Notices

Abstract

The water load test seems to be a poor diagnostic test for functional dyspepsia because of poor sensitivity. However, future research should examine whether the water load test is identifying a subset of children with functional dyspepsia experiencing a specific mechanosensory dysfunction and whether the water load test can predict clinical response to specific therapeutic interventions.

The Effect of a Meal and Water Loading on Heart Rate Variability in Children with Functional Dyspepsia

“…In contrast to an earlier report by our group, the water load volume did not differ between FD patients and controls in this study [22]. In the previous report, FD patients as a group had significantly lower water load volumes as compared to controls [22].…”

“…In the previous report, FD patients as a group had significantly lower water load volumes as compared to controls [22]. However, there was considerable variation in volumes within the FD patients and water load volume had a low sensitivity in identifying patients with FD.…”

“…It is possible that this altered response resulted from previous medications; however, all medications were held on the day of evaluation, making it unlikely to have been an acute medication effect. In our study, we chose to use the rapid water loading method because this has been characterized in control children and we have previously demonstrated differences in water loading between FD patients and controls as a group utilizing this method [19,22]. In contrast to the solid meal, the autonomic response to water loading did not differ between FD patients and controls with the exception of a lower IC in FD in both the pre-and post-water loading periods.…”

“…The second method, known as rapid water loading, involves the subject drinking water ad libitum over a 3-5 min period until full [19,20]. Water volumes consumed during the water load test have been shown to differ between patients with FD and healthy controls in both adults and children [21,22].…”

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

“…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 ...…”