Impaired Accommodation of the Proximal Stomach in Children With Recurrent Abdominal Pain

Abstract

The results support the view that recurrent abdominal pain in children may be a motility disorder that can be detected in the proximal stomach as an impairment of adaptive relaxation in response to a meal. This new ultrasonographic method may become a valuable diagnostic tool in patients with recurrent abdominal pain.

Effect of Nutritional Rehabilitation on Gastric Motility and Somatization in Adolescents with Anorexia

“…13 Ultrasonography offers a safe, well-tolerated alternative to these methods. Ultrasound examination has been used to assess gastric emptying, gastric volumes, and accommodation in healthy patients, 17–19 as well as in patients with functional dyspepsia, 48 diabetes, 49 gastroesophageal reflux and esophagitis, 50 recurrent abdominal pain, 51 and obesity. 52 Ultrasonography has been shown to yield comparable results to the gold standard tests, 20,21 with antral diameter providing a measure of gastric accommodation and RGV reflecting gastric emptying, and to have good reliability and reproducibility, as well as low interobserver variation and error.…”

Non-invasive measurement of gastric accommodation in humans

“…Gastric tone (that is, accommodation and contraction) is therefore modulated by the central nervous system (CNS), vagal discharge, and a network of reflexes that arise from the stomach wall. 3 Abnormal gastric accommodation occurs in functional dyspepsia, 4 5 in children with recurrent abdominal pain, 6 in rumination syndrome, 7 achalasia, 8 gastro-oesophageal reflux disease, 9 and diabetic vagal neuropathy, and postvagotomy. 10 11 Despite widespread interest in the possible aetiology role of impaired postprandial accommodation in the pathogenesis of functional dyspepsia, there are relatively few published studies addressing this subject.…”

Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia

“…Gastric emptying and water-load capacity are certainly affected by accommodation, but neither is a specific measure of fundic relaxation. Impaired accommodation was demonstrated in pediatric RAP patients assessed by 2-dimensional ultrasound [94] . Participants, most of whom had dyspeptic symptoms, had decreased proximal stomach saggital area and increased rate of proximal stomach emptying after a liquid meal when compared to healthy controls.…”

“…Although the water load test may not be useful for identification of pediatric FD due to suboptimal sensitivity, children diagnosed with FD often have abnormal test results [36] . In a controlled study by Schurman et al [36] , 68 pediatric patients with FGIDs and 26 healthy children completed the Behavioral Assessment Scale for Children- [36] 28 FD Hoffman et al [37] 15 FD Chitkara et al [38] 101 CAP Anderson et al [39] Gastric barostat 16 FD Hoffman et al [47] 10 RAP, 10 IBS Di Lorenzo et al [48] Electromechanical function Gastric emptying breath test 28 FD Hoffman et al [37] 15 FD Chitkara et al [38] Gastric emptying scintigraphy 57 FD Chitkara et al [76] 30 FD Friesen et al [77] Gastric Emptying ultrasound 41 FD Devanarayana et al [78] 42 FD Boccia et al [79] Accommodation ultrasound 20 RAP Olafsdottir et al [94] 20 RAP Olafsdottir et al [95] 20 non-ulcer dyspepsia Cucchiara et al [96] SPECT 15 FD Chitkara et al [38] Electrogastrogram 30 FD Friesen et al [77] 15 FD Chen et al [106] 7 non-ulcer dyspepsia Di Lorenzo et al [114] Antroduodenal manometry 11 non-ulcer dyspepsia Cucchiara et al [109] 34 non-ulcer dyspepsia Di Lorenzo et al [110] 7 non-ulcer dyspepsia Di Lorenzo et al [114] Wireless motility capsule 22 mixed upper GI symptoms Green et al [118] [138] Citalopram 25 RAP Campo et al [140] Famotidine 25 RAP with dyspepsia See et al [148] Omeprazole 169 FD Dehghani et al [149] Cisapride 10 non-ulcer dyspepsia Riezzo et al [154] Erythromycin 7 FD Cucchiara et al [172] Cyproheptadine 44 FD Rodriguez et al [187] Peppermint oil 42 IBS Kline et al [191] Gut-directed hypnotherapy 52 FAP or IBS Vlieger et al [200] 34 ...…”