title: Relationship of gastrointestinal symptoms and psychosocial distress to gastric retention in children.
abstract: OBJECTIVE
  To determine whether gastrointestinal (GI) symptoms (abdominal pain, nonpain GI symptoms, nausea) and/or psychosocial distress differ between children with/without gastroparesis and whether the severity of GI symptoms and/or psychosocial distress is related to the degree of gastroparesis.
  
  
  METHODS
  Children aged 7-18 years (N = 100; 63 female patients) undergoing a 4-hour gastric emptying scintigraphy study completed questionnaires evaluating GI symptoms, anxiety, and somatization for this prospective study. Spearman correlation, Mann-Whitney, t-test, and χ(2) tests were used as appropriate for statistical analysis.
  
  
  RESULTS
  Children with gastroparesis (n = 25) were younger than those with normal emptying (12.6 ± 3.5 vs 14.3 ± 2.6 years, P = .01). Because questionnaire responses from 7- to 10-year-old children were inconsistent, only patient-reported symptoms from 11- to 18-year-olds were used. Within this older group (n = 83), children with gastroparesis (n = 17) did not differ from children with normal emptying in severity of GI symptoms or psychosocial distress. In children with gastroparesis, gastric retention at 4 hours was related inversely to vomiting (r = -0.506, P = .038), nausea (r = -0.536, P = .019), difficulty finishing a meal (r = -0.582, P = .014), and Children's Somatization Inventory score (r = -0.544, P = .024) and positively correlated with frequency of waking from sleep with symptoms (r = 0.551, P = .022).
  
  
  CONCLUSIONS
  The severity of GI symptoms and psychosocial distress do not differ between children with/without gastroparesis who are undergoing gastric emptying scintigraphy. In those with gastroparesis, gastric retention appears to be inversely related to dyspeptic symptoms and somatization and positively related to waking from sleep with symptoms.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX.
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Wong
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX; ARS/USDA Children's Nutrition Research Center, Houston, TX.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Shulman
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
authors.forename: Hoda M
authors.initials: HM
authors.lastname: Malaty
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX.
authors.forename: Danita
authors.initials: D
authors.lastname: Czyzewski
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX.
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Seghers
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX; ARS/USDA Children's Nutrition Research Center, Houston, TX.
authors.forename: Deborah
authors.initials: D
authors.lastname: Thompson
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX. Electronic address: chumpita@bcm.edu.
authors.forename: Bruno P
authors.initials: BP
authors.lastname: Chumpitazi
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000503:physiopathology*; D000293:Adolescent; D002648:Child; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009325:Nausea / Q000175:diagnosis / Q000503:physiopathology*; D011877:Radionuclide Imaging; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis / Q000503:physiopathology*; D011795:Surveys and Questionnaires
references.citation: Clin Gastroenterol Hepatol. 2011 Jul;9(7):567-76.e1-4
references.pmid: 21397732
references.citation: Neurogastroenterol Motil. 2006 Apr;18(4):263-83
references.pmid: 16553582
references.citation: Dig Dis Sci. 1998 Nov;43(11):2398-404
references.pmid: 9824125
references.citation: Gastroenterology. 2003 May;124(5):1220-9
references.pmid: 12730863
references.citation: J Pediatr. 1997 Nov;131(5):751-4
references.pmid: 9403659
references.citation: Gastroenterology. 2011 Jan;140(1):101-15
references.pmid: 20965184
references.citation: Gastroenterology. 2009 Apr;136(4):1225-33
references.pmid: 19249393
references.citation: Gut. 1994 Mar;35(3):327-32
references.pmid: 8150341
references.citation: Gastroenterology. 1998 Sep;115(3):747-62
references.pmid: 9721173
references.citation: Psychosom Med. 2007 Jun;69(5):455-63
references.pmid: 17556644
references.citation: Gastroenterology. 1996 Apr;110(4):1036-42
references.pmid: 8612991
references.citation: Am J Gastroenterol. 2003 Apr;98(4):783-8
references.pmid: 12738456
references.citation: Am J Physiol. 1998 Sep;275(3):G381-6
references.pmid: 9724247
references.citation: Pediatrics. 2011 Jun;127(6):e1542-9
references.pmid: 21624874
references.citation: Aliment Pharmacol Ther. 2011 Feb;33(3):403-11
references.pmid: 21138454
references.citation: Neurogastroenterol Motil. 2004 Apr;16 Suppl 1:137-42
references.pmid: 15066020
references.citation: Pediatrics. 2005 Feb;115(2):e210-5
references.pmid: 15687428
references.citation: Clin Gastroenterol Hepatol. 2003 Jul;1(4):264-72
references.pmid: 15017667
references.citation: Am J Gastroenterol. 2010 Nov;105(11):2357-67
references.pmid: 20588262
references.citation: Diabetes Care. 2003 May;26(5):1553-79
references.pmid: 12716821
references.citation: Gastroenterol Hepatol (N Y). 2008 Feb;4(2):140-8
references.pmid: 21904491
references.citation: Diabetologia. 1996 Jul;39(7):823-30
references.pmid: 8817107
references.citation: Clin Gastroenterol Hepatol. 2010 Aug;8(8):676-81
references.pmid: 20472097
references.citation: Digestion. 2008;78(2-3):144-51
references.pmid: 19033686
references.citation: J Pediatr Gastroenterol Nutr. 2013 Apr;56(4):439-42
references.pmid: 23111764
references.citation: Am J Gastroenterol. 2008 Mar;103(3):753-63
references.pmid: 18028513
references.citation: J Pediatr Psychol. 2009 May;34(4):430-40
references.pmid: 18782857
references.citation: Neurogastroenterol Motil. 2013 May;25(5):427-38, e300-1
references.pmid: 23414452
references.citation: Gastroenterology. 2005 Nov;129(5):1437-44
references.pmid: 16285945
references.citation: Diabetes. 2000 Oct;49(10):1731-9
references.pmid: 11016458
references.citation: Am J Gastroenterol. 2000 Jun;95(6):1456-62
references.pmid: 10894578
references.citation: Gut. 2008 Dec;57(12):1666-73
references.pmid: 18625692