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Liquid and solid gastric emptying and correlation with clinical characteristics in pediatric patients with dyspepsia
Neha R Santucci1,2, Joshua Corsiglia1, Khalil El-Chammas1,2
1Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Insights
Dyspeptic children often show delayed liquid gastric emptying, with over half affected. Abnormal gastric emptying is linked to mental health disorders, suggesting a need for screening and treatment.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
- Medical Imaging
Background:
- Gastric emptying data in pediatric dyspepsia is scarce.
- Understanding gastric emptying is crucial for diagnosing and managing pediatric dyspepsia.
Purpose of the Study:
- To assess solid and liquid gastric emptying rates in children with dyspepsia.
- To correlate gastric emptying patterns with clinical features and comorbidities.
Main Methods:
- Retrospective chart review of 1078 dyspeptic children.
- Utilized 4-hour dual-phase gastric scintigraphy to evaluate gastric emptying.
- Collected data on demographics, symptoms, and comorbidities.
Main Results:
- Delayed liquid emptying was observed in over 50% of patients; 26.16% had delayed liquid with normal solid emptying.
- Abnormal solid emptying (rapid/delayed) was more frequent in children with mental health disorders (p=0.027).
- Nausea was associated with normal solid emptying (p<0.0001) but underreported in younger children with vomiting.
Conclusions:
- Delayed liquid gastric emptying is common in pediatric dyspepsia.
- Dual-phase gastric emptying studies can guide therapy in these children.
- Screening for and treating mental health disorders is recommended due to their association with abnormal gastric emptying.
Background:
There is limited data on gastric emptying in dyspeptic children. We aimed to determine solid and liquid emptying rates in dyspeptic children and correlate with clinical characteristics.
Methods:
Charts of dyspeptic children undergoing 4-hour dual-phase gastric scintigraphy were reviewed for demographics, symptoms, and comorbidities.
Key Results:
In 1078 dyspeptic patients (65% females, median age 13 years) vomiting (55%), nausea (53%), and abdominal pain (52%) were the most common symptoms. The most common comorbidities were mental health (32%), neurologic (27%), and hypermobility spectrum disorders (20%). Solid and liquid emptying rates were aligned in 61.23%. Delayed solid with normal liquid emptying were noted in 2.5%, compared to delayed liquid with normal solid emptying in 26.16%. Abdominal pain had a trend for association with delayed or normal solid emptying (p = 0.06). Nausea was mostly reported with normal solid emptying (p < 0.0001) and underreported in patients <12 years with vomiting (29%). Abnormal solid emptying (rapid and delayed) was noted more frequently in children with mental health disorders (p = 0.027). Rapid liquid emptying was more common in children with genetic disorders (p = 0.032).
Conclusion And Inferences:
Over half of children with dyspepsia had delayed liquid gastric emptying, and one quarter had delayed liquid with normal solid emptying. Dual-phase gastric emptying studies may help target therapy in dyspeptic children. Nausea is not a reliable symptom for dyspepsia in younger children. Given the significant association of abnormal gastric emptying in children with mental health disorders, we recommend screening and treating children with dyspepsia.
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