The water load test in school children and adolescents with functional gastrointestinal disorders
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ORIGINAL ARTICLE
The water load test in school children and adolescents with functional gastrointestinal disorders Juan Javier Peralta-Palmezano 1,2
&
Rafael Guerrero-Lozano 1
Received: 22 April 2020 / Accepted: 6 July 2020 # Indian Society of Gastroenterology 2020
Abstract Background/Aims We hypothesize that patients with functional gastrointestinal disorders (FGID) drink less water volume than healthy subjects during water load test. We evaluated and compared the water load test in students with and without FGID using the Rome III questionnaire. Methods We performed the water load test in 142 students from two schools in Colombia. Students were diagnosed using the Spanish version of the Rome III questionnaire. Students drank water ad libitum for 3 min or until pain, satiety, or vomiting occurred. We correlated anthropometric variables with water volumes drunk. We recorded symptoms like pain and nausea, before and after the water load test. Results We evaluated 142 students, with a mean age of 12.1 ± 0.2 years and 59.9% girls. Mean water volume drunk was 459 ± 22 mL. There was no significant difference between water volume drunk by students with and without FGID (466 ± 36 vs. 453 ± 27 mL, p = 0.108). We found a significant correlation between water volume drunk and gender, age, weight, height, and body mass index. Conclusions Students with and without FGID ingest similar volumes of water. Test adverse effects are minimal, and the test is safe to perform and well tolerated. Keywords Adverse effects . Diagnostic procedure . Functional dyspepsia . Functional gastrointestinal disorder . Gastrointestinal diseases . Gastroparesis . Gastric emptying . Reference values . Rome criteria . Water consumption
Introduction Functional gastrointestinal disorders (FGID) are a group of disorders characterized by symptoms related to any combination of disturbed motility, visceral hypersensitivity, altered mucosal immune function, changes in gut microbiota, and altered central nervous system processing [1]. Patients with functional dyspepsia present alterations in gastric motility, which could include impaired gastric accommodation, visceral hypersensitivity, and delayed gastric emptying [2–6]. The gastrointestinal (GI) tract includes multiple organs arising from a common primitive gut tube, extending from * Juan Javier Peralta-Palmezano [email protected] 1
Department of Pediatrics, Universidad Nacional de Colombia, Bogotá, Colombia
2
HOMI Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
mouth to anus. Primate gut tube is lined by a single layer of cuboidal/columnar endoderm/epithelium and encircled by a thin layer of splanchnic mesoderm. Mesoderm grows and differentiates into smooth muscle, resulting in clear demarcations in the foregut, midgut, and hindgut [7], with a combination of cells (neural crest cells, smooth muscle cells, and interstitial cells of Cajal) necessary for intestinal neuromuscular activity [8]. Embryology, therefore, may explain the overlap between different subtypes of functional G
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