Dyspeptic Symptoms in Children: The Result of a Constipation-Induced Cologastric Brake?

Boccia, Gabriella; Buonavolontà, Roberta; Coccorullo, P.; Manguso, Francesco; Fuiano, Laura; Staiano, Annamaria

doi:10.1016/j.cgh.2008.01.001

Cited by 45 publications

(40 citation statements)

References 35 publications

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“…Authors concluded that chronic constipation may retard growth status in children, and long-term medications may be beneficial for growth. Another recent study conducted by Boccia et al [5] in 2008 looked to correlate chronic functional constipation with functional dyspepsia and determine the efficacy of osmotic laxatives as treatment. This study demonstrated that the majority of patients with functional dyspepsia were also diagnosed with functional constipation and that improving bowel habits improves dyspeptic symptoms.…”

Section: Introductionmentioning

confidence: 98%

Recent advances in chronic constipation

Walia

Mahajan

Steffen

2009

Current Opinion in Pediatrics

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The recent literature on chronic constipation has provided some new knowledge providing a more evidence-based approach to treating these patients. We review the scope of this problem and the estimated cost of treating constipation. The availability of long-term outcome data enhances our understanding of the natural history of this problem. Newer pharmacological approaches provide optimism for treatment for this common problem.

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Section: Introductionmentioning

confidence: 98%

Recent advances in chronic constipation

Walia

Mahajan

Steffen

2009

Current Opinion in Pediatrics

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“…These symptoms are related to the impaired gastrointestinal myoelectrical activity, delayed gastric emptying, and slow small bowel transit [1][2][3][4][5][6][7]. It is reported that abnormalities of upper gut motility occur frequently in 70 % of the patients with slow-transit constipation [1].…”

Section: Introductionmentioning

confidence: 99%

Inhibitory Effects and Sympathetic Mechanisms of Distension in the Distal Organs on Small Bowel Motility and Slow Waves in Canine

Song

Yin

Chen

2015

Cell Biochem Biophys

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Rectal distension (RD) is known to induce intestinal dysmotility. Few studies were performed to compare effects of RD, colon distension (CD) and duodenal distension (DD) on small bowel motility. This study aimed to investigate effects and underlying mechanisms of distensions in these regions on intestinal motility and slow waves. Eight dogs chronically implanted with a duodenal fistula, a proximal colon fistula, and intestinal serosal electrodes were studied in six sessions: control, RD, CD, DD, RD + guanethidine, and CD + guanethidine. Postprandial intestinal contractions and slow waves were recorded for the assessment of intestinal motility. The electrocardiogram was recorded for the assessment of autonomic functions. (1) Isobaric RD and CD suppressed intestinal contractions (contractile index: 6.0 ± 0.4 with RD vs. 9.9 ± 0.9 at baseline, P = 0.001, 5.3 ± 0.2 with CD vs. 7.7 ± 0.8 at baseline, P = 0.008). Guanethidine at 3 mg/kg iv was able to partially block the effects. (2) RD and CD reduced the percentage of normal intestinal slow waves from 92.1 ± 2.8 to 64.2 ± 3.4 % (P < 0.001) and from 90 ± 2.7 to 69.2 ± 3.7 % (P = 0.01), respectively. Guanethidine could eliminate these inhibitory effects. (3) DD did not induce any changes in small intestinal contractions and slow waves (P > 0.05). (4) The spectral analysis of the heart rate variability showed that both RD and CD increased sympathetic activity (LF) and reduced vagal activity (HF) (P < 0.05). Isobaric RD and CD could inhibit postprandial intestinal motility and impair intestinal slow waves, which were mediated via the sympathetic pathway. However, DD at a site proximal to the measurement site did not seem to impair small intestinal contractions or slow waves.

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“…Gastric emptying appears to have no relationship to satiety in children [37] . Delays in gastric emptying may also be affected by concurrence of constipation in pediatric dyspepsia [79] . FD patients with constipation had longer gastric emptying times than FD patients without constipation, and treatment with lactulose over 3 mo resolved the difference.…”

Section: Gastric Emptyingmentioning

confidence: 99%

“…Although the water load test may not be useful for identification of pediatric FD due to suboptimal sensitivity, children diagnosed with FD often have abnormal test results [36] . In a controlled study by Schurman et al [36] , 68 pediatric patients with FGIDs and 26 healthy children completed the Behavioral Assessment Scale for Children- [36] 28 FD Hoffman et al [37] 15 FD Chitkara et al [38] 101 CAP Anderson et al [39] Gastric barostat 16 FD Hoffman et al [47] 10 RAP, 10 IBS Di Lorenzo et al [48] Electromechanical function Gastric emptying breath test 28 FD Hoffman et al [37] 15 FD Chitkara et al [38] Gastric emptying scintigraphy 57 FD Chitkara et al [76] 30 FD Friesen et al [77] Gastric Emptying ultrasound 41 FD Devanarayana et al [78] 42 FD Boccia et al [79] Accommodation ultrasound 20 RAP Olafsdottir et al [94] 20 RAP Olafsdottir et al [95] 20 non-ulcer dyspepsia Cucchiara et al [96] SPECT 15 FD Chitkara et al [38] Electrogastrogram 30 FD Friesen et al [77] 15 FD Chen et al [106] 7 non-ulcer dyspepsia Di Lorenzo et al [114] Antroduodenal manometry 11 non-ulcer dyspepsia Cucchiara et al [109] 34 non-ulcer dyspepsia Di Lorenzo et al [110] 7 non-ulcer dyspepsia Di Lorenzo et al [114] Wireless motility capsule 22 mixed upper GI symptoms Green et al [118] [138] Citalopram 25 RAP Campo et al [140] Famotidine 25 RAP with dyspepsia See et al [148] Omeprazole 169 FD Dehghani et al [149] Cisapride 10 non-ulcer dyspepsia Riezzo et al [154] Erythromycin 7 FD Cucchiara et al [172] Cyproheptadine 44 FD Rodriguez et al [187] Peppermint oil 42 IBS Kline et al [191] Gut-directed hypnotherapy 52 FAP or IBS Vlieger et al [200] 34 ...…”

Section: Water Load Testmentioning

confidence: 99%

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

Rosen

Cocjin

Schurman

et al. 2014

WJGPT

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Functional gastrointestinal disorders (FGID) are common clinical syndromes diagnosed in the absence of biochemical, structural, or metabolic abnormalities. They account for significant morbidity and health care expenditures and are identifiable across variable age, geography, and culture. Etiology of abdominal pain associated FGIDs, including functional dyspepsia (FD), remains incompletely understood, but growing evidence implicates the importance of visceral hypersensitivity and electromechanical dysfunction. This manuscript explores data supporting the role of visceral hypersensitivity and electromechanical dysfunction in FD, with focus on pediatric data when available, and provides a summary of potential therapeutic targets. Visceral sensitivity and intestinal electromechanical function both are demonstrated to be altered in some FD patients and are potential targets for treatment. Limited studies in pediatric FD are available, but available evidence supports adult data that targeting visceral hypersensitivity and electromechanical dysfunction is warranted, particularly in the context of the biopsychosocial model. Future studies in pediatrics are needed to determine optimal therapy and appropriate patient application.Rosen JM, Cocjin JT, Schurman JV, Colombo JM, Friesen CA. Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia. World

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Dyspeptic Symptoms in Children: The Result of a Constipation-Induced Cologastric Brake?

Cited by 45 publications

References 35 publications

Recent advances in chronic constipation

Recent advances in chronic constipation

Inhibitory Effects and Sympathetic Mechanisms of Distension in the Distal Organs on Small Bowel Motility and Slow Waves in Canine

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

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