Gastric motility in children with aerophagia.

Abstract

BACKGROUND/AIMS: Aerophagia is a functional gastrointestinal disease characterized by repetitive air swallowing, abdominal distension, belching and flatulence. When severe, it can lead to pneumoperitonium, volvulus and intestinal perforation. Gastric motility in children with aerophagia has never been studied, and our main objective was to assess it. METHODS: All children referred to the Gastroenterology Research Laboratory, Faculty of Medicine, University of Kelaniya, Sri Lanka, from 1st January 2007 to 31, December 2011 were screened and those fulfilling Rome III criteria for aerophagia were recruited. None had clinical or laboratory evidence of organic diseases. An age and sex compatible group of healthy children were selected as controls. Liquid gastric emptying rate (LGER) and antral motility parameters were assessed using a previously reported ultrasound method. RESULTS: A total of 18 children with aerophagia (9 [50.0%] males, 4-14 years, mean 8.0 years, SD 2.9 years) and 20 controls (8 [40%] males, 4-14 years, mean 8.4 years, SD 3.0 years) were recruited. Average LGER (44.2% vs. 66.2% in controls), amplitude of antral contractions (49.2% vs. 89.0%), frequency of contractions per 3 mm (8.5 vs. 9.3) and antral motility index (4.2 vs. 8.3) were significantly lower in patients with aerophagia compared to controls (P < 0.05). GER in children with aerophagia exposed to stressful life events was 35.4% compared to 53.0% in those not exposed to such events (P = 0.01). CONCLUSIONS: LGER and antral motility parameters were significantly impaired in patients with aerophagia. However, no significant association observed between gastric motility and symptoms. Affected children exposed to emotional stress had a lower LGER than those not exposed to such events.