Dyspeptic symptoms in children: the result of a constipation-induced cologastric brake?
OBJECTIVE
Patients with constipation frequently complain of dyspeptic symptoms that may be explained by reflex inhibition of upper-gastrointestinal motor activity by colonic stimuli. We sought to evaluate the following: (1) the prevalence of functional constipation (FC) and gastric emptying characteristics in children with functional dyspepsia (FD), and (2) the efficacy of osmotic laxatives on constipation, dyspeptic symptoms, and gastric motility.


METHODS
We recruited 42 children (males/females, 22/20; mean age, 80.5 mo) affected by FD (Rome II criteria). All subjects underwent ultrasonographic measurement of the total gastric emptying time (TGEt) at baseline (T0) and after 3 months (T3). Children's bowel habits and the dyspeptic symptomatic score were evaluated at entry and after 1 (T1), 2 (T2), and 3(T3) months. Constipated patients were treated with osmotic laxatives for 3 months. Dyspeptic children without constipation represented the comparison group.


RESULTS
FC was present in 28 of 42 (66.6%) patients. Constipated dyspeptic children had significantly more prolonged TGEt than subjects without constipation (median value [interquartile range], 180 (50) vs 150 (28) min, respectively; P = .004). Patients on osmotic laxatives had a significant decrease in TGEt at 3 months (P < .001). The median dyspeptic symptomatic score as well as the number and consistency of evacuations per week significantly improved at T1 in comparison with T0 and even more at T2 and T3 (P < .001, for each).


CONCLUSIONS
In our study group, the majority of children with FD were affected by FC associated with delayed gastric emptying. Normalization of bowel habit may improve gastric emptying as well as dyspeptic symptoms.
Boccia
Gabriella
G
Department of Pediatrics, University Federico II, Naples, Italy.
Buonavolontà
Roberta
R
Coccorullo
Paola
P
Manguso
Francesco
F
Fuiano
Laura
L
Staiano
Annamaria
A
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003248:Constipation / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004415:Dyspepsia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000187:drug effects / Q000502:physiology*; D005769:Gastrointestinal Motility / Q000187:drug effects / Q000502:physiology*; D005772:Gastrointestinal Transit; D006801:Humans; D054368:Laxatives / Q000008:administration & dosage*; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D054368:Laxatives