Plasma ghrelin and liquid gastric emptying in children with functional dyspepsia consistent with post‐prandial distress syndrome

Background Adult studies indicate a role for ghrelin in functional dyspepsia ( FD ) mediated through ghrelin's effect on gastric emptying ( GE ). This study examines the relationship between ghrelin, liquid GE , and pain in children with FD . Methods Thirteen FD patients reporting symptoms consistent with post‐prandial distress syndrome ( PDS ) and 17 healthy controls were enrolled. All participants received a liquid meal containing 13 C‐sodium acetate. Pain severity, liquid GE utilizing exhaled 13 CO 2 from the sodium acetate breath tests ( ABT ), plasma acyl ghrelin ( AG ), and des‐acyl ghrelin concentrations were measured at specific intervals over 240 min following ingestion. Key Results FD ‐ PDS patients demonstrated lower mean baseline AG (14.8 ± 9.7 vs 27.2 ± 14.0 fmol/mL; p  = 0.013), AG C max (24.6 ± 8.2 vs 40.5 ± 16.8 fmol/mL; p  = 0.007), and AG flux (18.2 ± 7.8 vs 32.7 ± 17.3 fmol/mL; p  = 0.015) than controls. The time to reach maximum exhaled 13 CO 2 concentration (T max ) was longer in FD patients than controls (47.5 ± 18.5 vs 35.8 ± 11.8 min; p  = 0.046). Significant relationships between ghrelin analyte ratios and ABT parameters were largely confined to control participants. Conclusions & Inferences FD ‐ PDS in children is associated with lower fasting and maximum AG concentrations, and dampened AG flux. These data suggest a possible role for altered ghrelin physiology in the pathogenesis of PDS .