Paolo Quitadamo1, Letizia Zenzeri2, Enza Mozzillo3, Irene Cuccurullo3, Alba Rocco4, Adriana Franzese3, Gerardo Nardone4, Annamaria Staiano3. 1. Department of Translational Medical Science, Section of Pediatrics, "Federico II" University of Naples, Naples, Italy; Department of Pediatrics, A.O.R.N. Santobono-Pausilipon, Naples, Italy. Electronic address: paoloquitadamo@yahoo.it. 2. Department of Pediatrics, University of Perugia, Perugia, Italy. 3. Department of Translational Medical Science, Section of Pediatrics, "Federico II" University of Naples, Naples, Italy. 4. Department of Gastroenterology, "Federico II" University of Naples, Naples, Italy.
Abstract
OBJECTIVES: To provide further evidence regarding the relationship between obesity and gastroesophageal reflux disease (GERD) in children, through the use of 13C-octanoic acid breath test for gastric emptying time (GET) assessment and esophageal multichannel intraluminal impedance pH-testing (MII-pH). STUDY DESIGN: Obese children aged 4-17 years completed a questionnaire investigating reflux symptoms, the presence of functional gastrointestinal disorders, and quality of life. A subgroup of obese patients with and without GERD symptoms were asked to undergo 13C-octanoic acid breath test. Symptomatic patients were also required to undergo MII-pH. Age- and sex- matched asymptomatic nonobese children were enrolled as a comparison group. RESULTS: Of 113 enrolled patients, 44 (38.9%) reported reflux symptoms; 22 of the 44 underwent MII-pH. Their mean reflux index was 14.6%, and their mean number of daily reflux episodes was 51.8. The mean T½ GET of symptomatic was 107.6 minutes vs 116.5 minutes in asymptomatic obese children. Healthy nonobese children had a mean T½ GET of 100.1 minutes. The mean GET of symptomatic obese patients having >70 daily reflux events was 121.8 vs 87.6 minutes of patients with <70 daily reflux events (P <.05). Both symptomatic and asymptomatic obese patients had a worse quality of life than nonobese (P = 0.003 and P = 0.0002, respectively); a narrow waist circumference was directly related to GET (P = 0.01). CONCLUSIONS: A high percentage of obese children and adolescents experience GERD symptoms. GET was directly related to the narrow waist circumference of obese children with GERD and was significantly delayed in obese children with increased reflux events. Both symptomatic and asymptomatic obese patients had a worse quality of life compared with nonobese healthy patients.
OBJECTIVES: To provide further evidence regarding the relationship between obesity and gastroesophageal reflux disease (GERD) in children, through the use of 13C-octanoic acid breath test for gastric emptying time (GET) assessment and esophageal multichannel intraluminal impedance pH-testing (MII-pH). STUDY DESIGN:Obesechildren aged 4-17 years completed a questionnaire investigating reflux symptoms, the presence of functional gastrointestinal disorders, and quality of life. A subgroup of obesepatients with and without GERD symptoms were asked to undergo 13C-octanoic acid breath test. Symptomatic patients were also required to undergo MII-pH. Age- and sex- matched asymptomatic nonobese children were enrolled as a comparison group. RESULTS: Of 113 enrolled patients, 44 (38.9%) reported reflux symptoms; 22 of the 44 underwent MII-pH. Their mean reflux index was 14.6%, and their mean number of daily reflux episodes was 51.8. The mean T½ GET of symptomatic was 107.6 minutes vs 116.5 minutes in asymptomatic obesechildren. Healthy nonobese children had a mean T½ GET of 100.1 minutes. The mean GET of symptomatic obesepatients having >70 daily reflux events was 121.8 vs 87.6 minutes of patients with <70 daily reflux events (P <.05). Both symptomatic and asymptomatic obesepatients had a worse quality of life than nonobese (P = 0.003 and P = 0.0002, respectively); a narrow waist circumference was directly related to GET (P = 0.01). CONCLUSIONS: A high percentage of obesechildren and adolescents experience GERD symptoms. GET was directly related to the narrow waist circumference of obesechildren with GERD and was significantly delayed in obesechildren with increased reflux events. Both symptomatic and asymptomatic obesepatients had a worse quality of life compared with nonobese healthy patients.
Authors: P Quitadamo; L Zenzeri; E Mozzillo; V Giorgio; A Rocco; A Franzese; G Nardone; A Staiano Journal: J Endocrinol Invest Date: 2020-09-22 Impact factor: 4.256