Gastric motility in children with abdominal migraine

Abstract

BACKGROUND/AIMS: Abdominal migraine (AM) is an uncommon disease in children. Approximately 0.2 to 1% of children suffer from this distressing problem. Pathophysiology of this disorder has not been studied in children. The aim of this study was to evaluate the gastric motility in children with AM. METHODS: Consecutive 17 children [6 (46.3%) males, age 4–15 years, mean 9.5 years, SD 3.1 years) referred to Gastroenterology Research Laboratory, Faculty of Medicine, University of Kelaniya, Sri Lanka, January 2007 to December 2011, were screened and those fulfilling Rome III criteria for AM were recruited. None had clinical or laboratory evidence of organic disorders. Twenty healthy children were recruited as controls [8 (40%) males, age 4–14 years, mean 8.4 years, SD 3.0 years]. Liquid gastric emptying rate (GER) and antral motility parameters were assessed using a well-established and validated ultrasound method. RESULTS AND DISCUSSION: Average GER (41.6 vs. 66.2%, in controls), amplitude of antral contractions (57.9 vs. 89%) and antral motility index (5.04 vs. 8.3) were lower and fasting antral area (1.8 cm2 vs. 0.6 cm2) was higher in patients with AM (p < 0.01). Frequency of antral contractions (8.8 vs.9.3) did not show a significant difference (p = 0.08). Scores obtained for severity of abdominal pain had a negative correlation with amplitude of antral contractions (r = −0.55, p = 0.03). Negative correlations were observed between duration of the disease and amplitude of antral contractions (r = –0.55, p = 0.03), frequency of antral contractions (r = –0.52, p = 0.03), and motility index (r = −0.57, p = 0.03). A similar correlation was observed between average duration of an abdominal pain episodes and GER (r = –0.58, p = 0.02). CONCLUSIONS: Gastric emptying rates and antral motility parameters are signifi cantly lower in children with AM. Furthermore, we observed a signifi cant correlation between symptoms and gastric motility. These fi ndings indicate the possible role of abnormal gastric motility in pathogenesis of AM