Evaluation of pancreatic insufficiency / partial pancreatic enzyme deficiency prevalence in patients with functional abdominal painvan yüzüncü yil university, faculty of medicine, department of pediatrics, specialty thesis

The aim of this study was to evaluate the frequency of pancreatic insufficiency / pancreatic partial enzyme deficiency in children with chronic abdominal pain. Material and Methods: A total of 110 patients who presented with functional abdominal pain between April 1/ 2019- September 1/2019) in the Pediatric Clinic of Dursun Odabaş Medical Center, Yüzüncü Yıl University, were included in the study. Eighty patients without any gastrointestinal complaints were selected as the control group.Complete blood count, renal and liver function tests, amylase, lipase, pancreatic amylase, immune reactive trypsinogen (IRT), complete urine analysis, stool microscopy, stool H. pylori antigen and fecal elastase (FE-1) were studied.Children with fecal parasites, abnormal biochemical parameters, active infection or additional chronic diseases were excluded from the study.Patient and control groups were compared in demographic and laboratory settings. Results: A total of 108 patients, 51.9% of whom were girls and the mean age was 8.7 ± 3.13 years were included in the study group.The control group consisted of 77 patients (55.8% male) with a mean age of 9.23 ± 3.55 years.There was no statistically significant difference between patient and control groups in terms of age, sex, weight SDS, lipase, pancreatic amylase, IRT and glucose (p=0,347, p=0,302, p=0,064, p=0,672, p=0,432, p=0,110, p=0,801).Amylase levels were significantly higher and fecal elastase values were lower in the patient group (p=0,007, p=<0.001).The diagnostic decision-making properties of faecal elastase values for predicting functional abdominal pain were examined by ROC analysis.The significant cut-off value was 140.107 (μg / g).According to this limit value, the sensitivity of fecal elastase was 82.1%, specificity was 66.2%, positive predictive value was 77% and negative predictive value was 73%. Conclusion: The underlying causes of functional abdominal pain in children are still unclear.When the etiopathogenesis is examined, factors such as increased mucosal proinflammatory cytokines, changes in microbiology, dysbiosis, increased intestinal permeability and impaired motility are blamed.We planned this study considering that there may be a relationship between patients with functional abdominal pain and exocrine pancreatic insufficiency.The diagnosis of pancreatic exocrine insufficiency may be missed in the clinic, which prevents early diagnosis and response to treatment.For this purpose, we evaluated pancreatic exocrine functions in children with functional abdominal pain by measuring amylase, lipase, pancreatic amylase, fecal elastase-1 and IRT levels used in the diagnosis of pancreatic exocrine insufficiency.We found low fecal elastase-1 levels in the case groups included in the study. We think that the reason of this decrease in faecal elastase may be the result of malabsorption secondary to dysbiosis. We think that this study may contribute to the literature because of the lack of studies evaluating pancreatic exocrine insufficiency in children with functional abdominal pain.