Neurogastroenterol Motil. 2022 Mar 7;e14334. doi: 10.1111/nmo.14334. Online ahead of print.

Ilaria Rochira 1 2, Atchariya Chanpong 1 3 4, Lorenzo Biassoni 5, Marina Easty 5, Elizabeth Morris 5 6, Efstratios Saliakellis 1, Keith Lindley 1, Nikhil Thapar 1 4 7, Anna Rybak 1, Osvaldo Borrelli 1

Author information

¹Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK.

²Department of Paediatrics, Children's Hospital, ASST Spedali Civili, University of Brescia, Brescia, Italy.

³Division of Gastroenterology and Hepatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

⁴Stem cell and Regenerative Medicine, UCL Great Ormond Street Institute of Child Health, London, UK.

⁵Nuclear Medicine Unit, Department of Radiology, Great Ormond Street Hospital for Children, London, UK.

⁶Nuclear Medicine Physics, Clinical Physics, Barts Health NHS Trust, London, UK.

⁷Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Queensland, Australia.

Abstract

Background/objectives: Gastric emptying (GE) requires precise antropyloroduodenal coordination for effective transpyloric flow, the mechanisms of which are still unclear. We aimed to correlate gastric antral function assessed by antroduodenal manometry (ADM) with GE scintigraphy (GES) for liquid feeds in children with suspected gastrointestinal dysmotility.

Methods: Children who underwent both ADM and GES over a five-year period were reviewed. ADM tracings were re-analyzed to assess antral frequency, amplitude, and motility index (MI) pre-prandially and postprandially. Transpyloric propagation (TPP) was defined as antegrade propagated antral activity preceding duodenal phase III of the migrating motor complex (MMC). TPP was defined as "poor" if occurring in <50% of all presented duodenal phases III. For GES, regions of interest over the whole stomach, fundus, and antrum were drawn to calculate GE half-time (GE-T_1/2) and retention rate (RR) in each region at 1 and 2 h.

Results: Forty-seven children (median age: 7.0 years) were included. Twenty-two had PIPO, 14 functional GI disorders, and 11 gastroparesis. Children with poor TPP had longer GE-T_1/2 (113.0 vs 66.5 min, p = 0.028), higher RR of the whole stomach and fundus at 1 h (79.5% vs 63.5%, p = 0.038; 60.0% vs 41.0%, p = 0.022, respectively) and 2 h (51.0% vs 10.5%, p = 0.005; 36.0% vs 6.5%, p = 0.004, respectively). The pre-prandial antral amplitude of contractions inversely correlated with GE-T_1/2 , RR of the whole stomach, and fundus at 2 h.

Conclusions: TPP during phase III of the MMC correlated with gastric emptying of liquid and its assessment on ADM might predict abnormalities in postprandial gastric function.