DUODENAL-MOTILITY PATTERNS IN INFANTS AND CHILDREN

Abstract

Intraluminal pressure in the duodenum has been recorded in infants and children utilizing a strain gauge transducer and an open tube method. This method was used in a group of 31 normal children, 11 children with cystic fibrosis of the pancreas and 6 with the celiac syndrome. All the waves of the duodenum could be divided into two main wave forms. The most frequent wave seen was of a duration of less than 8 seconds, classified as a type I wave. Such waves occurred in both rhythmic and non-rhythmic bursts with a consistent frequency of 12 waves/min. The non-rhythmic type I wave was the most common wave form observed in the duodenal motility of children. The second wave form, type III, consisted of an elevation of the base-line longer than 8 seconds in duration with superimposed type I waves and a frequency of 96.8 waves/hr. No significant difference was present in the three groups in both total wave activity and in the incidence of specific wave types. Duodenal motility resulting from a milk feeding of 60 ml was studied in 16 normal children and 5 with cystic fibrosis of the pancreas. A significant response in total activity resulting from a rise in the number of non-rhythmic type I waves followed milk ingestion. Concurrent with the rise in total activity and non-rhythmic type I waves seen after ingestion of milk, there was a significant decline in the rhythmic type I wave bursts. The response to 0.1 mg/kg dose of bethanichol chloride injected subcutaneously was observed in 10 normal children. A significant increase in total activity, manifested principally by a rise in the non-rhythmic type I waves, was demonstrated. At the same time there was a significant decrease in the incidence of type I rhythmic wave bursts and type III waves. The duodenal motility of children had a higher incidence of type I rhythmic wave bursts and frequency of non-rhythmic waves than the duodenal motility reported previously in adults. Under the conditions of this experimental method there was a lower incidence of non-rhythmic type I waves and type III waves in children compared to the results reported in adults.