Skip to main content

Advertisement

SpringerLink
Log in

Gastric emptying evaluation in children with erosive gastroesophageal reflux disease

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Background/aims

Delayed gastric emptying may be an important contributing factor to gastroesophageal reflux disease (GERD) in children, but there are limited data on its evaluation in children with erosive-GERD. This study aims to evaluate the gastric emptying of a solid meal in patients with erosive-GERD.

Methods

Nineteen patients (age range 8.79–17.9 years) with erosive esophagitis and 14 healthy controls (age range from 8.04 to 18.7 years) were compared. Esophagitis was graded according to Los Angeles classification. The gastric emptying was evaluated by 13C-octanoic breath test, which was performed after a 344 kcal standardized solid test meal. Symptoms were evaluated using a standardized questionnaire.

Results

The two most prevalent symptoms were nausea and epigastric pain, which were reported by 12 (63.2%) patients. Irritable bowel syndrome was present in 26.3% (5/19). The median gastric emptying half-time in patients was 160 min (interquartile range [IQR] 140–174 min), which was not different from the controls’ figure (median 157 min, IQR 143–170 min). Additionally, the lag time and the gastric emptying coefficient were not significantly different between the study groups.

Conclusion

Delayed gastric emptying is not associated with erosive esophagitis in children with GERD, when compared to controls.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Franzese A, Borrelli O, Corrado G, Rea P, Di Nardo G, Grandinetti AL, Dito L, Cucchiara S (2002) Domperidone is more effective than cisapride in children with diabetic gastroparesis. Aliment Pharmacol Ther 16:951–957

    Article  CAS  PubMed  Google Scholar 

  2. Friesen CA, Lin Z, Hyman PE, Andre L, Welchert E, Schurman JV, Cocjin JT, Burchell N, Pulliam S, Moore A, Lavenbarg T, McCallum RW (2006) Electrogastrography in pediatric functional dyspepsia: relationship to gastric emptying and symptom severity. J Pediatr Gastroenterol Nutr 42:265–269. doi:10.1097/01.mpg.0000189367.99416.5e

    Article  PubMed  Google Scholar 

  3. Estevão-Costa J, Campos M, Dias JA, Trindade E, Medina AM, Carvalho JL (2001) Delayed gastric emptying and gastroesophageal reflux: a pathophysiologic relationship. J Pediatr Gastroenterol Nutr 32:471–474

    Article  PubMed  Google Scholar 

  4. Vandenplas Y, Hassall E (2002) Mechanisms of gastroesophageal reflux and gastroesophageal reflux disease. J Pediatr Gastroenterol Nutr 35:119–136

    Article  PubMed  Google Scholar 

  5. Papaila JG, Wilmot D, Grosfeld JL, Rescorla FJ, West KW, Vane DW (1989) Increased incidence of delayed gastric emptying in children with gastroesophageal reflux. A prospective evaluation. Arch Surg 124:933–936

    CAS  PubMed  Google Scholar 

  6. Argon M, Duygun U, Daglioz G, Omür O, Demir E, Aydogdu S (2006) Relationship between gastric emptying and gastroesophageal reflux in infants and children. Clin Nucl Med 31:262–265. doi:10.1097/01.rlu.0000210500.64440.76

    Article  PubMed  Google Scholar 

  7. Gupta SK, Hassall E, Chiu YL, Amer F, Heyman MB (2006) Presenting Symptoms of Nonerosive and Erosive Esophagitis in Pediatric Patients. Dig Dis Sci 51:858–863. doi:10.1007/s10620-006-9095-3

    Article  PubMed  Google Scholar 

  8. Fass R (2007) Erosive esophagitis and nonerosive reflux disease (NERD): comparison of epidemiologic, physiologic, and therapeutic characteristics. J Clin Gastroenterol 41:131–137. doi:10.1097/01.mcg.0000225631.07039.6d

    Article  PubMed  Google Scholar 

  9. Locke GR 3rd, Zinsmeister AR, Fett SL, Melton LJ 3rd, Talley NJ (2005) Overlap of gastrointestinal symptom complexes in a US community. Neurogastroenterol Motil 17:29–34. doi:10.1111/j.1365-2982.2004.00581.x

    Article  PubMed  Google Scholar 

  10. Kujime S, Inoue S, Nomura M, Endo J, Uemura N, Kishi S, Nakaya Y, Ito S (2005) Evaluation of gastric emptying by electrogastrography and ultrasonography in gastroesophageal reflux disease. Dig Endosc 17:131–137. doi:10.1111/j.1443-1661.2005.00489.x

    Article  Google Scholar 

  11. Machado RS, Reber M, Patrício FR, Kawakami E (2008) Gastric emptying of solids is slower in functional dyspepsia unrelated to Helicobacter pylori infection in female children and teenagers. J Pediatr Gastroenterol Nutr 46:403–408. doi:10.1097/MPG.0b013e318159224e

    Article  PubMed  Google Scholar 

  12. Dixon MF, Genta RM, Yardley JH, Correa P (1996) Classification and grading of gastritis. The Updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 20:1161–1181

    Article  CAS  PubMed  Google Scholar 

  13. Carelli AP, Patrício FR, Kawakami E (2007) Carditis is related to Helicobacter pylori infection in dyspeptic children and adolescents. Dig Liver Dis 39:117–121. doi:10.1016/j.dld.2006.10.012

    Article  CAS  PubMed  Google Scholar 

  14. Kawakami E, Machado RS, Reber M, Patrício FR (2002) 13 C-urea breath test with infrared spectroscopy for diagnosing Helicobacter pylori infection in children and adolescents. J Pediatr Gastroenterol Nutr 35:39–43

    Article  CAS  PubMed  Google Scholar 

  15. Ghoos YF, Maes BD, Geypens BJ, Mys G, Hiele MI, Rutgeerts PJ, Vantrappen G (1993) Measurement of gastric emptying rate of solids by means of a carbon-labeled octanoic acid breath test. Gastroenterology 104:1640–1647

    CAS  PubMed  Google Scholar 

  16. Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS (2006) Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 130:1527–1537. doi:10.1053/j.gastro.2005.08.063

    Article  PubMed  Google Scholar 

  17. Benini L, Sembenini C, Castellani G, Caliari S, Fioretta A, Vantini I (1996) Gastric emptying and dyspeptic symptoms in patients with gastroesophageal reflux. Am J Gastroenterol 91:1351–1354

    CAS  PubMed  Google Scholar 

  18. Estevão-Costa J, Dias JA, Campos M, Trindade E, Teixeira-Pinto A, Carvalho JL (2004) Can esophageal pH monitoring predict delayed gastric emptying? J Pediatr Surg 39:1537–1540

    Article  PubMed  Google Scholar 

  19. Keshavarzian A, Bushnell DL, Sontag S, Yegelwel EJ, Smid K (1991) Gastric emptying in patients with severe reflux esophagitis. Am J Gastroenterol 86:738–742

    CAS  PubMed  Google Scholar 

  20. Tefera S, Gilja OH, Olafsdottir E, Hausken T, Hatlebakk JG, Berstad A (2002) Intragastric maldistribution of a liquid meal in patients with reflux oesophagitis assessed by three dimensional ultrasonography. Gut 50:153–158

    Article  CAS  PubMed  Google Scholar 

  21. Miyazawa R, Tomomasa T, Kaneko H, Morikawa A (2006) Effect of formula thickened with locust bean gum on gastric emptying in infants. J Paediatr Child Health 42:808–812. doi:10.1111/j.1440-1754.2006.00982.x

    Article  PubMed  Google Scholar 

  22. Chen CL, Yi CH, Cook IJ (2008) Differences in oesophageal bolus transit between patients with and without erosive reflux disease. Dig Liver Dis 40:348–354. doi:10.1016/j.dld.2007.12.017

    Article  CAS  PubMed  Google Scholar 

  23. Rieder F, Cheng L, Harnett KM, Chak A, Cooper GS, Isenberg G, Ray M, Katz JA, Catanzaro A, O’Shea R, Post AB, Wong R, Sivak MV, McCormick T, Phillips M, West GA, Willis JE, Biancani P, Fiocchi C (2007) Gastroesophageal reflux disease-associated esophagitis induces endogenous cytokine production leading to motor abnormalities. Gastroenterology 132:154–165. doi:10.1053/j.gastro.2006.10.009

    Article  CAS  PubMed  Google Scholar 

  24. Fass R, Stanghellini V, Monnikes H (2006) Baseline analysis of symptom spectrum in GERD clinical trial patients: result from ReQuest database. Gastroenterology 130:A629

    Google Scholar 

  25. Hyams JS, Burke G, Davis PM, Rzepski B, Andrulonis PA (1996) Abdominal pain and irritable bowel syndrome in adolescents: a community-based study. J Pediatr 129:220–226

    Article  CAS  PubMed  Google Scholar 

  26. Dong L, Dingguo L, Xiaoxing X, Hanming L (2005) An epidemiologic study of irritable bowel syndrome in adolescents and children in China: a school-based study. Pediatrics 116:e393–e396. doi:10.1542/peds.2004-2764

    Article  PubMed  Google Scholar 

  27. Varni JW, Lane MM, Burwinkle TM, Fontaine EN, Youssef NN, Schwimmer JB, Pardee PE, Pohl JF, Easley DJ (2006) Health-related quality of life in pediatric patients with irritable bowel syndrome: a comparative analysis. J Dev Behav Pediatr 27:451–458

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Ms. Renata Vigliar, Dr. Lair Valio, Ms. Rosana Cássia Ribeiro Barros, and Ms. Marinalva Andrade Santos, whose contributions made this study feasible.

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Pediatric Gasteroenterology Division, Department of Pediatrics, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo 441, São Paulo, 04039-031, Brazil

    Rodrigo Strehl Machado, Érica Yamamoto, Marialice Reber & Elisabete Kawakami

  2. Department of Pathology, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo 441, São Paulo, 04039-031, Brazil

    Francy Reis da Silva Patrício

Authors
  1. Rodrigo Strehl Machado
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Érica Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Francy Reis da Silva Patrício
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marialice Reber
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elisabete Kawakami
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rodrigo Strehl Machado.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Machado, R.S., Yamamoto, É., da Silva Patrício, F.R. et al. Gastric emptying evaluation in children with erosive gastroesophageal reflux disease. Pediatr Surg Int 26, 473–478 (2010). https://doi.org/10.1007/s00383-010-2579-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-010-2579-4

Keywords

Search

Navigation