Causal relationship between delayed gastric emptying and gastroesophageal reflux in patients with neurological impairment.

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Causal relationship between delayed gastric emptying and gastroesophageal reflux in patients with neurological impairment.

Pediatr Surg Int. 2015 Oct;31(10):917-23

Authors: Kawahara H, Tazuke Y, Soh H, Usui N, Fukuzawa M

Abstract
PURPOSE: To investigate the causal relationship between delayed gastric emptying (DGE) and gastroesophageal reflux (GER) in patients with neurological impairment (NI).
METHODS: Subjects included 30 NI patients (age, 1-34 years; median, 6 years). Combined multichannel intraluminal impedance-pH (MII-pH) monitoring and (13)C-breath test evaluated acid/non-acid reflux episodes (RE) and gastric emptying rates, respectively. Values are shown with medians and ranges.
RESULTS: Percentage time for esophageal pH < 4.0 (reflux index: RI) and numbers for total RE and RE > 5 min were 8.3 (0-35.7), 44 (0-129), and 5 (0-22), respectively. Total percentage time and bolus RE numbers were 1.4 (0.0-6.9) and 49 (2-159), respectively. Median bolus clearance time was 16 s (9-45). T 1/2, T lag, and GEC were 103 s (75-204), 54 s (18-97), and 3.4 (2.3-4.3), respectively. Gastric emptying rates and acid/non-acid reflux parameters were not significantly correlated, except T 1/2 correlated significantly with the numbers of RE > 5 min (p = 0.04). T 1/2 inversely correlated with bolus clearance time (p = 0.01). Reflux parameters between DGE and non-DGE patients were not significantly different, except median bolus clearance time was significantly shorter in DGE patients (p = 0.01).
CONCLUSIONS: NI patients showed a wide range of gastric emptying rates without any significant causal relationship between DGE and GER.

PMID: 26276427 [PubMed - indexed for MEDLINE]

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