Delayed orocecal transit in pediatric gut-brain interaction disorders: A comparative study using the lactulose breath...

Area of Science:

• Pediatric Gastroenterology
• Gut-Brain Interaction Disorders
• Digestive Physiology

Background:

• Functional abdominal pain disorders (FAPDs) are prevalent gut-brain interaction disorders with incompletely understood pathophysiology.
• Impaired gastrointestinal motility, particularly small intestinal dysmotility, is implicated but understudied.
• Orocecal transit time (OCTT) serves as an indirect measure of small intestinal transit, offering insights into FAPD mechanisms.

Purpose of the Study:

• To compare OCTT in children diagnosed with FAPDs against healthy controls.
• To utilize the lactulose breath hydrogen test for assessing small intestinal transit.

Main Methods:

• The study included 34 children with FAPDs (Rome IV criteria) and 19 healthy controls, aged 5-12 years.
• Orocecal transit time (OCTT) was measured using a validated lactulose breath hydrogen test after an overnight fast.
• Breath hydrogen levels were monitored for 180 minutes post-ingestion to determine OCTT.

Main Results:

• Children with FAPDs demonstrated significantly longer OCTT (median 90 minutes) than healthy controls (median 75 minutes) (P=0.0045).
• Children with functional dyspepsia showed the longest mean OCTT (110.8 ± 26.7 minutes).
• No significant correlation was found between abdominal pain severity, stress exposure, and OCTT.

Conclusions:

• Pediatric FAPDs are associated with delayed small intestinal transit as indicated by prolonged OCTT.
• The absence of a strong correlation between OCTT and symptom severity suggests that delayed transit is not the sole or primary factor in FAPD pathophysiology.