Gastric emptying in children in health and diseasemeasured with 13C-breath tests

Abstract

Gastric emptying (GE) is an important step in the assimilation of nutrients.
GE can be delayed in various paediatric diseases. The “gold standard” for
measuring GE is gastric emptying scintigraphy (GES). The 13C-acetate
breath test (13C-ABT) for measuring GE of liquids and the 13C-octanoic acid
breath test (13C-OBT) for measuring GE of solids were developed as an
alternative for GES. There are however only limited data in the literature
concerning the measurement of GE with the 13C-ABT and the 13C-OBT
using non dispersive infrared spectrometry (NDIRS) in children. The aim of
this research project was to study GE of liquids with the 13C-ABT and GE of
solids with the 13C-OBT using NDIRS in healthy children and in paediatric
conditions possibly associated with delayed GE. We have shown a significant
correlation between the gastric half-emptying times (t1/2-GE) measured
with the 13C-ABT and the 13C-OBT using NDIRS in comparison with GES for
the measurement of GE of respectively a standardized test milk-drink and a
standardized pancake test meal in children with upper gastrointestinal
symptoms. We have also established normal values for t1/2-GE of these test
meals in a standardized way in a relatively large number of healthy children
and propose age-specific normative values for t1/2-GE of liquids and solids.
We have shown that there is an important inter- and intra-individual
variability for GE of liquids and solids that probably reflects true day-to-day
variations in GE rather than variations with the measurement technique.
Finally, we have shown that in children with cystic fibrosis and gastrooesophageal
reflux (GOR) symptoms, almost half of them have increased
acid GOR and almost a quarter has delayed GE but that there is no relation
between GOR and GE.

Date of Award	2 Oct 2017
Original language	English
Awarding Institution	Vrije Universiteit Brussel
Supervisor	Yvan Vandenplas (Promotor), G Veereman (Jury), M. Benninga (Jury), P. Bontems (Jury), Ilse Hoffman (Jury), M. Deneyer (Jury), Hendrik Everaert (Jury) & Fazia Mana (Jury)