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Functional dyspepsia in children
Last reviewed: 12.07.2025
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Functional dyspepsia in children (synonyms: non-ulcer dyspepsia, essential dyspepsia, idiopathic dyspepsia, pseudo-ulcer syndrome, epigastric distress syndrome) is a complex of disorders that includes pain or discomfort in the epigastric region, early satiety, nausea, vomiting, belching, heartburn and is not caused by organic damage to the gastrointestinal tract. A feature of the syndrome in children is the predominant localization of pain in the umbilical region (55-88%); in 95% of children, pain occurs within the boundaries of a triangle, the base of which is the right costal arch, and the apex is the umbilical ring.
[ Epidemiology
The prevalence of functional dyspepsia in the population is 25-40% and is approximately the same in all age groups. According to the new edition of the Rome criteria (2006), this term is not used until the child reaches 4 years of age due to the insufficient structuring of complaints required for diagnosis.
Symptoms of functional dyspepsia in children
According to Rome criteria III (2006), postprandial (dyskinetic according to Rome criteria II) and painful (ulcer-like according to Rome criteria II) variants of functional dyspepsia are distinguished. The first is characterized by the predominance of dyspepsia, the second - abdominal pain. A prerequisite for making a diagnosis is the persistence or recurrence of symptoms for at least 3 months.
Pathognomonic for functional dyspepsia are considered to be early (arising after eating) pain, rapid satiety, a feeling of bloating and fullness in the upper abdomen. Often the pain is situational: it occurs in the morning before leaving for a preschool or school, on the eve of exams or other exciting events in the child's life. In many cases, the child (parents) cannot indicate a connection between the symptoms and any factors. Patients with functional dyspepsia often have various neurotic disorders, most often of the anxiety and asthenic type, appetite and sleep disorders. A combination of abdominal pain with pain in other locations, dizziness, sweating is typical.
Where does it hurt?
What's bothering you?
Diagnostics of functional dyspepsia in children
Since peptic ulcer disease predominates in the structure of dyspepsia syndrome in children, early diagnostics of this disease is recognized as a priority task. Epidemiological criteria that increase the risk of peptic ulcer disease: age over 10 years (= 10 times), belonging to the male sex (3-4 times), aggravated heredity (6-8 times). Clinically, the presence of peptic ulcer disease is indicated by night and "hunger" pains, severe rare pain, heartburn and sour belching. If a child has at least one of the listed alarm symptoms, EGDS is indicated as a matter of priority. Contraindications to EGDS are acute circulatory disorders, pulmonary and cardiac insufficiency, pronounced anatomical and topographic changes in the esophagus, mental illness, severe condition of the patient, risk of bleeding.
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Treatment of functional dyspepsia in children
In the treatment of functional dyspepsia, it is important to follow the stages and sequence. Symptomatic treatment is aimed at eliminating clinical signs taking into account pathogenetic mechanisms, and begins at the initial appointment. Provides a quick, often short-term effect. Etiotropic treatment is usually based on instrumental and laboratory data. Allows to eliminate the detected causes of dyspepsia syndrome and ensure a long-term favorable prognosis.
To increase the effectiveness of symptomatic treatment, it is especially important to correctly interpret the patient's complaints, since many modern drugs are highly selective in terms of the mechanism of action and point of application. It is advisable to use the criteria for functional gastrointestinal diseases adopted at the national and international level and allowing for the rationalization of diagnostic and therapeutic measures.
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