Advancing Nutritional Science for Children With Functional Dyspepsia

This study evaluates four different meals and how they induce gastrointestinal symptoms in children with functional dyspepsia. All subjects will receive each meal and rate their gastrointestinal symptoms during each meal.

Food can often exacerbate gastrointestinal symptoms in adults and children with functional dyspepsia. However, it is unclear which foods exacerbate symptoms more than others. Children with post-prandial distress functional dyspepsia will receive four different meals with variables being: semi-solid vs. solid and high fat vs high carbohydrate. At the time of ingestion and for up to 3 hours after each meal, subjects will rate their gastrointestinal symptoms. Comparisons of symptom onset and severity will be made for each meal. Enrolled subjects will have undergone previous gastrointestinal evaluations: gastric emptying study and/or upper endoscopy. In addition, subjects will complete psychosocial measures: Behavioral Assessment for Children-3, childhood somatization inventory. The first goal is to compare the severity of gastrointestinal symptoms with different composition and consistency meals. The second goal is to correlate the severity of postprandial gastrointestinal symptoms to psychosocial distress, gastric neuromotor function (emptying and accommodation), and duodenal inflammation.

Meals will be provided in a randomized fashion with only the metabolic research unit kitchen (which prepares the meals) knowing what is being provided to the subject.

Gastric retention values will be captured from a previously completed 4-hour gastric emptying scintigraphy study

Anxiety, Depression, and Somatization will be determined using Behavioral Assessment for Children-3 (t-scores for anxiety and depression) and Children's Somatization Inventory Score (total score).

Gastric accommodation will be determined from a previously completed 4-hour gastric scintigraphy study using analysis of the time zero image.

Inclusion Criteria: Rome IV Functional Dyspepsia with post-prandial distress Previously completed normal upper endoscopy with duodenal biopsies and/or previously completed a gastric emptying scintigraphy study Exclusion Criteria: Previous abdominal surgery Current or previous formal psychiatric diagnosis (e.g. anxiety disorder) requiring therapy or psychotropics Serious chronic medical condition requiring regular medical care Allergy to meal components to be ingested during the study On specialized diet required for a medical condition Pregnancy Inability to eat by mouth