Author(s)

Tadao Okada, Shohei Honda, Hisayuki Miyagi, Masashi Minato, Akinobu Taketomi

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Introduction: Delayed gastric emptying (DGE) often occurs in patients with gastroesophageal reflux (GER) due to neurological impairment (NI). ¹³C has been used as an alternative tool for measuring the gastric emptying rates. The aim of this study was to predict gastric emptying in children with GER using ¹³C-acetate breath test (ABT) by 24-hour pH monitoring. Methods: Nineteen patients were divided into 2 groups: a DGE group with NI (14 patients), and normal-emptying group without NI (5 patients). The liquid test meal consisted of Racol^TM (5 ml/kg) mixed with ¹³C-acetate (50 mg for infants, 100 mg for children, and 150 mg for adolescents). ¹³CO₂ was measured using a gas chromatograph-isotope ratio mass spectrometer. The results are expressed as the % of ¹³C expired per hour and cumulative ¹³C excretion over a 3-hour periods including the parameters of half excretion and lag time. Results: The mean half excretion time was 1.762 hour in the DGE group and 1.095 hour in the normal-emptying group (P = 0.0196). The mean lag time was 0.971 hour in the DGE group and 0.666 hour in the normal-emptying group (P = 0.0196). Therefore, DGE was significantly more prevalent in the DGE compared to the normal-emptying group. The percentage of the time when the pH was less than 4 on 24-hour esophageal pH monitoring was 21.6% ± 9.2% in the DGE group and 28.5% ± 11.6% in the normal-emptying group (P = 0.4634). Conclusion: The percentage of time when the pH is less than 4 on 24-hour pH monitoring cannot predict DGE measured by the ¹³C-ABT in GER.

Delayed Gastric Emptying; Gastroesophageal Reflux; Neurological Impairment; ¹³C-Acetate Breath Test; 24-Hour pH Monitoring

T. Okada, S. Honda, H. Miyagi, M. Minato and A. Taketomi, "Can pH Monitoring Predict Gastric Emptying Measured by ¹³C-Acetate Breath Test in Gastroesophageal Reflux with Neurological Impairment?," Surgical Science, Vol. 5 No. 1, 2014, pp. 20-24. doi: 10.4236/ss.2014.51005.