Research Article

Evaluation of Children with Chronic Abdominal Pain and Cost Analysis


  • Göksel Vatansever
  • Aydan Kansu Tanca
  • Ceyda Tuna Kırsaçlıoğlu
  • Arzu Meltem Demir
  • Zarife Kuloğlu

Received Date: 09.03.2021 Accepted Date: 04.04.2021 J Ankara Univ Fac Med 2021;74(3):324-331


We aimed to identify the frequency of functional and organic abdominal pain by history, physical examination and diagnostic tests in children who presented with chronic abdominal pain (CAP) and to determine the cost per patient.

Materials and Methods:

The children who presented to pediatric gastroenterology outpatient clinic with CAP, aged 4-18 years, were reviewed for demographic data, history, physical examination, laboratory, imaging, endoscopic and histopathological findings retrospectively. The total cost of examinations performed at the diagnosis stage of the cases and the amount per patient were calculated.


Among 324 patients (11.26±3.80 years, 67% female), 222 (68.3%) patients were detected to have functional abdominal pain due to functional gastrointestinal disorders (FGID) and 102 (31.7%) were found to have organic causes. Gastritis in the organic-caused abdominal pain group (31.1%), gastroesophageal reflux (22.6%) Helicobacter pylori infection (19.8%) and celiac disease (7.5%) were the most frequent causes. Within patients in the FGID group, 40.1% had functional dyspepsia, 32.5% had functional abdominal pain, 21.5% had functional constipation, 5.5% had irritable bowel syndrome, and 0.4% had cyclic vomiting. The severity degree (p=0.01), duration time (for more than 1 hour) (p=0.01) and awaking from sleep (p=0.014) of abdominal pain, presence of vomiting (p=0.01), weight loss (p=0.045), fever (p=0.035), arthritis (p=0.014), upper pathological finding in physical examination were more frequent in patients with organic causes. The average cost of diagnostic tests per patient in the organic group (163.79 TL) was approximately 3 times higher than in the FGID group (50.66 TL).


The most common etiology of chronic abdominal pain in childhood is due to FGID. The presence of alarm symptoms suggests more organic causes. Organic etiology can be excluded by detailed medical history and physical examination without unnecessary cost.

Keywords: Abdominal Pain, Gastritis, Dyspepsia, Cost-Analysis

Full Text (Turkish)