Dyspepsia in childhood. Clinical manifestations and management

Abstract

SUMMARY
Objectives: In recent studies there is little data regarding
functional dyspepsia in childhood. This study aimed to
determine the frequency, clinical manifestations and
treatment of functional dyspepsia in childhood.
Methods: The study sample consisted of 548 children with
recurrent abdominal pain (age range: 4-14 years). A
standardized questionnaire was used to investigate the
symptoms of functional dyspepsia as recorded in similar
studies for adults. Baseline laboratory tests were carried
out for each patient. Additionally, the severity of clinical
manifestations and the presence of accompanying symptoms,
which might trigger or exacerbate the condition, were
investigated. Prokinetic or acid-reducing drugs were used
according to the judgment of the attending pediatrician.
Results: Finally 348 children (180 male, 168 female) met
the inclusion criteria. Children within severe form of
dyspepsia had more frequent nausea (p<0.0001), vomiting
(p<0.0001) and belching (p<0.0001), while children with a
moderate form of dyspepsia had postprandial fullness
(p<0.002) and bloating (p<0.0001). The frequency of
functional dyspepsia was 70.73%. Paleness (p<0.0001) was
the most frequent symptom in organic dyspepsia whereas
epigastric pain was more prevalent in functional dyspepsia
(p<0.007). As far as the treatment of these patients was
concerned, children treated with cisapride responded marginally better than those who received ranitidine.
Conclusions: The frequency of functional dyspepsia in
childhood reached a percentage of 70%. The majority of
patients exhibited mild disease manifestations whereas the
most frequent symptoms of the condition were nausea,
vomiting, belching, bloating and postprandial fullness.
Therapeutically, cisapride seemed to be superior to acidreducing
drugs but in a non significant manner.
Key words: Dyspepsia, functional dyspepsia, recurrent abdominal
painIntroduction