title: Ultrasonographic assessment of liquid gastric emptying and antral motility according to the subtypes of irritable bowel syndrome in children.
abstract: OBJECTIVE
  Gastric motor abnormalities have been reported in adults with irritable bowel syndrome (IBS), commonly in constipation-predominant IBS (IBS-C); however, such studies are uncommon in children. Furthermore, differences of gastric motility have not been studied in children with different IBS subtypes.
  
  
  METHODS
  Seventy-six children (33 [43%] boys, age 4-14 years, mean 7.9 years, SD 3.0 years) fulfilling Rome III criteria for IBS and 20 healthy controls (8 [40%] boys, age 4-14 years, mean 8.4 years, SD 3.0 years) were recruited (diarrhea-predominant IBS=21, IBS-C=31, mixed IBS=19, and unsubtyped IBS=5). Liquid gastric emptying rate (GER) and antral motility were assessed using an ultrasound method.
  
  
  RESULTS
  Average GER (43.8% vs 66.2% in controls), amplitude of antral contractions (56.4% vs 89%), and antral motility index (5.1 vs 8.3) were lower and fasting antral area (1.6 vs 0.6) was higher in patients with IBS (P<0.0001). Frequency of antral contractions F (8.9 vs 9.3) did not show a significant difference. Patients exposed to stressful events had a significantly lower GER, compared to those not exposed to such events (P=0.03). Gastric motility parameters had no correlation with severity of symptoms. GER (42.6%, 46.3%, 39.6%), fasting antral area (1.4 cm², 1.8 cm², 1.8 cm²), amplitude of antral contractions (53%, 58.9%, 51.8%), frequency of antral contractions (8.7, 8.9, 9.2), and antral motility index (4.7, 5.3, 4.8) were not different among diarrhea-predominant IBS, IBS-C, and mixed IBS (P>0.05).
  
  
  CONCLUSIONS
  GER and antral motility parameters were significantly impaired in children with IBS compared with controls. GER and antral motility parameters were not different between IBS subtypes.
authors.affiliation: Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama, Sri Lanka. niranga1230@lycos.com
authors.forename: Niranga M
authors.initials: NM
authors.lastname: Devanarayana
authors.forename: Shaman
authors.initials: S
authors.lastname: Rajindrajith
authors.forename: Chandrika
authors.initials: C
authors.lastname: Bandara
authors.forename: Gayani
authors.initials: G
authors.lastname: Shashiprabha
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003248:Constipation / Q000209:etiology*; D003967:Diarrhea / Q000209:etiology*; D005260:Female; D005746:Gastric Emptying; D005753:Gastric Mucosa / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D005769:Gastrointestinal Motility; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D010528:Peristalsis; D012720:Severity of Illness Index; D013270:Stomach / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D013312:Stress, Physiological; D013315:Stress, Psychological / Q000150:complications; D014463:Ultrasonography