[Evaluation of clinical manifestations and therapeutic and diagnostic progression of dyspepsia in children referred to Boo-Ali Hospital of Sari in 2005-2006]

ABSTRACT

Chronic abdominal pain is a common clinical problem in children. Apleys reported the incidence of 10-15% of chronic abdominal pain in school age children, but recent studies reported 20% of that type of pain. The aim of this study was determining the spectrum of clinical manifestations of dyspeptic children and to identify the relation between some clinical symptoms, organic or functional dyspepsia, and long term follow up of functional type. This descriptive case series study was done on 232 children between 4 and 18 years of age complaining about chronic abdominal pain chiefly who had referred to pediatric gastroenterology department of Boo-Ali Hospital of sari in 2005-2006. A checklist composed of patient demographic criteria and pain characteristics was prepared. Physical exam and laboratory tests such as AST, ALT, U/A, U/C, S/E, ESR, CBC were performed for all patients. If there were any alarming signs of organic abdominal pain-persistence or recurrence of symptoms and severe disability despite the use of H-blockers-upper GI endoscopies was indicated. Recorded data were analyzed by SPSS software and Chi- square tests. 102 of 232 patients had dyspepsia; 59 were girls [9.2y/o], and 43 were boys [7.5y/o]. 65 out of 102 patients had dominant abdominal pain and the rest had flatulence, vomiting and early fullness. 64 of them went under UGI endoscopies. 28 of 64 had mucosal erosion. Because the functional or organic abdominal pain has not unique diagnostic criteria, and the data about pathological change in children are fewer than that of adults we recommend the clinical findings and biochemical change of mucosa for differential diagnosis in children