Electrogastrography Abnormalities in Pediatric Gastroduodenal Disorders: A Systematic Review and Meta-analysis

Objectives Electrogastrography (EGG) is a non-invasive method of measuring gastric electrophysiology. Abnormal gastric electrophysiology is thought to contribute to disease pathophysiology in patients with gastroduodenal symptoms, but this has not been comprehensively quantified in pediatric populations. This study aimed to quantify the abnormalities in gastric electrophysiology on EGG in neonatal and pediatric patients. Methods Databases were systematically searched for articles utilizing EGG in neonatal and pediatric patients (≤18 years). Primary outcomes were prevalence of abnormality, percentage of time in normal rhythm and power ratio. Secondary outcomes were correlations between patient symptoms and abnormal gastric electrophysiology on EGG. Results A total of 33 articles (1,444 participants) were included. EGG methodologies were variable. Pooled prevalence of abnormalities on EGG ranged from 61-86% in patients with functional dyspepsia (FD), gastro-esophageal reflux disease (GERD) and type 1 diabetes mellitus (T1DM). FD patients averaged 20.8% (p=0.011) less preprandial and 21.6% (p = 0.031) less postprandial time in normogastria compared to controls. Electrophysiological abnormalities were inconsistent in GERD. T1DM patients averaged 46.2% (p = 0.0003) less preprandial and similar (p = 0.32) postprandial time in normogastria compared to controls, and had a lower power ratio (SMD -2.20, 95%CI: -4.25, -0.15; p = 0.036). Symptom correlations with gastric electrophysiology were inconsistently reported. Conclusions Abnormalities in gastric electrophysiology were identifiable across a range of pediatric patients with gastroduodenal symptoms on meta-analysis. However, techniques have been inconsistent, and standardized and more reliable EGG methods are desirable to further define these findings and their potential utility in clinical practice.