Gallbladder motility in children with chronic functional abdominal pain (original) (raw)
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Neurogastroenterology & Motility, 2012
Background Gastric sensorymotor dysfunctions have been implicated in the pathophysiology of some functional gastrointestinal disorders, such as functional dyspepsia and irritable bowel syndrome. Therefore, we hypothesized that abnormal gastric emptying and impaired antral motility are possible underlying mechanisms of symptoms in children with functional abdominal pain (FAP). Methods Hundred and two children [37 (36.3%) males, 4-14 years, mean 7.8 years, SD 2.7 years] fulfilling Rome III criteria for FAP were recruited for this study. An age and sex compatible group of healthy children (n = 20) were selected as controls [8 (40%) males, 4-14 years, mean 8.4 years, SD 3.0 years]. Liquid gastric emptying rate (GER) and antral motility parameters (amplitude of antral contractions, frequency of antral contractions and antral motility index) were assessed using a previously reported ultrasound method. Key Results Average GER (42.1% vs 66.2% in controls), amplitude of antral contractions (56.5% vs 89%), frequency of contractions per 3 min (8.5 vs 9.3), and antral motility index (4.9 vs 8.3) were significantly lower in patients with FAP compared with controls (P < 0.01). Fasting antral area was higher in patients (1.4 vs 0.6, P < 0.0001). GER negatively correlated with the scores obtained for severity of abdominal pain (r = )0.29, P = 0.004). Conclusions & Inferences Gastric emptying rate and antral motility parameters were significantly impaired in patients with FAP and GER negatively correlated with symptom severity. These findings highlight the possible role of gastrointestinal motility abnormalities in the pathophysiology of childhood FAP.
Journal of Comprehensive Pediatrics, 2021
Introduction: Chronic abdominal pain in children is mostly functional, but in association with alarm symptoms such as recurrent vomiting, it is necessary to determine proper tests for the diagnosis of probable underlying organic problems. Case Presentation: Four patients with chronic refractory abdominal pain and nonspecific gastrointestinal symptoms presented to our tertiary pediatric center. After thorough medical and psychological investigations and hepatobiliary scintigraphy, and calculating gallbladder ejection fraction, laparoscopic cholecystectomy was performed. One year after the surgery, they were relatively symptom-free and returned to their routine life. Conclusions: Biliary tract abnormalities should be considered as a probable cause of chronic abdominal pain in children. Hepatobiliary scintigraphy can provide promising results to help to identify the underlying causes of chronic abdominal pain in association with nonspecific gastrointestinal manifestations.
Background Gastric sensorymotor dysfunctions have been implicated in the pathophysiology of some functional gastrointestinal disorders, such as functional dyspepsia and irritable bowel syndrome. Therefore, we hypothesized that abnormal gastric emptying and impaired antral motility are possible underlying mechanisms of symptoms in children with functional abdominal pain (FAP). Methods Hundred and two children [37 (36.3%) males, 4-14 years, mean 7.8 years, SD 2.7 years] fulfilling Rome III criteria for FAP were recruited for this study. An age and sex compatible group of healthy children (n = 20) were selected as controls [8 (40%) males, 4-14 years, mean 8.4 years, SD 3.0 years]. Liquid gastric emptying rate (GER) and antral motility parameters (amplitude of antral contractions, frequency of antral contractions and antral motility index) were assessed using a previously reported ultrasound method. Key Results Average GER (42.1% vs 66.2% in controls), amplitude of antral contractions (56.5% vs 89%), frequency of contractions per 3 min (8.5 vs 9.3), and antral motility index (4.9 vs 8.3) were significantly lower in patients with FAP compared with controls (P < 0.01). Fasting antral area was higher in patients (1.4 vs 0.6, P < 0.0001). GER negatively correlated with the scores obtained for severity of abdominal pain (r = )0.29, P = 0.004). Conclusions & Inferences Gastric emptying rate and antral motility parameters were significantly impaired in patients with FAP and GER negatively correlated with symptom severity. These findings highlight the possible role of gastrointestinal motility abnormalities in the pathophysiology of childhood FAP.
Role of Ultrasonoraphy in Gall bladder Dyskinsia as a cause of Functional Dyspepsia Symptoms
Benha Medical Journal
Background: Biliary dyskinesia (BD) is characterized by symptoms of biliary disease, no evidence of gallstones on ultrasonography (USG), and diminished gallbladder ejection fraction. Aim of the work: The aim of the current study is to evaluate the role of ultrasound in gall bladder dyskinesia. Patient and methods: 30 cases were referred from Tropical Medicine, All of these cases were complaining of generalized abdominal pain, heart burn, brubing and epigastric pain, Patients were asked about a history of endoscopic examination or any lab tests. Transabdominal ultrasound examination was carried out with the Patient lying flat using 3.5-5 Mhz convex probe. Results: the US mean volume pre-meal of the studied cases was 18.27 (±2.16 SD) with range (14-21) ml, the mean volume postmeal of the studied cases was 9.53 (±4.38 SD) with range (3-17) ml and the mean ejection fraction was 47.19 (±24.21 SD) with range (15-85.7). Conclusion: ultrasound is valuable non-invasive tool in diagnosis of patients with dyskinesia symptoms. A skilled ultrasonographer can examine most abdominal organs and often detect lesions that are not demonstrated by radiography.
Evaluation of Gallbladder Motilityin Patients With Functional Gallbladder Disorder
مجلة المختار للعلوم, 2018
Rome IV defines Functional gastrointestinal disorders (FGID) as disorders of gutbrain interaction. It is a group of disorders classified by gastrointestinal symptoms related to any combination of the following: motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous system processing. Patients with Gallbladder Functional disorder (GBFD) may have abnormal gastric emptying and colonic transit, suggesting a possible generalized gastrointestinal motility disorder. The presentation of functional gallbladder disorder mimics classic symptoms of biliary pain ,27 patients and 27 healthy volunteers (7 males and 20 females) in each group, age between 21 and 48 years were included into the study, and diagnosis of functional gallbladder disorder was based on Rome III criteria. All patients were given a standard test fatty meal, and Gallbladder volume was calculated manually by using the ellipsoid formula (Dodd's formula). The pre-meal and post-meal gallbladder volumes and ejection fraction (EF) of the gallbladder (GB) were estimated. The patients and control groups were compared for age, gender, and body mass index. The body mass index in our control and patients was high indicating a prevalence of overweight in both groups. This study demonstrated that fatty meal ultrasound is a cheap, easy to handle, and physiologic. GBFD patients have decreased emptying of gallbladder compared to healthy subjects. GBFD should be considered in patients presented with recurrent right upper quadrant abdominal pain, decreased emptying of gallbladder in the absence of visualized gallstones on abdominal ultrasound, and meeting the Rome III criteria.
Ultrasonography analysis of gallbladder motility in patients with functional dyspepsia
European Journal of Internal Medicine, 2014
Background: Gallbladder motility has been studied in patients with functional gastrointestinal disorders, such as functional dyspepsia, irritable bowel syndrome and biliary disorders without gallstones and results of these observations are often inconclusive and conflicting. Methods: The investigation was performed on 180 therapy-naïve newly diagnosed patients with functional dyspepsia (97 females and 83 males), aged 20-79 in which we have investigate ultrasonographically parameters of gallbladder motility. Results: Bonferroni post hoc correction stressed that fasting gallbladder volume and ejection fraction were significantly distorted in individuals with postprandial distress syndrome, although, the residual gallbladder volume was significantly lower in patients with epigastric pain syndrome comparing with other examinees. Ejection fraction of the gallbladder negatively correlated with body mass index. Conclusion: The impaired contractibility of the gall bladder in patients with functional dyspepsia, based on the results of this study, is illustrated by the changes in the ejection fraction, which was more pronounced in patients with the postprandial distress syndrome.
Journal of Pediatric Gastroenterology & Nutrition, 2011
Objectives-Nongastrointestinal (non-GI) somatic complaints are common in children and adults with functional gastrointestinal disorders (FGIDs). The aim of the present study was to determine whether non-GI somatic complaints in children with functional abdominal pain (FAP) were associated with FGIDs in adolescence and young adulthood. Patients and Methods-In a prospective clinic-based study, children and adolescents (ages 8-16 years) with FAP (n = 188) and well controls (n = 61) completed a validated measure of somatic symptoms. Participants were assessed 4 to 15 years later (as older adolescents and young adults) for presence of current FGIDs as defined by the Rome III criteria. Results-Of the 188 youths with pediatric FAP, 35.6% met criteria for FGIDs at follow-up. Initial levels of non-GI somatic symptoms were significantly higher in pediatric FAP participants who subsequently met criteria for FGIDs at follow-up compared with controls and pediatric FAP participants who did not meet criteria for FGIDs at follow-up. Conclusions-The association of non-GI somatic symptoms with FAP in children may identify a group that is at risk for FGIDs later in life. Keywords adolescents; children; chronic abdominal pain; follow-up; gastrointestinal; somatic symptoms Chronic or recurrent abdominal pain affects 8% to 25% of healthy school-age children (1-3) and is characterized by continuous or episodic abdominal pain. In most cases, the pain is functional-it cannot be adequately explained by structural or biochemical abnormalities (4). Pediatric functional abdominal pain (Ped-FAP) persists throughout development in a significant proportion of children (1,5-8) and has been linked to functional gastrointestinal disorders (FGIDs) such as irritable bowel syndrome in adulthood (7,9,10).
Evaluation of gallbladder motility in patients with irritable bowel syndrome
Swiss medical weekly, 2005
Abnormalities involving smooth muscle function in different systems of the body have been reported in irritable bowel syndrome (IBS). There are a few studies on gallbladder function in this disorder with conflicting results. To investigate the motility of gallbladder in patients with IBS. Forty-eight patients (15 male and 33 female) with IBS and 48 healthy volunteers (15 male and 33 female) were included into the study. Thirty-four patients (70.8%) had constipation predominant and 14 patients (29.2%) had diarrhoea predominant type of IBS. Fasting and postprandial gallbladder volumes were studied using real time ultrasonography and ejection fraction (EF) of gallbladder was calculated. While fasting gallbladder volume (FGV) was similar between IBS and control groups (18.0 +/- 4.0 ml vs. 17.8 +/- 4.9 ml, p >0.05), postprandial gallbladder volume (PGV) was lower in IBS group than in the control group (5.5 +/- 1.4 ml vs. 6.2 +/- 1.9 ml, p = 0.03). Accordingly, the mean EF of gallbladd...
Gall Bladder Ultrasonographic Changes in Children with Chronic Liver Diseases
The Medical Journal of Cairo University, 2020
Background: Chronic liver diseases in the pediatric age group are rather a common problem with minimal symptoms yet carries the risk of considerable morbidity and even mortality, especially in developing countries. Chronic liver diseases are diagnosed if clinical or laboratory data of liver dysfunction persist for more than six months. Aim of Study: Our study aimed to evaluate the gall bladder ultrasonographic changes in children with chronic liver diseases in comparison to healthy children in