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Electrogastrography in pediatric functional dyspepsia: relationship to gastric emptying and symptom severity
Craig A Friesen1, Zhiyue Lin, Paul E Hyman
1Section of Gastroenterology, The Children's Mercy Hospital and Clinics, Kansas City, Missouri 64108, USA. cfriesen@cmh.edu
Insights
Children with functional dyspepsia often show abnormal electrogastrogram (EGG) patterns and slow gastric emptying (GE). These EGG abnormalities correlate with more severe pain, suggesting a role in dyspeptic symptoms.
Area of Science:
- Pediatric Gastroenterology
- Digestive Physiology
- Medical Diagnostics
Background:
- Functional dyspepsia (FD) in children presents a diagnostic challenge.
- Understanding the physiological underpinnings of FD is crucial for effective management.
- Electrogastrography (EGG) and gastric emptying (GE) are key measures of gastrointestinal function.
Purpose of the Study:
- To characterize electrogastrographic (EGG) patterns in pediatric functional dyspepsia (FD).
- To examine the relationship between EGG findings, gastric emptying (GE) rates, and reported pain severity in children with FD.
- To identify potential electrophysiological mechanisms contributing to FD symptoms.
Main Methods:
- Electrogastrography (EGG) and a radiolabeled solid meal gastric emptying (GE) test were performed on 30 children diagnosed with FD.
- EGG recordings captured fasting and postprandial states, analyzing dominant frequency, power changes (deltaP), and percent dysrhythmia.
- GE was quantified by measuring isotope-labeled meal emptying over 60 minutes post-ingestion; symptom severity was graded by patients.
Main Results:
- Nearly half (47%) of the children exhibited slow GE, and 50% had abnormal EGG findings (dysrhythmia ≥30% or deltaP <0).
- A significant association was found between abnormal EGG and slow GE (73% vs. 20%, P=0.009).
- Abnormal EGG was linked to increased mean pain severity scores (3.5 vs. 2.5, P=0.002) and negatively correlated with fasting bradygastria.
Conclusions:
- A high proportion of children with FD present with either slow GE or abnormal EGG.
- Abnormalities in EGG are more prevalent in patients with slow GE, indicating a potential link between gastric motility and electrical activity.
- EGG abnormalities are associated with heightened postprandial pain, suggesting that altered gastric electrical activity may be a contributing mechanism in pediatric functional dyspepsia.
Objectives:
The aims of this study were to determine the electrogastrographic patterns in children with functional dyspepsia and to investigate the correlations among electrogastrogram (EGG), gastric emptying (GE), and pain severity.
Methods:
We studied 30 children (19 F; mean age 11.4 years) with functional dyspepsia. Electrogastrography was performed for 30 minutes fasting and for 1 hour during a GE test after ingestion of an isotope-labeled solid meal. The percent emptying was measured every 10 minutes for 1 hour after the meal. The dominant frequency of the EGG, the change in the postprandial peak power (deltaP), and percent dysrhythmia during each recording session were calculated. Specific symptoms were graded from 0 (none) to 4 (severe) by the patient.
Results:
Of 30 patients, 14 (47%) had slow GE, and 15 (50%) had abnormal EGG (dysrhythmia > or = 30% or deltaP < 0). GE was slow in 73% of patients with an abnormal EGG but was slow in only 20% of patients with normal EGG (P = 0.009). GE was negatively correlated with fasting bradygastria (r = -0.383, P = 0.04). Abdominal pain was the most severe dyspeptic symptom, both during fasting and after the meal. Patients with an abnormal EGG had an increased mean pain severity score (3.5 +/- 0.2 vs. 2.5 +/- 0.2, P = 0.002).
Conclusions:
Sixty percent of functional dyspepsia subjects had either slow GE or abnormal EGG. Patients with abnormal EGG were more likely to have slow GE. EGG abnormalities were associated with more severe postprandial pain and should be considered a possible mechanism for dyspeptic symptoms.
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