Causes of Chronic Abdominal pain in children aged 2 -15 years old in Erbil city

Abstract

Background and Objectives: Chronic abdominal pain (CAP) is a common complaint in childhood, with possible causes that represent a spectrum of functional to organic origins. The purpose of this study was to determine the spectrum and frequency of the causes of CAP in children aged 2–15 years in Erbil City, Kurdistan Region of Iraq.

Methods: A cross-sectional study was conducted over a duration of 12 months, from January to December 2024, among 360 children with CAP defined as pain occurring at least once per week for 8 to 52 weeks. Clinical assessment, anthropometry, laboratory investigations, and imaging investigations were performed in a standardized diagnostic manner.

Results: The mean age of participants was 9.36 ± 3.06 years, with 181 (50.3%) males and 179 (49.7%) females. Functional disorders constituted 332 (92.2%) of cases, while 28 (7.8%) had organic causes. The most prevalent functional diagnoses were functional abdominal pain not otherwise specified (56.1%), irritable bowel syndrome (19.5%), and functional dyspepsia (16.4%). Among organic causes, constipation with fecal loading (50.0%), Helicobacter pylori gastritis (28.6%), and parasitic infection (21.4%) predominated. Children with functional pain had higher BMI (16.89 ± 1.46 kg/m²) than those with organic pain (16.00 ± 0.98 kg/m²; p = 0.006), whereas fecal calprotectin was higher in the organic group (26.21 ± 4.05 μg/g vs. 24.07 ± 2.65 μg/g; p = 0.004).

Conclusion: Functional gastrointestinal disorders are unequivocally the most common cause of CAP in children in Erbil, which indicates that diligent evaluation and reassurance with a focus for investigation on cases with clinical or laboratory findings that are suggestive.