title: Impaired gastric emptying and small bowel transit in children with mitochondrial disorders.
abstract: OBJECTIVE
  The primary aim of our study was to evaluate gastric emptying (GE) and intestinal transit time (ITT) in children with mitochondrial disorders (MD), and secondarily to evaluate the effect of prokinetics in those with prolonged GE.
  
  
  METHODS
  We enrolled subjects 3 to 18 years with MD and having any of the following gastrointestinal (GI) symptoms: abdominal pain, vomiting, constipation, diarrhea, or gastroesophageal reflux. Abdominal pain was scored by visual analog pain scale (1-10). Age-appropriate diet was labeled with radioactive technetium-99 sulfur colloid and its movement tracked along the GI tract. Delayed GE based on our institutional standards was defined as half emptying time >90 minutes for a solid and >60 minutes for a semisolid meal. Prolonged ITT was defined as >4 hours for the tracer to pass from mouth to cecum. A prokinetic was instituted to those with delayed GE, and the study was repeated if possible in 4 to 8 weeks.
  
  
  RESULTS
  Of the 26 subjects, 18 (69%) had delayed GE (median GE 99 minutes) and 12 (46%) had prolonged ITT. The study was repeated in 9 subjects after administering a prokinetic for >1 month. GE normalized in only 3 subjects (median GE on treatment 128 minutes). Mean abdominal pain score, which was 4.8 (max 10) in the 9 subjects, did not improve (5.6 after prokinetic therapy).
  
  
  CONCLUSIONS
  A high prevalence of delayed GE and prolonged ITT was seen in children with MD having GI symptoms, and these abnormalities were poorly responsive to prokinetic therapy.
authors.affiliation: Department of Pediatrics, University of Texas Health Science Center at Houston Medical School, Houston, TX 77030, USA. jeetu_bhardwaj@yahoo.com
authors.forename: Jatinder
authors.initials: J
authors.lastname: Bhardwaj
authors.forename: David Q
authors.initials: DQ
authors.lastname: Wan
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Koenig
authors.forename: Yuying
authors.initials: Y
authors.lastname: Liu
authors.forename: Syed Shahrukh
authors.initials: SS
authors.lastname: Hashmi
authors.forename: Jon Marc
authors.initials: JM
authors.lastname: Rhoads
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005765:Gastrointestinal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000209:etiology; D005772:Gastrointestinal Transit / Q000187:drug effects; D018589:Gastroparesis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008928:Mitochondria; D028361:Mitochondrial Diseases / Q000150:complications*; D015995:Prevalence
chemical_list: D005765:Gastrointestinal Agents