Relationship of Gastrointestinal Symptoms and Psychosocial Distress to Gastric Retention in Children

Abstract

Objectives To determine whether gastrointestinal (GI) symptoms (abdominal pain, non-pain GI symptoms, nausea) and/or psychosocial distress differ between children with/without gastroparesis, and secondarily whether the severity of GI symptoms and/or psychosocial distress are related to the degree of gastroparesis. Study design Children 7 – 18 yr. of age (n=100; 63 female) undergoing a 4-hour gastric emptying scintigraphy (GES) study completed questionnaires evaluating GI symptoms, anxiety, and somatization for this prospective study. Spearman correlation, Mann-Whitney, t-test, and chi-square tests were utilized as appropriate for statistical analysis. Results Children with gastroparesis (n=25) were younger than those with normal emptying (12.6 ± 3.5 yr. vs. 14.3 ± 2.6, P=0.01). Because questionnaire responses from 7–10-year-old children were inconsistent, only patient-reported symptoms from 11–18-year-olds were used. Within this older group (n=83), children with gastroparesis (n=17) did not differ from children with normal emptying in severity of GI symptoms or psychosocial distress. In children with gastroparesis, gastric retention at 4 hr was related inversely to vomiting (r=−0.506, P=0.038), nausea (r=−0.536, P=0.019), difficulty finishing a meal (r=−0.582, P=0.014), and CSI-24 score (r=−0.544, P=0.024) and positively correlated with frequency of waking from sleep with symptoms (r=0.551, P=0.022). Conclusions The severity of GI symptoms and psychosocial distress do not differ between children with/without gastroparesis who are undergoing GES. In those with gastroparesis, gastric retention appears to be inversely related to dyspeptic symptoms and somatization, and positively related to waking from sleep with symptoms.

Gastroparesis

“…Symptoms evaluated in 83 patients with age more than 10 did not differ between those with normal and delayed emptying, and both groups had similar anxiety and somatization ratings. In the subgroup with delayed emptying, gastric retention was inversely correlated to severity of vomiting, nausea, difficulty to finish a normal sized meal, and somatization [6]. These findings confirm that symptoms and psychosocial distress cannot predict the presence of gastroparesis, and the majority of children with dyspeptic symptoms have normal gastric emptying.…”

“…In a study of symptom pattern and psychosocial distress in 100 children referred for gastric emptying scintigraphy, gastroparesis was diagnosed in 25 based on a scintigraphic gastric retention value more than 10% at 4 h (abnormal for adults) [6,7]. Symptoms evaluated in 83 patients with age more than 10 did not differ between those with normal and delayed emptying, and both groups had similar anxiety and somatization ratings.…”

Nausea in Children With Functional Abdominal Pain Predicts Poor Health Outcomes in Young Adulthood

“…Gastroparesis symptoms may be non-specific in children and can include nausea and abdominal pain 27,28 . The prevalence of gastroparesis in children is unknown but based on the low adult prevalence of 0.04–4% 29 , it is likely that the majority of our cohort would not have had gastroparesis.…”

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

“…Further, the symptom severity of functional GI disorders or the degree of psychosocial stressors does not necessarily correlate with delayed gastric emptying and any relationship among these remains unclear. 36,54,55,[57][58][59][60] Two studies were unable to find statistically significant correlation between functional dyspepsia and delayed gastric emptying. 17,60 Biliary dyskinesia with concomitant delayed gastric emptying has been associated with poorer outcomes than biliary dyskinesia alone.…”