Chronic Gastritis Is Not Associated with Gastric Dysrhythmia or Delayed Solid Emptying in Children with Dyspepsia

Abstract

To determine if chronic gastritis (CG) is associated with gastric dysrhythmia or delayed solid emptying in children with dyspepsia, 22 patients (7-15 years of age) with dyspepsia and normal gross endoscopies were studied. Antral biopsies were evaluated for chronic gastritis, and immunohistology was performed to determine densities of CD3+, CD20+, CD25+, and tryptase-positive cells. Electrogastrography (EGG) and gastric scintiscan evaluation were performed within 2-7 days of endoscopy. CG and increased immune cell densities were not associated with altered gastric emptying. Mean CD3+ cell counts were positively correlated with the percentage normal slow waves, and patients with a normal EGG had increased CD3+ cell density. In children with dyspepsia, chronic antral inflammation in the setting of a normal gross endoscopy is not associated with EGG abnormalities or delayed solid emptying. Chronic gastritis and gastric dysrhythmia may simply be two separate and distinct mechanisms resulting in the clinical entity of dyspepsia.

Antral Inflammatory Cells, Gastric Emptying, and Electrogastrography in Pediatric Functional Dyspepsia

“…These include delayed gastric emptying, impaired accommodation to a meal, hypersensitivity to gastric distension, altered antroduodenal motility, and abnormalities of gastric electrical rhythm [4]. In children with functional dyspepsia, 47-68% have delayed gastric emptying and 50-64% have abnormalities of gastric rhythm [12][13][14][15][16]. Hypersensitivity to distension and impaired accommodation have also been demonstrated in pediatric functional dyspepsia [15,17].…”

Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia

“…122 by 3 or more bouts of pain severe enough to interfere with activities and occurring over at least a 3 mo period. Children with a wide variety of clinical presentations and etiologies were included under the single entity of RAP.…”

“…However, this effect appears to require specific inflammatory pathways. For example, EGG abnormalities in children and adolescents with FD are independent of chronic gastritis, but associated with antral mast cell and eosinophil density [121,122] . Likewise, in children with FD, increased antral mast cell density is associated with slower gastric emptying [121] .…”

Dyspepsia in childhood and adolescence: Insights and treatment considerations

“…Gastric motor and/or myoelectric abnormalities have been shown in up to 77% of pediatric patients with FD [12]. The role of Helicobacter pylori infection [13] and food allergy in FD continues to be debated [14].…”