Impaired Accommodation of the Proximal Stomach in Children With Recurrent Abdominal Pain

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Abstract
A new ultrasonographic method was applied in children with recurrent abdominal pain, to study accommodation of the proximal stomach to a meal. After an overnight fast, 20 patients with recurrent abdominal pain (age, 7–14 years) and 23 healthy control subjects (age, 7–13 years), were scanned by a 5-MHz transducer positioned in the epigastrium, to monitor the size of the proximal stomach before and after a test meal of meat soup. Children with recurrent abdominal pain had a significantly smaller sagittal area of the proximal stomach at 10 and 20 minutes after the meal than in healthy control subjects (P = 0.01 for both) and significantly higher emptying fraction of the proximal stomach at 10 minutes after the meal than in healthy control subjects (P = 0.02). There was no significant difference in emptying of the distal stomach between the patients and healthy control subjects. Children with recurrent abdominal pain experienced more symptoms (pain, bloating) in response to the test meal than did healthy control subjects. The results support the view that recurrent abdominal pain in children may be a motility disorder that can be detected in the proximal stomach as an impairment of adaptive relaxation in response to a meal. This new ultrasonographic method may become a valuable diagnostic tool in patients with recurrent abdominal pain.