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Published on: August 27, 2021
[Myoelectrical activity of the stomach in children with gastroesophageal reflux]
Anna Jarzab1, Krzysztof Fyderek, Stanisław Pieczarkowski
1Klinika Pediatrii, Gastroenterdologii i Zywienia Polsko-Amerykańskiego Instytutu Pediatrii ul. Wielicka 265, 30-663 Kraków. ajarzab@mp.pl
Insights
Electrogastrography (EGG) reveals distinct gastric myoelectrical activity patterns in children with gastroesophageal reflux. Nocturnal reflux episodes correlate with altered EGG parameters, suggesting different underlying mechanisms.
Area of Science:
- Pediatric Gastroenterology
- Digestive Physiology
- Medical Diagnostics
Context:
- Gastroesophageal reflux (GER) is common in children.
- Accurate diagnosis and understanding of GER pathophysiology are crucial.
- Electrogastrography (EGG) measures gastric myoelectrical activity.
Purpose:
- To analyze changes in gastric myoelectrical activity using EGG in children with GER.
- To differentiate GER based on nocturnal reflux episodes.
- To investigate potential differences in GER pathomechanisms.
Summary:
- 103 children with GER underwent EGG and 24-hour intraesophageal pH monitoring.
- Children were grouped based on pH monitoring results and presence of nocturnal reflux.
- Key EGG parameters including dominant power (PDP) and bradygastria were analyzed pre- and postprandially.
Impact:
- Findings suggest that children with nocturnal GER episodes exhibit significantly different gastric myoelectrical activity compared to controls.
- Reduced postprandial bradygastria was observed in children with non-nocturnal GER.
- EGG analysis may help elucidate distinct pathomechanisms of GER in pediatric patients.
Abstract:
Aim of the study was analysis of the gastric myoelectrical activity changes recorded by cutaneous electrogastrography in children with gastroesophageal reflux. We analyzed cutaneous electrogastrograms (EGG) of 103 children also underwent 24-hours intraesophageal pH probe. We divided children into 2 groups basing on pH fraction time below 4 (FT): Reflux group (FT > 4%) and control group (FT < 4%). The Reflux group was formed of 54 children (27 girls and 27 boys) aged 3-17 years (mean 10.9), the control group consisted of 49 children (24 girls and 25 boys) aged 3-18 years (mean 11.4). Then we divided the Reflux group into two subgroups: "N"--with nocturnal episodes of gastroesophageal reflux--29 children (14 boys and 15 girls), "D"--with no reflux episodes during the nightime--25 children (12 girls and 13 boys). We analyzed the following pre- and postprandial EGG parameters: percentage of bradygastria, normogastria and tachygastria, total percentage of dysryhthmias, dominant frequency (PDF), dominant power (PDP), post/preprandial power ratio (PR), dominant frequency instability coefficient (DFIC). In the Reflux N group PDP was 10.24 mV2 preprandially and 17.34 mV2 after meal; in the control group PDP was 49.83 and 104.34 mV2 respectively (the differences between groups were statistically significant in both fasting and fed states: p < 0.02). In the Reflux D group comparing to the controls we found less percentage of postprandial bradygastria (p < 0.05). The other EGG parameters were no statistically different. EGG analysis suggests a different pathomechanism of gastroesophageal reflux episodes in the patients with nocturnal reflux episodes.
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