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Abstract
Background: Using two-dimensional (2D) ultrasonography, we previously found indications of impaired adaptive relaxation of the proximal stomach in children with recurrent abdominal pain (RAP). In the present study, we applied a new three-dimensional (3D) ultrasonographic method to investigate intragastric volumes and distribution of a liquid meal in another group of children with RAP. Methods: Twenty patients with RAP (age 10-15 years) and 20 healthy subjects (age 11-15 years) underwent ultrasonographic measurements of the stomach. A position sensor was used based on magnetic scanhead tracking for acquisition of 3D images after a liquid meal. The children scored abdominal symptoms before and after the meal. Results: Expressed as a fraction of ingested volume, the patients had a smaller volume of the proximal stomach and a larger antral volume at 2 r min postprandially compared to healthy subjects ( P r = r 0.03 and P r = r 0.001, respectively). The patients also showed a decreased proximal to distal gastric volume ratio at 2 r min postprandially ( P r = r 0.001). Patients experienced more pain in response to the meal than healthy subjects ( P r = r 0.04), but there was no correlation between pain and proximal or distal gastric volumes. Conclusions: RAP in children may be associated with an early intragastric maldistribution of a meal.