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

Objectives To determine whether gastrointestinal (GI) symptoms (abdominal pain, nonpain GI symptoms, nausea) and/or psychosocial distress differ between children with/without gastroparesis and whether the severity of GI symptoms and/or psychosocial distress is related to the degree of gastroparesis....

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Published in:The Journal of pediatrics 2014-07, Vol.165 (1), p.85-91.e1
Main Authors: Wong, Gregory K., MD, Shulman, Robert J., MD, Malaty, Hoda M., MD, MPH, PhD, Czyzewski, Danita, PhD, Seghers, Victor J., MD, Thompson, Deborah, PhD, Chumpitazi, Bruno P., MD, MPH
Format: Article
Language:English
Subjects:
Abdominal Pain - diagnosis
Abdominal Pain - physiopathology
Adolescent
Child
Female
Gastric Emptying - physiology
Gastroparesis - diagnosis
Gastroparesis - diagnostic imaging
Gastroparesis - physiopathology
Humans
Male
Nausea - diagnosis
Nausea - physiopathology
Pediatrics
Radionuclide Imaging
Severity of Illness Index
Stress, Psychological - diagnosis
Stress, Psychological - physiopathology
Surveys and Questionnaires
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Summary:Objectives To determine whether gastrointestinal (GI) symptoms (abdominal pain, nonpain GI symptoms, nausea) and/or psychosocial distress differ between children with/without gastroparesis and whether the severity of GI symptoms and/or psychosocial distress is related to the degree of gastroparesis. Study design Children aged 7-18 years (N = 100; 63 female patients) undergoing a 4-hour gastric emptying scintigraphy study completed questionnaires evaluating GI symptoms, anxiety, and somatization for this prospective study. Spearman correlation, Mann-Whitney, t -test, and χ2 tests were used as appropriate for statistical analysis. Results Children with gastroparesis (n = 25) were younger than those with normal emptying (12.6 ± 3.5 vs 14.3 ± 2.6 years, P  = .01). Because questionnaire responses from 7- to 10-year-old children were inconsistent, only patient-reported symptoms from 11- to 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 hours was related inversely to vomiting ( r  = −0.506, P  = .038), nausea ( r  = −0.536, P  = .019), difficulty finishing a meal ( r  = −0.582, P  = .014), and Children's Somatization Inventory score ( r  = −0.544, P  = .024) and positively correlated with frequency of waking from sleep with symptoms ( r  = 0.551, P  = .022). Conclusions The severity of GI symptoms and psychosocial distress do not differ between children with/without gastroparesis who are undergoing gastric emptying scintigraphy. 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.
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2014.02.063