Location: Children's Nutrition Research CenterTitle: Meal induced symptoms in children with dyspepsia-relationships to sex and the presence of gastroparesis
|FEBO-RODRIGUEZ, LIZ - Baylor College Of Medicine|
|CHUMPITAZI, BRUNO - Baylor College Of Medicine|
|MUSAAD, SALMA - Children'S Nutrition Research Center (CNRC)|
|SHER, ANDREW - Texas Children'S Hospital|
|SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)|
Submitted to: Journal of Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/16/2020
Publication Date: 4/1/2021
Citation: Febo-Rodriguez, L., Chumpitazi, B.P., Musaad, S., Sher, A.C., Shulman, R.J. 2021. Meal induced symptoms in children with dyspepsia-Relationships to sex and the presence of gastroparesis. Journal of Pediatrics. 231:117-123. https://doi.org/10.1016/j.jpeds.2020.12.048.
Interpretive Summary: Children with very slow stomach emptying (gastroparesis) and those with a condition called functional dyspepsia appear to have similar symptoms. However, previous studies have asked patients to recall their symptoms using a questionnaire. In this study children ate a standardized meal and while eating the meal and for 4 hours afterwards they reported any tummy symptoms they were having. The results showed that children with very slow stomach emptying reported nausea that was related to the severity of the delay in stomach emptying; this was not the case for functional dyspepsia. In children with very slow stomach emptying girls had worse symptoms than boys. Future studies are needed to further evaluate the relationship of emptying and dyspepsia.
Technical Abstract: To test the hypothesis that in children with dyspepsia, prospective symptom severity following ingestion of a meal would correlate with percent gastric retention, and those ultimately diagnosed with gastroparesis would report worse symptoms. prospective, single-center study with 104 children with dyspepsia completing a prospective dyspepsia symptom questionnaire before and after eating a standardized Tougas meal during gastric emptying scintigraphy. Main outcomes included correlation between gastric retention and symptoms and comparison of symptom severity between those with and without gastroparesis. Fifty-two children (50%) had gastroparesis (gastroparesis: 12.5 +/- 2.9 years, 65% female; nongastroparesis: 13.0 +/- 2.9 years, 60% female; all P > .05). Bloating was the only symptom significantly worse in youth with gastroparesis. For the entire cohort, bloating and fullness correlated with percent retention. However, in those with gastroparesis, only nausea correlated with retention (4 hours.; rs = 0.275, P < .05). Girls with gastroparesis had significantly worse symptoms (except satiety) when compared with boys with gastroparesis (P < .05). Overall in children, there is little difference in symptom severity between children with gastroparesis vs normal emptying based on current standards. However, girls with gastroparesis have worse symptoms vs boys with gastroparesis, underscoring a need for further studies into the role of sex in gastroparesis symptoms. In all children, both bloating and fullness correlated modestly with gastric retention, and nausea correlated in those with gastroparesis.