Gastric myoelectrical activity in children and youth with gastroesophageal reflux disease

Aim: The aim of the study was to evaluate gastric myoelectrical activity in children and youth with clinical symptoms suggesting gastroesophageal reflux (GER), including groups with different types of GER and without reflux.

Material and methods: The study included 129 children between 4 and 18 years of age (mean age: 11.5 years, 61 males and 68 females) who were diagnosed because of symptoms suggesting GER. All patients simultaneously underwent the 24-h pH-impedance (Sandhill Scientific) and the transcutaneous multichannel electrogastrography (Synectics, Medtronic, Polygram NET). According to the result of the pH-impedance children were divided into four groups (with acid, mixed and nonacid GER and without reflux). The study compared each group with the existing standards and groups with different types of gastroesophageal reflux and without GER among themselves.

Results: Electrogastrography showed gastric myoelectrical activity disorders in 128 of 129 children with clinical symptoms suggesting GER. The only statistically significant difference in electrogastrography between children with different GER types and children without reflux was a higher percentage of postprandial bradygastria recorded in the fundus of the stomach in the group of patients with nonacid gastroesophageal reflux (13.94% vs. 7.46%, p = 0.0024). No statistically significant differences were showed between groups of patients with acid and mixed GER and without reflux. The only statistically significant difference in electrogastrography between groups of patients with acid and nonacid GER was a higher percentage of preprandial arrhythmia in the antrum in the group with acid gastroesophageal reflux (32.48% vs. 14.70%, p = 0.0069). There were statistically significant differences in EGG between groups of children with mixed and nonacid gastroesophageal reflux. Patients with nonacid GER had a higher percentage of postprandial bradygastria in the fundus of the stomach (9.39% vs. 13.94%, p = 0.0316), whereas children with mixed GER had a higher percentage of preprandial arrhythmia in the antrum (30.61% vs. 14.70%, p = 0.0135).

Conclusions: The majority of children and youth with gastroesophageal reflux symptoms have gastric myoelectrical activity disorders. No statistically differences were showed between groups of patients with acid and mixed gastro­esophageal reflux and without GER. Clinical symptoms in these patients may be caused by gastric motor activity disorders, not by the gastroesophageal reflux. Children with nonacid gastroesophageal reflux have specific gastric myoelectrical activity disorders, different from other types of GER.