The Etiologies and Characteristics of Chronic Abdominal Pain in Children and Adolescents in Korea.

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.