Temporal relationship between gastroesophageal reflux and rate of gastric emptying in children

Objectives There are conflicting reports for the relationship of reflux and the gastric emptying rate In addition, the acquisition period is not well defined for the gastroesophageal reflux studies The aim of our study was to evaluate the temporal distribution of the reflux episodes and to evaluate whether the gastric emptying rate changed with the gastroesophageal reflux time or amount Methods We used radionuclide scintigraphy to evaluate 211 pediatric patients (0-10 years of age) Scintigraphic studies were performed by acquiring 15 s images for 1 h in a supine position after ingesting milk containing 05 mCi (18 5 MBq) Tc-99m colloid Reflux episodes were calculated every 10 min for each patient who had reflux The gastric emptying rate was measured by drawing an region of interest over the gastric activity Results Gastric reflux was observed in 104 patients (49 280/0) The number of reflux episodes was higher in the first and second 10 min (33 7 and 29 1% respectively) The lowest reflux episode was observed in the last 10 min (between 50 and 60 mm) (2 6%) suggesting that the reflux episode was decreasing by the gastric emptying Within the first 30 min, reflux was observed in 98 of 104 patients (94 23%) The gastric emptying rate was calculated to be 73 min in patients with a higher incidence of reflux and 62 min in patients who had delayed and lower incidence of reflux episodes In 104 patients, the average gastric emptying rate was 71 60 min There were no significant differences in the gastric emptying rates between patients who had reflux episodes beginning in the first 30 min of the study and those who had reflux episodes in the last 30 min of the study (P>0 05) Conclusion This study has suggested that the number of reflux episodes were not related with the gastric emptying rate However, reflux could be observed in a higher frequency before gastric emptying, which also suggested that a 30-min period may be sufficient when reflux is shown early In negative cases, a 60 min acquisition time is recommended for the diagnosis of gastroesophageal reflux Nucl Med Commun 31 1059-1062 (C) 2010 Wolters Kluwer Health I Lippincott Williams & Wilkins Nuclear Medicine Communications 2010 31 1059-1062