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Peripheral Electrogastroenterography and Diagnosis of Gastroesophageal Reflux Disease in Paediatric Patients

Study Objective: To assess the relation between clinical manifestations of gastroesophageal reflux disease (GERD) and specific gastrointestinal (GIT) motility in children using electrogastroenterography (EGEG). Study Design: observational comparative study. Materials and Methods. We examined 55 children at the age of 7 to 17 years old with confirmed GERD. All patients underwent EGEG. In order to study the specificity of GIT motility and evacuation in patients with traditional signs of GERD, we compared complaints with fasting and postprandial EGEG results. Complaints included heartburn, belching, nausea, and vomiting. Study Results. The study made it possible to identify statistically significant correlations between clinical manifestations of GERD in children and EGEG results. Patients complaining of fasting heartburn had electric activity (Р(I)/PS, %) at ileum frequencies that was significantly lower than in children who did not complain of heartburn (р = 0.033); these changes evidence impaired ileum motility. P(I)/P(I + 1) jejunum /ileum ratio in patients with heartburn was significantly higher than without heartburn (р = 0.043), thus evidencing dislocated motility in these GIT sections. Children with fasting belching demonstrated a significant increase in the rhytmicity coefficient (Kritm) at the frequencies of the duodenum, jejunum and ileum (р = 0.042, р = 0.035, р = 0.036, respectively), thus evidencing non-propulsive contractions in these GIT sections. Patients with postprandial nausea, P(I)/P(I + 1) duodenum/ jejunum was significantly lower than in patients without complaints (р = 0.029). In children with fasting vomiting, Р(I)/PS, % at the stomach and duodenum frequencies was significantly higher than in children who did not have this problem (р = 0.028, р = 0.036, respectively); therefore, motility in these sections was increased. Patients complaining of vomiting demonstrated higher P(I)/P(I + 1) duodenum/ jejunum (р = 0.048). In patients with vomiting, Kritm in all GIT sections was significantly lower than in children not complaining of vomiting. Conclusion. Children with GERD who complained of vomiting and belching demonstrated the highest number of significant changes in fasting EGEG results, namely Р(I)/PS, % at the stomach and duodenum frequencies; and Kritm of all GIT sections. These changes evidence impaired motility, its incoordination, non-propulsive contractions, justifying prescription of medicines that can correct impaired motility. Keywords: gastroesophageal reflux disease, motility, gastrointestinal tract, peripheral electrogastroenterography, children.