Gastric emptying with gastro-oesophageal reflux.

The time taken for gastric emptying of a liquid (milk) or a semi-liquid (pudding) meal was evaluated in 477 infants and children. These patients were referred for suspected gastro-oesophageal reflux and underwent gastro-oesophageal scintigraphy, prolonged oesophageal pH study, manometric evaluation of the lower oesophageal sphincter pressure, and fibreoptic endoscopy. No difference in gastric emptying was observed in children aged under 3 years, regardless of the presence or absence of the gastro-oesophageal reflux, the pressure of the lower oesophageal sphincter, or the presence of oesophagitis. In children over 6 years, however, gastric emptying was significantly delayed in those presenting with reflux compared with those without reflux; in children over 3 years there was slower gastric emptying in those with a decreased lower oesophageal sphincter pressure compared with those with higher pressure and in those with overt oesophagitis compared with those without oesophagitis. This study suggests that gastro-oesophageal reflux is more severe in childhood than in infancy, probably due to more complex motor disorders affecting the gastric fundus as well as lower oesophageal sphincter function.