hospital between March 2009 and February 2019.
Main Results:
- Functional abdominal pain disorders (FAPDs) were the most common cause (88.3%), including functional abdominal pain-not otherwise specified (70.2%).
- Organic causes (8.4%) included H. pylori gastritis (4.2%) and inflammatory bowel disease (2.3%).
- Significant differences in alarm signs (e.g., weight loss, blood in stool) were observed across etiologic groups.
Conclusions:
- FAPDs are the predominant cause of pediatric CAP.
- Recognizing specific etiologies and alarm symptoms can guide clinical evaluation and management strategies for children with chronic abdominal pain.
Purpose:
This study aimed to comprehensively identify the etiologies and distribution of subtypes of organic and non-organic chronic abdominal pain (CAP) and to examine their associations with clinical features in children.
Methods:
This single-center, observational, retrospective study included 384 pediatric patients (1.9 -18 years) whose chief complaint was abdominal pain lasting at least 2 months and who visited or were admitted to a tertiary hospital between March 2009 and February 2019.
Results:
Functional abdominal pain disorders (FAPDs) were the most prevalent etiology of CAP (88.3%), followed by organic causes (8.4%) and functional constipation (2.6%). Regarding the subgroup distribution of FAPDs, functional abdominal pain-not otherwise specified-accounted for the highest proportion (70.2%), followed by irritable bowel syndrome (15.3%), functional dyspepsia (12.7%), and abdominal migraine (1.8%). Among patients with FAPDs, 4.7% had comorbid psychiatric disorders, and 1.2% had intended weight loss. Organic causes included gastritis associated with Helicobacter pylori (4.2%), inflammatory bowel disease (2.3%), duodenal ulcer (0.5%), abdominal mass (0.5%), choledochal cyst (0.5%), and other conditions (1.2%). Involuntary weight loss, gastrointestinal blood loss, right upper quadrant tenderness, bloody stool, and elevated erythrocyte sedimentation rate and C-reactive protein levels differed significantly among etiologic groups (p<0.05).
Conclusion:
A comprehensive understanding of the etiologies and characteristics of CAP in children may facilitate the development of a structured clinical approach guided by alarm signs and symptoms for this prevalent and challenging condition.
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