Evaluation of childhood patients undergoing endoscopy forchronic abdominal pain

Chronic abdominal pain (CAP) is a common symptom in childhood and significantly affects quality of life. It is observed in 10–15% of school-aged children and encompasses a wide differential diagnosis, including both functional and organic etiologies. Although CAP was previously considered predominantly functional in origin, recent advances in diagnostic methods have led to increased detection of organic causes. In this study, medical records of children aged 4–17 years who presented with CAP and underwent upper gastrointestinal endoscopy at Zonguldak Bülent Ecevit University Hospital, Pediatric Gastroenterology Clinic, between 2014 and 2024 were retrospectively evaluated. A total of 507 patients were screened, and 364 patients who met the inclusion criteria were included in the analysis. Of the patients, 65.9% were female, and the mean age was 13.04 ± 3.87 years. Endoscopy revealed normal findings in only 35 patients (9.6%), while at least one organic etiology was identified in 338 patients (92.9%). The most common organic pathologies were gastritis (83%), duodenitis (35.7%), Helicobacter pylori infection (32.6%), and celiac disease (17%). Notably, all 119 patients who were clinically evaluated as having functional abdominal pain prior to endoscopy were found to have at least one organic lesion. The findings of this study demonstrate that endoscopy provides substantial diagnostic value in children presenting with chronic abdominal pain, particularly in clarifying the diagnosis in patients with alarm symptoms. Endoscopy emerges as an important diagnostic tool in determining the etiology of CAP during childhood. Keywords: Chronic Abdominal Pain, Endoscopy, Organic Etiology, Functional Abdominal Pain.