[Gastric myoelectrical activity in children and youth with dyspeptic symptoms]

Abstract

The aim: of the study was to analyze gastric myoelectrical activity in children and youth with dyspeptic symptoms.

Material and methods: 113 children and youth aged 4.5 to 18 years (mean age 13.4 years) with dyspeptic symptoms were enrolled into the study. They were divided into 4 groups: group I--30 patients--without gastrooesophageal acid reflux GER (-) and Helicobacter pylori infection Hp (-), group II--35 patients, GER (+) Hp (-); group III--20 patients, GER (-) Hp (+); group IV --28 patients, GER (+) Hp (+). Gastrooesophageal acid reflux was recognized using 24-hour pH-metry. Helicobacter pylori infection was diagnosed based on histopathological examination of gastric body and/or antrum specimens, urease test and (or) C13 urea breath test. Gastric myoelectrical activity was performed using multichannel electrogastrography (Medtronic POLYGRAM NETTM). Six EGG electrodes were fixed on the subject's abdomen in standard places. Fasting EGG was recorded for 30 minutes followed by one hour postprandial recording after an ingestion of standard meal. Variables assessed were: dominant frequency (DF), the power of the dominant frequency (DP), percentage of bradygastria, normal, tachygastria and arrhythmia frequency, dominant frequency instability coefficient (DFIC), dominant power instability coefficient (DPIC) recorded from each channel (C1, C2, C3, C4) and average percentage slow wave coupling (%SWC) among channels. Comparisons were performed using Kruskal-Wallis's test.

Results: In comparison to group II GER (+) Hp (-) in group I GER (-) Hp (-) were recorded significantly higher percentage of bradygastria frequency in C1 and C2 (5% vs 2% and 4% vs. 1%) and postprandialy significantly higher percentage of arrhythmia in C4 (18% vs 13%). In comparison to group Ill GER (-) Hp (+) in group I GER (-) Hp (-) fasting were observed significantly lower dominant frequency (2.89 vs 3.07 cpm), higher percentage of tachygastria frequency in C1 (3% vs. 1%), lower percentage of arrhythmia frequency in C2 (20% vs 29%), higher DPIC in C4 (1.46 vs 1.27), higher average percentage %SWC 2-3 (70% vs 59%) and postprandialy lower DFIC in C4 (0.45 vs 0.54). In comparison to group IV GER (+) Hp (+) in group I GER (-) Hp (-) fasting were recorded lower percentage of arrhythmia frequency in C1 and C2 (18% vs 27% and 20% vs 30%) and postprandialy lower percentage of arrhythmia frequency in C2 (11% vs 17%) and lower DFIC in C2 (0.37 vs 0.48). In comparison to group Ill GER (-) Hp (+) in group II GER (+) Hp (-) fasting were observed significantly lower percentage of bradygastria frequency in C1 (2% vs 4%), higher DPIC in C2 (1.87 vs 1.28), higher average percentage %SWC 1-3 and 2-3 (71% vs 63% and 71% vs 59%) and postprandialy higher percentage of bradygastria frequency in C1 (5% vs 3%) and higher average percentage %SWC 3-4 (68% vs 58%). In comparison to group IV GER (+) Hp (+) in group II GER (+) Hp (-) fasting were recorded significantly higher percentage of normal frequency in C1 and C2 (76% vs 68% and 75% vs 67%) and higher average percentage %SWC 1-2 (77% vs 69%) and postprandialy significantly lower percentage of arrhythmia frequency in C1 (12% vs 18%). In comparison to group IV GER (+) Hp (+) in group Ill GER (-) Hp (+) fasting were observed significantly higher dominant frequency (3.07 vs. 2.87 cpm, p < or = 0.01) and lower percentage of tachygastria frequency in C1 (1% vs 2%) and postprandialy lower percentage of bradygastria frequency in C1 and C2 (3% vs 5% and 3% vs 5%) and lower DFIC in C2 (0.33 vs 0.48).

Conclusion: In dyspeptic children and youth Helicobacter pylori infection and/ or gastrooesophageal acid reflux have influence on the gastric myoelectrical activity EGG abnormalities in patients with these diseases are varied, mostly preprandialy and recorded from proximal part of the stomach.