Organic Upper Digestive Diseases in Children with Chronic Abdominal Pain

Organic diseases are prevalent in about 5 to 10% of children with chronic abdominal pain. The most common diseases of the upper digestive tract include gastroesophageal reflux disease (GERD), chronic gastritis with or without Helicobacter pylori (H. pylori), and peptic ulcer. The H. pylori infections acquired during childhood persist lifelong without eradication. Although the majority of H. pylori infected children remain asymptomatic, H. pylori infection may cause various digestive and extra-digestive diseases. There are still debates about a causal relationship between H. pylori-gastritis and abdominal symptoms in the absence of peptic ulcer disease. The number of Korean children infected with antibiotic resistant H. pylori is increasing even though the prevalence decreases after eradication. The choices of rescue therapy are limited in children after eradication failure. Antioxidant supplements with regimens against H. pylori have been tried with limited effects. Here I wanted to review the findings of recent reports on common upper digestive diseases such as GERD, peptic ulcer, and H. pylori infection in children with chronic abdominal pain. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 232∼244)