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Nutritional implications of chronic dyspepsia in childhood
A Papadopoulou1, A Vazeou, C Siafakas
1Department of Paediatrics, Faculty of Nursing, University of Athens, P & A Kyriakou Children's Hospital, Greece.
Insights
Children with chronic dyspepsia and postprandial fullness experience impaired gastric emptying and lower weight scores. Treatment with cisapride improved weight in this group, highlighting the link between gastric function and nutrition.
Area of Science:
- Pediatric Gastroenterology
- Digestive Physiology
Background:
- Chronic dyspepsia is prevalent in pediatric populations.
- The relationship between specific dyspeptic symptoms, gastric emptying, and nutritional status in children requires further elucidation.
Purpose of the Study:
- To investigate the association between predominant symptoms of chronic dyspepsia and gastric emptying.
- To assess the impact of these symptoms on children's nutritional status.
- To evaluate the efficacy of cisapride treatment on gastric emptying and nutritional parameters.
Main Methods:
- 31 children with chronic dyspepsia were classified by predominant symptoms (epigastric pain vs. postprandial fullness).
- Gastric emptying (GE) T(1/2) of a solid meal was measured.
- Weight for age z scores were recorded before and after a two-month cisapride treatment.
- Upper gastrointestinal endoscopy was performed in treatment failures.
Main Results:
- Moderate to severe postprandial fullness (PF) was associated with prolonged gastric emptying T(1/2) and lower weight for age z scores compared to epigastric pain (P < 0.0001 and P = 0.003).
- Children with moderate to severe PF showed significant weight improvement after cisapride treatment (P = 0.0003).
Conclusions:
- Impaired gastric emptying is common in pediatric patients with postprandial fullness.
- Postprandial fullness significantly impacts the nutritional status of dyspeptic children.
- Cisapride treatment demonstrates potential benefits for weight improvement in this specific pediatric subgroup.
Abstract:
Chronic dyspepsia is common in children. However, the association of individual predominant symptoms with gastric emptying and their impact on nutritional status are poorly defined. We therefore studied 31 children (mean age 11 years, 14 boys) with chronic dyspepsia and classified their predominant symptoms (PS) by their character and severity. Gastric emptying (GE) T(1/2) of a solid meal was carried out in all patients, while upper gastrointestinal endoscopy was done in the treatment failures. All patients received two months treatment with cisapride. Weight for age z scores were recorded before and three months after treatment. There were 12 patients with epigastric pain (EP) as the PS (7 moderate/severe). Postprandial fullness (PF) was the PS in 19 patients (12 moderate/severe). GE T(1/2) was prolonged and weight for age z scores were lower in children who had moderate/severe (but not mild) PF comparing to those who had EP (P < 0.0001 and P = 0.003, respectively). A significant improvement in weight was observed in the same group alone following treatment with cisapride (P = 0.0003). In conclusion, impaired GE is common in dyspeptic children with PF and have adverse effects on nutritional status.