Ultrasound measurement of gastric emptying time in patients with cystic fibrosis and effect of ranitidine on delayed gastric emptying,☆☆,

Presented in abstract form at the Fourth Joint Meeting of the North American Society for Pediatric Gastroenterology and Nutrition and the European Society for Paediatric Gastroenterology and Nutrition, Houston, Tex., Oct. 10-12, 1994.
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Abstract

Intestinal dysmotility is commonly reported in patients with cystic fibrosis (CF); however, gastric motor activity has rarely been investigated. We measured with real-time ultrasonography the antral distention and gastric emptying time of a solid-liquid meal in 29 patients with CF (age range, 5 to 17 years). A significantly prolonged gastric emptying time was present in 26 patients compared with 13 healthy control subjects (age range, 5 to 16 years); an exaggerated antral distention in the fed period was also detected. The patients with CF and delayed gastric emptying were randomly allocated to receive cisapride or ranitidine for 4 weeks. Twelve patients treated with ranitidine and 11 with cisapride completed the trial. There was a marked decrease in gastric emptying time, antral distention, and dyspeptic symptomatic score in patients receiving ranitidine but not in patients treated with cisapride. We conclude that gastric dysmotility is commonly detected in patients with CF and that H2 receptor blockers are more effective than prokinetics in improving dyspeptic symptoms and gastric emptying and distention. (J PEDIATR 1996;128:485-8)

Section snippets

METHODS

In 29 patients with CF (16 girls; median age, 10.2 years; range, 5 to 17 years), gastric emptying time of a solid-liquid mixed meal was measured by ultrasonography of the stomach. In all patients, the diagnosis of CF had been established through a previous positive sweat test result (sweat chloride determination, >70 mmol/L) and the presence of typical clinical symptoms and signs. Patients entering into the study had not exhibited severe clinical features of intestinal dysmotility, such as

RESULTS

Gastric emptying time was significantly delayed in patients with CF in comparison with control subjects; distention of the antral area (percentage of increase compared with baseline value) was markedly higher in patients with CF both 60 and 90 minutes after feeding, in comparison with control subjects (Table I). Twenty-six patients with CF had a gastric emptying time beyond the range of values measured in the control subjects; these patients were randomly allocated to receive either cisapride

DISCUSSION

This study shows that gastric motor abnormalities such as delayed gastric emptying and exaggerated postfeeding antral distention can be found in a high proportion of patients with CF. Gastric motility was assessed through real-time ultrasonography, a recently introduced and validated tool for studying the gastric motor profile.11, 13, 14 Previous reports on patients with CF had shown a normal gastric emptying time of liquid meals.15, 16 Gastric emptying time is commonly believed to be

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    From the Department of Pediatrics, University of Naples “Federico II,” Naples, Italy

    ☆☆

    Reprint requests: Salvatore Cucchiara, MD, Department of Pediatrics, Gastrointestinal Motility and Endoscopy Unit, University of Naples “Federico II,” Via S.Pansini 5, 80131 Napoli, Italy.

    0022-3476/96/$5.00 + 0 9/20/71607

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