TITLE:
Can pH Monitoring Predict Gastric Emptying Measured by 13C-Acetate Breath Test in Gastroesophageal Reflux with Neurological Impairment?
AUTHORS:
Tadao Okada, Shohei Honda, Hisayuki Miyagi, Masashi Minato, Akinobu Taketomi
KEYWORDS:
Delayed Gastric Emptying; Gastroesophageal Reflux; Neurological Impairment; 13C-Acetate Breath Test; 24-Hour pH Monitoring
JOURNAL NAME:
Surgical Science,
Vol.5 No.1,
January
9,
2014
ABSTRACT: 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 RacolTM (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.