Diagnostic Yeild of Esophagogastrodudenoscopy in Pediatric Chronic Abdominal Pain

Inclusion criteria

• Children aged 6 to 18 years presenting with chronic abdominal pain which defined according to the Rome IV criteria as persistent or recurring abdominal pain that has been present for at least 3 months, with symptom onset at least 6 months prior to diagnosis. This pain must be continuous or nearly continuous, and only occasionally related to physiological events like eating or defecation. Furthermore, the pain must limit some aspect of daily functioning, and it is not feigned or explained by another medical condition and referred to GIT unit for Esophagogastroduodenoscopy and not undertreatment based on clinical judgment due to the presence of one or more of the following:

• Alarm symptoms (e.g., weight loss, anemia, Hematemesis, Dysphagia, persistent vomiting, nocturnal pain)
• Failure of empiric therapy (e.g., proton pump inhibitors or dietary modifications)
• Suspicion of an underlying organic disease (e.g., celiac disease or Helicobacter pylori infection)

Exclusion criteria

• Acute abdominal pain
• Children aged less than 6 years and more than 18 years
• Recent use of proton pump inhibitors (within 2 weeks) or antibiotics (within 4 weeks) before endoscopy.
• Children meeting the criteria of functional abdominal pain according to Rome IV criteria in which was defined as as recurrent or chronic abdominal pain that is not explained by another medical condition and is not solely associated with physiological events like eating or menstruation. It must occur at least 4 times per month for at least 2 months, and diagnostic evaluation should rule out other conditions .
• Children with contraindications to undergoing EGD (e.g., severe respiratory or cardiac conditions).
• Children who refuse to participate or whose parents do not provide consent.
• Children previously diagnosed with recurrent abdominal pain -