The Intragastric Pressure Measurement: A Novel Method to Assess Gastric Accommodation in Functional Dyspepsia Children.

Impaired gastric accommodation (GA) is proposed as a main pathophysiological mechanism for functional dyspepsia (FD). At present, the gastric barostat is the gold standard to measure GA. Hence, this procedure is very invasive and it might alter gastric physiology. Recently, we proposed the measurement of intragastric pressure (IGP) by means of high resolution manometry during nutrient intake as a potential alternative for assessing GA in adults. Objectives: Our aim was first to study the feasibility of the IGP measurement with nutrient tolerance in children with FD and second to compare these results with young healthy adults. Methods: A HRM probe and a feeding tube were positioned in the proximal stomach. The IGP was measured before and during intragastric infusion of a nutrient drink (ND, 300 Kcal, 60 ml/min). Subjects were asked to score their satiation and epigastric symptoms. The test ended when the subjects scored maximal satiation. Results: 15 healthy subjects (HVs, 21.7 +/- 4.7 years, 21.1 +/- 0.3 kg.m2) and 17 FD patients (14.4 +/- 0.7 years, 19.6 +/- 0.7 kg.m2) participated. FD patients suffered mainly from postprandial fullness (86%), epigastric pain (71%) and bloating (62%). In both groups, intragastric infusion of ND induced a drop in IGP (AAC FD: -15.5 +/- 3.5 mmHg vs. HVs: -18.0 +/- 8.7 mmHg; p = 0.57). Patients showed impaired nutrient tolerance compared to HVs (587.6 +/- 80.2 Kcal vs. 936 +/- 66.2 Kcal; p = 0.003). All patients and HVs tolerated the catheters and could finalize the study. Conclusion: The measurement of IGP during intragastric nutrient drink infusion was well tolerated in children. Nutrient tolerance was reduced in FD children compared to healthy subjects. In the future, this might be a useful tool to assess GA accommodation and nutrient tolerance in children. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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