Dyspepsia in children: Organic or functional? Experience in a tertiary care hospital

Introduction: Dyspepsia comprises a group of symptoms that can either have an organic cause or functional origin. The purpose of this study was to describe the main causes of dyspepsia and the its clinical evolution in children cared for in a tertiary care hospital. Material and methods: Retrospective study in children with dyspepsia. Patients underwent endoscopy and rapid urease test to detect the presence of Helicobacter pylori. In case of normal endoscopy and biopsy, hydrogen breath test was performed. In all cases, follow-up was provided in order to evaluate symptom improvement. Results: One hundred children were included, out of whom 52 were girls; mean age was 8.59 years. Esophagitis or erosive gastropathy were found in 54% of the cases (n = 54). H. pylori infection in 12% (n = 12), small intestine bacterial overgrowth in 12% (n = 12), and functional dyspepsia in 20% (n = 20). Conclusion: In children with dyspepsia, organic causes should first be ruled out before dyspepsia being characterized as functional. In general terms, we consider that a stepped approach that includes endoscopy with biopsy, search for H. pylori and hydrogen breath test is necessary.