Su1772 Diagnostic Yield of Colonoscopy in Children With Chronic Abdominal Pain

Su1772 Diagnostic Yield of Colonoscopy in Children With Chronic Abdominal Pain Kalpesh H. Thakkar*, Emma M. BRAVO, Seiji Kitagawa, Douglas S. Fishman GI, Baylor College of Medicine, Houston, TX; Rice University, Houston, TX Background: Colonoscopy is often performed in the evaluation of chronic abdominal pain (CAP) in children. However, the diagnostic yield in this clinical scenario is unknown. Methods: We conducted a prospective cohort study to examine the diagnostic yield in children (4-18 years) who underwent colonoscopy for the primary indication of CAP between Nov 2007 and March 2010 at a pediatric GI referral center in the USA. Patients were screened prior to colonoscopy to meet inclusion criteria: 1. Abdominal pain for at least 2 months without a known organic etiology; 2. No significant co-morbidities, and 3. No previous endoscopy. Demographics and clinical features (e.g. alarm features, Rome criteria) were systematically captured. . Results: We enrolled 52 patients (mean age 11.9; SD 3.5) undergoing colonoscopy including 30 (66%) females and 19 (75%) patients with diarrhea. Findings from biopsy specimens included lymphonodular hyperplasia (21.0%, nZ17), non-specific colitis (4.1%, nZ16), eosinophilic colitis (3.8%, nZ14), and normal histology (0.3%, nZ5). Short term outcomes were available in 43% of the patients enrolled. We found that medical therapy effectively reduced CAP symptoms in approximately 67% (4/6) of patients with non-specific colitis and 43% (3/7) of patients with eosinophilic colitis. Conclusions: Non-specific colitis is the most common diagnosis followed by eosinophilic colitis. Our findings suggest that colonoscopy has a low diagnostic yield in children presenting primarily with chronic abdominal pain.