Clinical management of motility disorders in children

Gariepy, Cheryl E.; Mousa, Hayat

doi:10.1053/j.sempedsurg.2009.07.004

Cited by 52 publications

(30 citation statements)

References 92 publications

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Section: Treatmentmentioning

confidence: 99%

“…Regimes to achieve this include specialised feeds and diets that transit the intestine most effectively and contain minimal residue. Continuous rather than bolus feeds via a gastrostomy or jejunostomy may be required 78,79,80 .Drug use is largely limited to control of inflammation and immuno-modulation, and of bacterial overgrowth, with variable success reported with prokinetics 80,81 . The best studied and apparently most effective motility agents such as cisapride and tegaserod are no longer available given safety concerns.…”

mentioning

confidence: 99%

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Gastrointestinal and nutritional problems in neurologically impaired children

Quitadamo

Thapar

Staiano

et al. 2016

European Journal of Paediatric Neurology

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Fax: + 44 20 7813 8382Gut Motility disorders comprise a heterogeneous group of disorders that result from disruption of the functional integrity of the intrinsic neuromusculature of the gastrointestinal (GI) tract. This intrinsic neuromusculature includes the smooth muscle layers, the intrinsic nervous system of the GI tract (enteric nervous system or ENS) and the interstitial cells of Cajal. The contribution of each of these components to function can be compromised by alterations in structure (ranging from absence to derangement in numbers and/or anatomy) or of function (complete or partial failure in physiological function). This pathology can be primary or secondary to a number of insults e.g. infections, inflammation, toxins etc. In children disorders may be congenital being present from birth or acquired later in life. Finally involvement of the enteric neuromusculature can be patchy/segmental or affect the gastrointestinal tract diffusely.Neuro-gastroenterology is the study of the interface of all aspects of the gastrointestinal tract or digestive system with the different branches of the body's nervous system including the enteric, central and autonomic nervous systems. The combined terms 'Neurogastroenterology and motility' are designed to encompass the study of all the components of the enteric neuromuscualture and their modulating influences and represents one of the fastest growing areas in gastroenterology clinical practice and research. This chapter aims to address some of the most common neurogastroenterology and motility conditions seen in clinical practice ranging from those with defined pathology to those which fall under the umbrella of functional gastrointestinal disorders. The latter comprise some of the commonest but challenging disorders and the term 'functional' reflects the fact that in the majority of such conditions no organic cause can be found. It should also be noted that at the present time many functional disorders e.g. abdominal pain-related functional GI disorders, represent symptom complexes that can further be subdivided into more discrete entities e.g. irritable bowel syndrome, functional abdominal pain etc depending on the nature, location and associations of the symptoms. Clinicians will often rely on the presence or absence of 'red flags' e.g. associated weight loss, severe or significant symptoms etc to decide whether patients are likely to have organic or functional disorders. Exhaustive investigations in the latter are likely to prove fruitless, expensive and perpetuate 'illness behaviours' in the patients. Abdominal pain-related functional gastrointestinal disorders IntroductionAbdominal pain-related functional gastrointestinal disorders (FGID) constitute a spectrum of conditions characterised by the presence of recurrent abdominal pain in the absence of any defined pathology 1 . In the past these disorders fell under the single term 'Recurrent abdominal pain' (RAP) but have since been recategorised under an international initiative (Rome Foundation) to improve the dia...

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Section: Treatmentmentioning

confidence: 99%

mentioning

confidence: 99%

Gastrointestinal and nutritional problems in neurologically impaired children

Quitadamo

Thapar

Staiano

et al. 2016

European Journal of Paediatric Neurology

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“…It is believed that the prokinetic effect is related to the activation of serotonin 4 receptors, thereby enhancing acetylcholine signaling from intrinsic cholinergic motor neurons [6,44,55]. Although metoclopramide has been shown to increase lower esophageal sphincter tone, improve gastric emptying, and facilitate antropyloroduodenal contractions, placebo-controlled or head-to-head comparisons have failed to demonstrate that it is more effective than placebo [56][57][58].…”

Section: Antidopaminergic Agentsmentioning

confidence: 96%

“…The data regarding the use of metoclopramide are derived from 1 randomized, controlled trial [58] (level Ib, class A), 2 nonrandomized studies [55,56] (level IV, class C), and expert opinion [57,60] (level 5, class D). With the apparent lack of efficacy, side effect profile, and overall lack of highquality evidence, metoclopramide should be considered as a class D recommendation.…”

Section: Antidopaminergic Agentsmentioning

confidence: 99%

Medical management of motility disorders in patients with intestinal failure: a focus on necrotizing enterocolitis, gastroschisis, and intestinal atresia

Dicken¹,

Sergi²,

Rescorla³

et al. 2011

Journal of Pediatric Surgery

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“…Delayed gastric emptying is most commonly reported to occur after viral infections, although it may also result from eosinophilic gastropathy. 93 Gastroparesis is not a significant feature in pediatric diabetic patients; however, idiopathic functional GOO has been described in children. 94 Endoscopy is indicated for children with evidence to suggest gastric emptying delay, gastroparesis, or functional GOO to examine for mucosal pathology.…”

Section: Special Considerations For the Pediatric Populationmentioning

confidence: 98%