Proceedings of the 2018 Advances In Motility and In NeuroGastroenterology

Abstract

Objectives:Motility and functional disorders are common in children and often debilitating, yet these disorders remain challenging to treat effectively. At the 2018 Annual North American Society for Pediatric Gastroenterology, Hepatology and Nutrition meeting, the Neurogastroenterology and Motility Committee held a full day symposium entitled, 2018 Advances In Motility and In NeuroGastroenterology – AIMING for the future. The symposium aimed to explore clinical paradigms in pediatric gastrointestinal motility disorders and provided a foundation for advancing new scientific and therapeutic research strategies.Methods:The symposium brought together leading experts throughout North America to review the state of the art in the diagnosis and management of motility and functional disorders in children. Presentations were divided into esophageal, antral duodenal, and colorectal modules. Each module included oral presentations by experts in the respective fields, leading to thought-provoking discussions. There were 2 breakout sessions with small group discussions on select topics, focusing on defining scientific insights into the diagnosis and management of pediatric functional gastrointestinal and motility disorders in a systematic, segment-based approach.Conclusions:The field of neurogastroenterology has made remarkable progress in the last decade. The current report summarizes the major learning points from the symposium highlighting the diagnosis and promising therapies on the horizon for pediatric neurogastrointestinal and motility disorders.

Anorectal Manometry in Children

“…Anorectal manometry (ARM) is used to obtain an objective (quantitative and qualitative) assessment of function and can identify disorders that are not always recognised on clinical picture alone. It provides comprehensive information regarding abnormalities in anorectal function by evaluating recto-anal muscles and dynamic characteristics, including coordination, integrity and magnitude of sphincter tonic contractions, baseline reflexes, subjective perineal and internal rectal sensation, and recto-anal coordination (10,11).…”

Advances on Neurogastroenterology and Motility Disorders: Pathophysiology, Diagnostics and Management

“…The last decade has witnessed important advances in diagnostic tools and technologies used for the improved assessment of gastrointestinal function and motility [ 5 , 6 ]. A review by the International Working Group for Disorders of Gastrointestinal Motility and Function revealed that the performance of these diagnostics can identify clinically relevant pathologies that may guide management [ 7 , 8 ].…”

Diagnostics of Gastrointestinal Motility and Function: Update for Clinicians

“…In recent years, substantial progress had occurred in technologies used to investigate GI motility and function [ 6 , 7 ]. An analysis by the International Working Group for Disorders of Gastrointestinal Motility and Function found that the routine implementation of these diagnostics would find clinically relevant pathologies that may direct management [ 8 , 9 ].…”

“…The advent of the HRM catheters has enabled a continuous representation of esophageal pressures and has facilitated a more accurate evaluation of esophageal body and sphincters’ function. Intraluminal impedance is an important addition to HRM catheters and enables objective assessment of bolus transit through the esophagus [ 6 , 7 ]. This is performed by measuring the resistance to electrical current conduction on impedance electrodes spanning the length of the HRM catheter.…”