Plasma ghrelin and liquid gastric emptying in children with functional dyspepsia consistent with post‐prandial distress syndrome

Hijaz, Nadia; Friesen, Craig A.; Schurman, Jennifer Verrill; Pearce, Robin E.; Abdel‐Rahman, Susan M.

doi:10.1111/nmo.12591

Cited by 9 publications

(8 citation statements)

References 31 publications

(80 reference statements)

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“…110 Gastric accommodation is defined by the ability of the stomach to distend appropriately during a meal with an increase in gastric volume in the absence of increased gastric pressure. Gastric motility can be explored by a number of different methods (sodium acetate breath tests, 111 gastric emptying scintigraphy, 112 or electrogastrography 113 for example) and can be compared in FD and control patients in the pediatric and adult populations. Studies have shown delayed gastric emptying, 111,112 antral hypomotility, 113 and a negative correlation between gastric emptying rate and severity of abdominal pain 114 among dyspeptic patients.…”

Section: Functional Dyspepsiamentioning

confidence: 99%

“…Gastric motility can be explored by a number of different methods (sodium acetate breath tests, 111 gastric emptying scintigraphy, 112 or electrogastrography 113 for example) and can be compared in FD and control patients in the pediatric and adult populations. Studies have shown delayed gastric emptying, 111,112 antral hypomotility, 113 and a negative correlation between gastric emptying rate and severity of abdominal pain 114 among dyspeptic patients. This impaired accommodation may be linked to abnormalities of the vagal reflex and intrinsic inhibitory innervation.…”

Section: Functional Dyspepsiamentioning

confidence: 99%

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Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine

Lenglart

Caula

Moulding

et al. 2021

J Neurogastroenterol Motil

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Migraine is one of the most frequent causes of primary headache and 9% of children suffer from migraines. Most children will continue to experience migraine attacks as adults, therefore it is imperative that we have a thorough understanding of this major health issue. This article considers the so-called abdominal variants of migraine, which are more commonly seen in children rather than adults: abdominal migraine, cyclic vomiting syndrome, and infantile colic. Other functional abdominal pain disorders such as irritable bowel syndrome and functional dyspepsia have also been linked to migraine in clinical studies. The common pathophysiological root of these diseases seems to be the gut-brain axis mechanism. Abdominal variants of migraine are considered pediatric precursors of migraine whereas the functional abdominal pain disorders related to migraine seem to share a pathophysiological root with no temporarily link as for today. In this review we aim to describe the epidemiological background, the current pathophysiological theories and the relationship of each disease to migraine. This review is the first to compile abdominal variants of migraine and functional abdominal pain disorders associated with migraine and we endeavor to elucidate the broad spectrum of migraine-related episodes in children.

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Section: Functional Dyspepsiamentioning

confidence: 99%

Section: Functional Dyspepsiamentioning

confidence: 99%

Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine

Lenglart

Caula

Moulding

et al. 2021

J Neurogastroenterol Motil

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“…9 One study showed altered ghrelin physiology in children with functional dyspepsia-postprandial distress syndrome during liquid meal gastric emptying study using octanoid test. 16 Another study showed no significant difference of gastric emptying between children with gastroesophageal reflux and healthy children with wide range of gastric emptying using 99Tc-DTPA-marked milk. 17 There is limited data on gastric emptying of solids and liquids following a dual-phase test meal in dyspeptic children.…”

Section: Introductionmentioning

confidence: 97%

Liquid and solid gastric emptying and correlation with clinical characteristics in pediatric patients with dyspepsia

Santucci,

Corsiglia,

El‐Chammas

et al. 2023

Neurogastroenterology Motil

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BackgroundThere 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.MethodsCharts of dyspeptic children undergoing 4‐hour dual‐phase gastric scintigraphy were reviewed for demographics, symptoms, and comorbidities.Key ResultsIn 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 InferencesOver 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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“…Delayed liquid emptying has been demonstrated in two previous studies on youth with functional abdominal pain or FD. 14,15 One of these studies only enrolled subjects with PDS. 15 Electrogastrographic abnormalities also have been implicated in FD.…”

mentioning

confidence: 99%

“…14,15 One of these studies only enrolled subjects with PDS. 15 Electrogastrographic abnormalities also have been implicated in FD. Electrogastrography (EGG) is the technique of obtaining a cutaneous recording of gastric myoelectrical activity.…”

mentioning

confidence: 99%

Electrogastrographic and autonomic nervous system responses to solid and liquid meals in youth with functional dyspepsia

Luna

Huerta-Franco

Schurman

et al. 2020

Neurogastroenterology Motil

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Background Meal‐related symptoms are common in paediatric functional dyspepsia (FD). There are only a small number of paediatric studies assessing mechanisms for meal‐related symptoms, and these have not utilized Rome IV criteria. The aim of the current study was to assess gastric myoelectric and autonomic nervous system (ANS) responses to both liquid and solid meals in youth with Rome IV‐defined FD. Methods In healthy controls (N = 14) and youth with FD (N = 12), we recorded electrocardiograph (to assess heart rate variability; HRV) and electrogastrograph (EGG) signals before and after two test meals, one liquid and one solid. EGG parameters and HRV were assessed for the entire pre‐ and postprandial periods and in short time intervals. Additionally, liquid gastric emptying was assessed utilizing a 13C‐acetate breath test. Key Results During the EGG, the dominant power increased with both meals in controls but not patients with FD. During HRV assessment, the low frequency to high frequency ratio was higher after the liquid meal in controls, despite being similar preprandial, as compared to patients with FD. In controls, both standard deviation of normal to normal waves (SDNN) and root mean square of successive ECG R peaks (R‐R interval) differences (rMSSD) increased after the liquid meal (but not after the solid meal) in controls but not patients with FD. Conclusions and Inferences Youth with Rome IV‐defined FD lacks the normal postprandial EGG dominant power response or autonomic nervous system response following a liquid meal. The latter appears to indicate a lack of ANS flexibility.

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Plasma ghrelin and liquid gastric emptying in children with functional dyspepsia consistent with post‐prandial distress syndrome

Abstract: FD-PDS in children is associated with lower fasting and maximum AG concentrations, and dampened AG flux. These data suggest a possible role for altered ghrelin physiology in the pathogenesis of PDS.

Cited by 9 publications

References 31 publications

Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine

Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine

Liquid and solid gastric emptying and correlation with clinical characteristics in pediatric patients with dyspepsia

Electrogastrographic and autonomic nervous system responses to solid and liquid meals in youth with functional dyspepsia

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