Gallbladder motility in children with chronic functional abdominal pain
DOI:
https://doi.org/10.18203/2349-3291.ijcp20193721Keywords:
Childhood functional abdominal pain, Gallbladder, UltrasonographyAbstract
Background: Chronic abdominal pain is a common gastrointestinal symptom in children that significantly lowers their quality of life. In adults, Gall bladder (GB) hypomotility / dyskinesia is associated with many functional abdominal disorders but there is scarcity of evidence on its role in childhood gastro-intestinal disorders. Aim of the study is to evaluate the GB motility in children with chronic functional abdominal pain (FAP).
Methods: Children aged 5-15 years with chronic abdominal pain fulfilling ROME-III criteria and healthy controls were included and all study participants were subjected to ultrasonographic evaluation of the gall bladder volume in fasting state and post - Fatty test meal (FTM) and its ejection fraction was calculated.
Results: Sixtysix children including 31 with chronic FAP underwent sonographic evaluation for GB motility. The mean ejection fraction (EF) of cases and controls were 51.72±17.76% and 57.3±23.26% (p value - 0.158). The mean EF of cases with upper abdominal pain and lower/peri-umbilical abdominal pain were 41.7±17.1% and 57.2±15.9% respectively (p value < 0.0001). Increasing BMI had no significant association with GB motility among the participants.
Conclusions: There is lack of significant association between children with chronic FAP and GB hypomotility. Children with upper abdominal pain have lesser GB EF, suggesting a possible abnormal GB motility.
References
Chitkara DK, Rawat DJ, Talley NJ. The epidemiology of childhood recurrent abdominal pain in Western countries: a systematic review. The Am J gastroenterol. 2005;100(8):1868.
Spee LA, Lisman-Van Leeuwen Y, Benninga MA, Bierma-Zeinstra SM, Berger MY. Prevalence, characteristics, and management of childhood functional abdominal pain in general practice. Scandinavian journal of primary health care. 2013;31(4):197-202.
Youssef NN, Atienza K, Langseder AL, Strauss RS. Chronic abdominal pain and depressive symptoms: analysis of the national longitudinal study of adolescent health. Clinic Gastroenterol Hepatol. 2008;6(3):329-32.
Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterol. 2006;130(5):1527-37.
Hemingway D, Neilly JB, Finlay IG. Biliary dyskinesia in idiopathic slow-transit constipation. Diseases of the colon & rectum. 1996;39(11):1303-7.
Velanovich V. Biliary dyskinesia and biliary crystals: a prospective study. The Am surg. 1997;63(1):69-74.
Sari R, Balci MK, Coban E, Karayalcin U. Sonographic evaluation of gallbladder volume and ejection fraction in obese women without gallstones. J clinic ultrasound. 2003;31(7):352-7.
Halac U, Noble A, Faure C. Rectal sensory threshold for pain is a diagnostic marker of irritable bowel syndrome and functional abdominal pain in children. J ped. 2010;156(1):60-5.
Bakker MJ, Boer F, Benninga MA, Koelman JH, Tijssen MA. Increased auditory startle reflex in children with functional abdominal pain. J ped. 2010;156(2):285-91.
Carr JA, Walls J, Bryan LJ, Snider DL. The treatment of gallbladder dyskinesia based upon symptoms: results of a 2-year, prospective, nonrandomized, concurrent cohort study. Surg Laparoscop Endoscop Percutaneous Tech. 200;19(3):222-6.
Mehra R, Sodhi KS, Saxena A, Thapa BR, Khandelwal N. Sonographic evaluation of gallbladder motility in children with chronic functional constipation. Gut and liver. 2015;9(3):388.
Dodds WJ, Groh WJ, Darweesh RM, Lawson TL, Kishk SM, Kern MK. Sonographic measurement of gallbladder volume. Am J roentgenol. 1985;145(5):1009-11.
Hofeldt M, Richmond B, Huffman K, Nestor J, Maxwell D. Laparoscopic cholecystectomy for treatment of biliary dyskinesia is safe and effective in the pediatric population. The Am surg. 2008;74(11):1069-72.