ABSTRACT
El dolor abdominal es una causa frecuente de consulta ambulatoria, sus causas son múltiples e incluyen patologías de riesgo vital u otras de bajo riesgo que requieren principalmente tratamiento y no requieren mayores estudios. La historia clínica y el examen físico son las herramientas principales para poder sospechar la etiología de la enfermedad que está causando el dolor abdominal. Es por esto que realizar una historia completa, haciendo preguntas dirigidas a confirmar o descartar sospechas diagnósticas, asociado a un examen físico completo y sistemático, es la principal forma de orientar el diagnóstico y estudio posterior del paciente. Conocer el cuadro clínico de las enfermedades que dentro de sus síntomas pueden presentar dolor abdominal, especialmente aquellas que son de riesgo vital permite poder diagnosticarlas con la rapidez que se requiere. Así mismo, es necesario reconocer aquellas enfermedades que son más frecuentes y que no requieren mayores estudios sino tratamiento básico, habitualmente ambulatorio. Existen personas que, por sus condiciones de salud o edad, pueden tener presentaciones atípicas de cuadros habituales o mayores riesgos de tener enfermedades infrecuentes o de mayor riesgo vital, que es importante reconocer al momento de la evaluación.
Abdominal pain is a common complaint in ambulatory medicine. It has multiples causes,including lifethreatening pathologies and other benign in which the need in treatment and no other tests. The clinical history and physical examination are the key to suspect the etiology of the underlying disease. A complete history includes make direct questions to confirm or discard the diagnostic suspects and with a complete and systematic physical examination are the main way to get the diagnosis and treatment of the patient. The clinician must know the syndromes which includes abdominal pain, especially those life-threatening which requires urgent treatment or surgery. Also needs to know the frequent benign syndromes that can be safely treated symptomatically with no further investigation. Older adults or patients with comorbidities may present with unusual causes of abdominal pain or may have an atypical presentation of common disorders. Also, may present more frequent serious etiologies that may require urgent interventions.
Subject(s)
Humans , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Physical ExaminationABSTRACT
ABSTRACT Objective: This narrative review aimed to provide practitioners a synthesis of the current knowledge on the role of a low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols diet in reducing symptoms associated with functional abdominal pain disorders in children. This review is focused on the pathophysiology, efficacy and criticism of low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols diet in children. Sources: Cochrane Database, Pubmed and Embase were searched using specific terms for Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols diet interventions and functional abdominal pain disorders. Summary of the findings: In children, only one Randomized Control Trial and one open-label study reported positive results of low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols diet; one Randomized Control Trial showed exacerbation of symptoms with fructans in children with Irritable Bowel Syndrome; no effect was found for the lactose-free diet whilst fructose-restricted diets were effective in 5/6 studies. Conclusions: In children there are few trials evaluating low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols in functional abdominal pain disorders, with encouraging data on the therapeutic efficacy particularly of fructose-restricted diet. Additional efforts are still needed to fill this research gap and clarify the most efficient way for tailoring dietary restrictions based on the patient's tolerance and/or identification of potential biomarkers of low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols efficacy, to maintain nutritional adequacy and to simplify the adherence to diet by labeling Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols content in commercial products.
RESUMO Objetivo: Nos últimos anos, foram feitos esforços consideráveis para esclarecer o papel da dieta com baixo teor de oligossacarídeos fermentáveis, dissacarídeos, monossacarídeos e polióis (FODMAPs) para o tratamento de distúrbios gastrintestinais funcionais (DGIFs). Esta revisão narrativa teve como objetivo fornecer aos profissionais uma síntese do conhecimento atual sobre o papel de uma dieta com baixo teor de FODMAPs (BFM) na redução dos sintomas associados a distúrbios funcionais de dor abdominal (DFDA) em crianças. Esta revisão está focada na fisiopatologia, eficácia e crítica da dieta BFM em crianças. Fontes: O banco de dados Cochrane, Pubmed e Embase foram pesquisados com o uso dos termos específicos para intervenções na dieta FODMAP e DFDA. Resumo dos achados: Em crianças, apenas um estudo controlado randomizado e um estudo aberto relataram resultados positivos da dieta BFM; um estudo controlado randomizado mostrou exacerbação dos sintomas com frutanos em crianças com síndrome do intestino irritável; nenhum efeito foi encontrado para a dieta livre de lactose, enquanto dietas com restrição de frutose foram eficazes em 5/6 estudos. Conclusões: Existem poucos estudos que avaliam BFM em DFDA em crianças, com dados encorajadores sobre a eficácia terapêutica, particularmente de dietas com restrição de frutose. Esforços adicionais ainda são necessários para preencher essa lacuna de pesquisa e esclarecer a maneira mais eficiente de adaptar as restrições dietéticas com base na tolerância do paciente e/ou identificação de biomarcadores potenciais de eficácia da BFM, para manter a adequação nutricional e simplificar a adesão à dieta, ao incluir informações sobre conteúdo de FODMAPs em rótulos de produtos comerciais.
Subject(s)
Humans , Abdominal Pain/diet therapy , Diet, Carbohydrate-Restricted , Oligosaccharides/metabolism , Oligosaccharides/therapeutic use , Irritable Bowel Syndrome , Diet , Disaccharides/metabolism , Disaccharides/therapeutic use , Monosaccharides/metabolism , Monosaccharides/therapeutic useABSTRACT
Background: Chronic abdominal pain is a common gastrointestinal symptom in children that significantly lowers their quality of life. In adults, Gall bladder (GB) hypomotility / dyskinesia is associated with many functional abdominal disorders but there is scarcity of evidence on its role in childhood gastro-intestinal disorders. Aim of the study is to evaluate the GB motility in children with chronic functional abdominal pain (FAP).Methods: Children aged 5-15 years with chronic abdominal pain fulfilling ROME-III criteria and healthy controls were included and all study participants were subjected to ultrasonographic evaluation of the gall bladder volume in fasting state and post - Fatty test meal (FTM) and its ejection fraction was calculated.Results: Sixtysix children including 31 with chronic FAP underwent sonographic evaluation for GB motility. The mean ejection fraction (EF) of cases and controls were 51.72'17.76% and 57.3'23.26% (p'value - 0.158). The mean EF of cases with upper abdominal pain and lower/peri-umbilical abdominal pain were 41.7'17.1% and 57.2'15.9% respectively (p'value < 0.0001). Increasing BMI had no significant association with GB motility among the participants.Conclusions: There is lack of significant association between children with chronic FAP and GB hypomotility. Children with upper abdominal pain have lesser GB EF, suggesting a possible abnormal GB motility.
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Objective To observe the clinical effect of Futongning Granules for the treatment of functional abdominal pain in children. Methods A total of 187 children with functional abdominal pain were randomized into treatment group(N = 122)and control group(N = 65). The treatment group was treated with Futongning Granules and the control group was treated with Compound Pepsin Powder. The gastrointestinal syndrome scores of the two groups were observed, and the short-term and long-term clinical efficacy of the two groups was evaluated after treatment. Results (1)The total effective rate and the effective rate for syndromes of abdominal internal cold, spleen-stomach deficiency cold, indigestion induced by milk and food stagnation, liver-Qi stagnation, blood collateral obstruction, gastrointestinal heat stagnation in the treatment group were 92.3％, 92.9％, 95.0％, 95.2％, 90.3％, 85.7％, 90.0％, and those in the control group were 71.0％, 69.2％, 69.2％, 86.7％, 66.7％, 50.0％, 60.0％, respectively. The total effective rate and the effective rate for various syndromes in the treatment group were superior to those of the control group (P < 0.05). (2) After treatment, gastrointestinal syndrome scores of various syndromes and overall scores in the two groups were obviously decreased(P<0.05 or P<0.01 compared with those before treatment), and the decrease in the treatment group was superior to that in the control group (P < 0.05). (3) The results of 6-month follow-up showed that the clinical efficacy during the follow-up in the treatment group was better than that in the control group(P < 0.05), and the difference was statistically significant(P<0.05). Conclusion Futongning Granules exert certain effect for the treatment of functional abdominal pain in children, and are effective for significantly relieving clinical symptoms and reducing the recurrence of disease.
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<p><b>OBJECTIVE</b>To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation (TCSOM) in treating patients with functional abdominal pain syndrome (FAPS) in comparison with Pinaverium Bromide (Dicetel, PBD), and to assess a possible cause for FAPS.</p><p><b>METHODS</b>Eighty patients with FAPS were randomly and equally assigned to the TCSOM group and PBD group according to the random number table. All patients in the TCSOM group were treated with a maximum of 5 times of spinal manipulations. Patients in the PBD group were instructed to take 50 mg 3 times a day, consistently for 2 weeks. The symptoms of pre- and post-treatment were assessed on a visual analog scale (VAS) pain score. A symptom improvement rating (SIR) was implemented to evaluate the effects of the treatments.</p><p><b>RESULTS</b>The symptoms of 27 cases of the TCSOM group were relieved soon after the first TCSOM treatment and 9 cases were significantly improved. The VAS pain scores in the TCSOM group were significantly lower than those in the PBD group after 2 weeks treatment. According to the SIR based on VAS, the TCSOM group included 30 cases with excellent results, 7 cases with good, and 3 cases with poor. Adverse events to the treatment were not reported. Based on VAS, the PBD group reported 8 cases with excellent results, 10 cases with good and 22 cases with poor. There was a significant difference between the two groups (P<0.01).</p><p><b>CONCLUSIONS</b>The displacement of intervertebral discs and/or vertebra in the thoracic or lumbar region seems to be a contributing factor in the symptoms of FAPS. TCSOM is an effective treatment for FAPS.</p>
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Functional abdominal pain is one of the most common problems in functional gastrointestinal disorders,and it's also one of the diseases benefit most from traditional Chinese medicine (TCM) treatment.This paper illustrates some key considerations on the study design of traditional Chinese medicine intended for the treatment of FAP based on the latest treatment and evaluation guidelines,technical guidance,professional authority works as well as the latest clinical studies,and combined with experience of clinical trial design.It hopes to offer helps for research designers in this genera.
ABSTRACT
Background: Chronic abdominal pain (CAP) is a prevalent condition with a wide etiology and is often associated with significant health care utilization. A functional diagnosis, particularly, Functional abdominal pain syndrome (FAPS) is more challenging and has been a less extensively studied condition in adults as compared to other common functional gastrointestinal disorders. Hence, this study attempts to formulate a definite line of investigations, study various causes of chronic abdominal pain and to evaluate FAPS, in a population from Central India. Methods: 100 patients in the age-group of 10-60 years with chronic abdominal pain were selected. A careful history, clinical examination and investigations were performed and final diagnosis was made on the basis of the available data. Results: Eighty-nine out of hundred patients were found to be having some organic disorder causing CAP while eleven had functional gastrointestinal disorders. FAPS was diagnosed in three patients on the basis of Rome III diagnostic criteria while one had unspecified functional abdominal pain. Conclusions: CAP is a multifactorial condition yet, a thorough history coupled with a complete physical examination and investigative profile help to a great extent in diagnosing the cause. FAPS should be diagnosed on the basis of a careful clinical history and characteristic pain behaviour during physical examination. A cost-effective and conservative approach should be adopted for investigations. Unlike the organic causes, FAPS should be treated with a biopsychosocial approach with a variable combination of pharmacological, cognitive-behavioural and psychological interventions.
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Introducción: El dolor abdominal crónico se presenta en forma frecuente e interfiere en la calidad de vida del niño; conocer su verdadera prevalencia en la consulta, contribuye a mejorar el abordaje diagnóstico y esclarecer la causa orgánica o funcional para indicar tratamiento específico. Objetivo: determinar la prevalencia de dolor abdominal crónico orgánico y funcional en la consulta de gastroenterología. Pacientes y Método: estudio descriptivo, retrospectivo y longitudinal (enero 2014-marzo 2015). Definición de dolor crónico, orgánico y funcional. Criterios de Roma III. Variables: edad, sexo, clínica, laboratorio, ecografía y endoscopia. Resultados: 137 niños con dolor abdominal crónico de un total de 1194 pacientes evaluados, para una prevalencia general en la consulta de 11,45% (IC 99%: 9,10-13,85). Edad promedio 9,8 años (rango 4-19), femenino 56,20% y masculino 43,8%; el grupo más afectado entre 10-15 años. En la identificación de la causa se realizó videogastroscopia al 64,96%, hallazgos anormales en ultrasonido abdominal en 11,67%. El dolor abdominal de origen orgánico se encontró en 92/137(67,15%) para una prevalencia real de 7,71% (IC 99%: 5,72-9,69), las causas: Gastroduodenitis con o sin infección Helicobacter pylori 71/92(77,17%), Enteropatía alérgica 12/92(13,04%), Parasitosis 5/92(5,43%), otras causas 4/92 (4,36%). Origen funcional 45/137(32,85%) con una prevalencia 3,77% (IC99%: 2,32-5,19), siendo el estreñimiento lo más frecuente, 30/45(66,66%), dispepsia 8/45(17,78%) y Síndrome de intestino irritable 7/45(15,56%). Conclusiones: el dolor abdominal crónico tiene una prevalencia importante en la consulta, la causa orgánica fue más frecuente que la funcional, y la utilización de definiciones claras permitió una mejor evaluación del paciente, identificar la causa e indicar el tratamiento específico.
Introduction: Chronic abdominal pain occurs on a frequent basis and interferes with the quality of life of the child; know its true prevalence in the consultation helps to improve the diagnostic approach and clarify the organic or functional cause to indicate specific treatment. Objective: determine the prevalence of organic and functional chronic abdominal pain in gastroenterology consultation. Patients and methods: A descriptive, retrospective and longitudinal study (January 2014-March 2015). Defintion of chronic abdominal pain, organic and functional. Rome III criteria. Variables: age, sex, clinical features, laboratory, ultrasound and upper endoscopy. Results: 137 children with chronic abdominal pain of a total of 1194 patients evaluated, for an overall prevalence in the consultation of 11.45% (99% CI: 9.10 to 13.85). Average age 9.8 years (range 4-19), 56.20% female and 43.8% male; the most affected age group 10-15. Upper endoscopy was performed at 64.96%, an abdominal ultrasound was altered in 11.67%. Abdominal pain of organic origin was found in 92/137 (67.15%) for a real prevalence of 7.71% (99% CI: 5.72 to 9.69), causes: gastroduodenitis with or without Helicobacter pylori infection 71/92 (77.17%), allergic enteropathyn 12/92 (13.04%), parasitosis 5/92 (5.43%), other causes 4/92 (4.36%). Functional abdominal pain 45/137 (32.85%) with a prevalence 3.77% (IC99%: 2.32 to 5.19), the most frequent was constipation, 30/45 (66.66%), dyspepsia 8/45 (17.78%) and irritable bowel syndrome 7/45 (15.56%). Conclusions: chronic abdominal pain is a significant prevalence in the consultation, the organic cause was more common than functional, and use of clear definitions allowed for better patient assessment, identify the cause and indicate the specific treatment.
ABSTRACT
Objective] To observe the clinical effect of Shaoyao Gancao Decoction on treating children functional abdominal pain to offer reference for further observation. [Method] Choose 200 children patients in pediatric outpatient department of Changxing County TCM Hospital, randomly divide them into treatment and control groups in order, n=100. The treatment one was administered revised Shaoyao Gancao Decoction, the control one orally took Medilac-Vita; both for 4 courses, then observe the cure effects. [Result] In treatment group, total effective rate 94.00%; for control one, it was 86.00%. The comparison of both had difference of statistical meaning( P<0.05). On comparing their abdominal pain relieve, in treatment group, there's more in first 2w and showed marked summit value in the first week; while in control one, there's no marked summit value; so the treatment group was more obvious than other one on relieving pain in the first 2w(P<0.05). The side effect occurrence rate of treatment group was less than other one, the difference between them had statistical meaning(P<0.05). [Conclusion] The revised Saoyao Gancao Decoction has marked cure effect on children functional abdominal pain, worth clinical promotion.
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El dolor abdominal crónico es muy frecuente en la edad pediátrica. Los criterios de Roma III permiten hacer el diagnóstico de las diferentes entidades con dolor abdominal funcional, en base a la sintomatología, y no como de exclusión. Actualmente se propone una etiología biopsicosocial, que obliga a una aproximación integrada para ofrecer tratamiento centrado en la sintomatología de cada paciente pudiendo combinarse cambios en la alimentación, fármacos e intervenciones psicosociales. Aunque la mayoría de los pacientes mejora al tranquilizarlos y con el tiempo, una proporción significativa sigue con sintomatología intensa y discapacitante en la adultez.
Chronic abdominal pain is common in childhood. Rome III criteria allows the diagnosis of different entities with functional abdominal pain, based on by symptoms, rather than exclusion. The biopsychosocial etiology proposed currently, requires an integrated approach to provide focused treatment to each patient's symptoms and may combine changes in food, drugs and psychosocial interventions. Although most patients will improve with reassurance and time, a significant number of patients continue to have intense and disabling symptoms in adulthood.
Subject(s)
Humans , Acute Disease , Diagnosis, Differential , Abdominal Pain/therapy , DyspepsiaABSTRACT
The thoracic splanchnic nerve block has been used in managing abdominal pain, especially for pains arising from abdominal cancers. A 27-year-old male patient who had a constant abdominal pain was referred to our clinic for pain management but had no organic disease. The numeric rating scale (NRS) for pain scored 7/10. We applied a diagnostic thoracic splanchnic nerve block under the diagnosis of functional abdominal pain syndrome. Since the block reduced the pain, we applied a radiofrequency thermocoagulation at the T11 and T12 vertebral level. Thereafter, his symptoms improved markedly with pain decreasing to an NRS score of 2-3/10. Hereby, we report a successful management of functional abdominal pain via radiofrequency thermocoagulation of the thoracic splanchnic nerves.
Subject(s)
Adult , Humans , Male , Abdominal Pain , Electrocoagulation , Pain Management , Splanchnic NervesABSTRACT
Functional abdominal pain (FAP) is one of the most common pain syndromes in childhood and is a functional gastrointestinal disorder (FGID). Recurrent abdominal pain (RAP) is characterized by three or more episodes of abdominal pain that occurover at least 3 months and are severe enough to interfere with activities. It may be caused by many conditions, including inflammatory bowel disease, peptic ulcer, pancreatitis or, functional abdominal pain. The most common clinical manifestation is periumbilical pain related to autonomic and functional symptoms like nausea, vomiting, pallor and other painful conditions like headache and limb pains. RAP requires accurate diagnostic tests to rule out organic causes of pain based on 'red flag' sign. Furthermore, to diagnose and classify functional abdominal pain, Rome III criteria were published and updated with multiple discussions of FGIDs. Conventional interventions for RAP include reassurance and general advice, symptom-based pharmacological therapies, and psychological and behavioral treatments. But further research should be conducted to advance our understanding of the multiple factors involved in the pathogenesis of this group of conditions and to provide evidence for its therapeutic benefit.
Subject(s)
Child , Humans , Abdominal Pain , Diagnostic Tests, Routine , Extremities , Gastrointestinal Diseases , Headache , Inflammatory Bowel Diseases , Nausea , Pallor , Pancreatitis , Peptic Ulcer , Rome , VomitingABSTRACT
[Background]Functional abdominal pain syndrome (FAPS) represents a chronic pain disorder localized in the abdomen and the symptoms largely are unrelated to food intake and defecation, which differ from other painful functional gastrointestinal disorders.<BR>We report a case of FAPS whose symptom was successfully improved by acupuncture.<BR>[Case Report]A 75-year-old female had been hospitalized at Meiji University of Integrative Medicine Hospital because of left lower abdominal pain from which she had repeatedly suffered for more than 2 years. Despite strict medication, her symptom had not been improved. After admission to the hospital, according to recommendation by her physician, acupuncture treatment was started. The patient received TCM-based acupuncture treatments five times a week over 13weeks. Primary acupuncture points used for the patient were LV3(Taichong), SP6 (Sanyinjiao), ST36 (Zusanli) and PC6 (Neiguan). Evaluation of the left lower abdominal pain was carried out with a Visual Analogue Scale (VAS). The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate QOL related to the digestive symptoms. VAS for the left lower abdominal pain showed a remarkable decrease immediately after the initial acupuncture session. The symptom disappeared within 4 weeks after commencement of the treatment and never appeared during her hospitalization. GSRS was also improved and it was maintained during hospitalization.<BR>[Conclusion]We suggested that acupuncture treatment might be one of the useful, non-pharmacological alternatives for symptoms of FAPS.
ABSTRACT
Functional gastrointestinal disorders are among the most common medical problems in children. Abdominal pain-related functional gastrointestinal disorders can be categorized as functional dyspepsia, irritable bowel syndrome, abdominal migraine and childhood functional abdominal pain according to the Rome III criteria for pediatric functional gastrointestinal disorders. The aim of this paper was to examine the evidence supporting the use of the range of therapeutic options available for functional gastrointestinal disorders.
Subject(s)
Child , Humans , Abdominal Pain , Dyspepsia , Gastrointestinal Diseases , Irritable Bowel Syndrome , Migraine Disorders , RomeABSTRACT
Functional gastrointestinal disorders are among the most common medical problems in children. Abdominal pain-related functional gastrointestinal disorders can be categorized as functional dyspepsia, irritable bowel syndrome, abdominal migraine and childhood functional abdominal pain according to the Rome III criteria for pediatric functional gastrointestinal disorders. The aim of this paper was to examine the evidence supporting the use of the range of therapeutic options available for functional gastrointestinal disorders.
Subject(s)
Child , Humans , Abdominal Pain , Dyspepsia , Gastrointestinal Diseases , Irritable Bowel Syndrome , Migraine Disorders , RomeABSTRACT
Os critérios de Roma foram desenvolvidos para padronizar a classificação dos distúrbios gastrointestinais funcionais de crianças usando como base os sintomas relatados. Os parentes muitas vezes têm importante papel na descrição dos sintomas das crianças. Os critérios de Roma foram estabelecidos por um grupo de especialistas internacionais. Estas informações levarão à melhor compreensão das diferentes apresentações clínicas dos distúrbios funcionais, maior acurácia do diagnóstico e aprimoramento nas investigações e tratamento destas desordens. Os distúrbios gastrointestinais funcionais são: regurgitação infantil, síndrome de ruminação infantil, síndrome dos vômitos cíclicos, dispepsia funcional, síndrome do intestino irritável, dor abdominal funcional, enxaqueca abdominal, aerofagia, diarréia funcional, constipação funcional, disquesia infantil, retenção fecal funcional, escape fecal funcional não retentivo...
The Pediatric Rome Criteria were developed to standardize the classification of functional gastrointestinal disorders of children using a symptom-based approach. The parents often play a large role in reporting their child's symptoms. The Rome Criteria has been established by a multinational team of experts. These intor- mations will lead to a better understanding of the different clinical presentations of functional disorders, more accurate diagnosis, and therefore improve treatment and investigations of the disor- ders. The functional Gastrointestinal disorders are: infant regurgi- tation, infant rumination syndrome, cyclic vomiting syndrome, functional dyspepsia, irritable bowel syndrome, functional abdo- minal pain, abdominal migraine, aerophagia, functional diarrhea, functional constipation, functional fecal retention and non-retentive fecal soiling...
Subject(s)
Humans , Child , Adolescent , Abdominal Pain/diagnosis , Gastrointestinal Diseases/diagnosisABSTRACT
PURPOSE: The purpose of this study was to research the incidence of H. pylori infection in children with upper gastrointestinal complaints according to age, sex, and diseases diagnosed by endoscopy. This study was also aimed at evaluating the usefullness of diagnostic methods, and to assess the effectiveness of treatment. METHODS: Upper gastrointestinal endoscopy and gastric mucosal biopsy were performed on 178 children who visited the OPD or were admitted to the Department of Pediatrics, Yonsei University College of Medicine between Aug. 1992 and Jul. 1994 due to abdominal pain and upper gastrointestinal bleeding. With biopsied specimens, CLO test (rapid urease test) and Warthin-Starry stain were performed, and the ELISA test was done with their serum at the same time. Patients with any positive results for H. pylori were treated with DeNol and amoxicillin for 4-6weeks. Endoscopic re-evaluation and the CLO test or the Warthin-Starry stain on biopsy specimens were performed in 10 follow-up patients. RESULTS: 1) The prevalence of H. pylori infection in children presenting with abdominal complaints was 25.3%. No sexual predominance was observed. 2) In the endoscopically normal group (61 cases), the prevalence of H. pylori infection was 11.5%, and showed no significant difference with advancing age. In the endoscopically abnormal group (117 cases), prevalence appeared to increase with advancing age (9.1% in the age group under 5 years, 16.1% in the age group 5 to 10 years, 42.3% in the age group over 10 years). Average prevalence was 32.5% for all patients. 3) The freqeuncy of H. pylori infection included chronic nodular gastritis in 61.3% (19 of 31 cases), duodenal ulcer in 53.8% (7 of 13 caes), gastric ulcer in 22.5%, superficial gastritis in 14.6% and erosive gastritis in 10%. 4) The frequency of H. pylori infection increased with advancing age in chronic nodular gastritis, duodenal ulcer, and gastric ulcer, and their infection rate in patients over 10 years of age was 70.8%, 54.5% and 50.0% respectively. There were no significant differences of prevalence rate related to age in the other remaining diseases. 5) When the Warthin-Starry stain was considered as the gold standard, the sensitivity and specificity of CLO test for H. pylori were 100%, 92%, and those of the ELISA test were 69.2%, 81.8% respectively. 6) Children with any positive results for H. pylori infection were treated with DeNol and amoxicillin for 4-6 weeks. In 5 of 10 children who could be followed up for endoscopy and gastric biopsy after treatment, H. pylori was eradicated with a negative conversion rate of 50%. CONCLUSIONS: The prevalence of H. pylori in children with abdominal complaints was 23.5%, indicating that H. pylori infection might be the cause of abdominal complaints in some children with presumed functional abdominal pain. A high prevalence rate of H. pylori infection which increased with advancing age, was noted in patients with chronic nodular gastritis or duodenal ulcer. Antral nodularity was the characteristic endoscopic finding of children infected with H. pylori. We suggest that an early detection of H. pylori infection using upper gastrointestinal endoscopy and CLO testing and proper treatment for children with abdominal complaints might lower the incidence of peptic ulcer diseases or gastric cancer with advancing age.