Gastric emptying and antral motility parameters in children with functional dyspepsia: Association with symptom severity

Background and Aims Functional dyspepsia (FD) is an important gastrointestinal problem with obscure etiology. Abnormal gastric motility is suggested as a possible pathophysiological mechanism for symptoms. The main objective of this study was to assess gastric motility in Sri Lankan children with FD. Methods Forty-one children (19 [46.3%] males, age 4-14 years, mean 7.5 years, SD 2.6 years) referred to the Gastroenterology Research Laboratory, Faculty of Medicine, University of Kelaniya, from January 2007 to December 2011, were screened. Those fulfilling Rome III criteria for FD were recruited. None had clinical or laboratory evidence of organic disorders. Twenty healthy children were recruited as controls (eight [40%] males, age 4-14 years, mean 8.4 years, SD 3.0 years). Liquid gastric emptying rate (GE) and antral motility parameters were assessed using an ultrasound-based method. Results Average GE (45.6% vs 66.2% in controls), amplitude of antral contractions (58.2% vs 89.0%) and antral motility index (5.1 vs 8.3) were lower and fasting antral area (1.5cm2 vs 0.6cm2) was higher in patients with FD (P<0.01). Frequency of antral contractions (8.8 vs 9.3) did not show a significant difference (P=0.07). Scores obtained for severity of abdominal pain negatively correlated with GE (r=-0.35, P=0.025). Children with FD, exposed to stressful events had higher fasting antral area (1.9cm2) than those not exposed to stress (1.0cm2) (P=0.02). Conclusions GE and antral motility parameters were significantly impaired in children with FD compared with controls. GE negatively correlated with severity of symptoms. This study points to disturbances in gastric motility as an etiological factor for FD.