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Review
. 2024 Sep 2;16(17):2955.
doi: 10.3390/nu16172955.

Nutritional Management of Pediatric Gastrointestinal Motility Disorders

Lucy Jackman  1 , Lauren Arpe  1 , Nikhil Thapar  2 , Anna Rybak  1 , Osvaldo Borrelli  1
Affiliations
Review

Nutritional Management of Pediatric Gastrointestinal Motility Disorders

Lucy Jackman et al. Nutrients. .

Abstract

Normal and optimal functioning of the gastrointestinal tract is paramount to ensure optimal nutrition through digestion, absorption and motility function. Disruptions in these functions can lead to adverse physiological symptoms, reduced quality of life and increased nutritional risk. When disruption or dysfunction of neuromuscular function occurs, motility disorders can be classified depending on whether coordination or strength/velocity of peristalsis are predominantly impacted. However, due to their nonspecific presenting symptoms and overlap with sensory disruption, they are frequently misdiagnosed as disorders of the gut-brain interaction. Motility disorders are a prevalent issue in the pediatric population, with management varying from medical therapy to psychological therapy, dietary manipulation, surgical intervention or a multimodal approach. This narrative review aims to discuss the dietary management of common pediatric motility disorders including gastroesophageal reflux, esophageal atresia, achalasia, gastroparesis, constipation, and the less common but most severe motility disorder, pediatric intestinal pseudo-obstruction.

Keywords: achalasia; atresia; enteral nutrition; gastroesophageal reflux; gastroparesis; motility disorders; nutritional management; parenteral nutrition; pediatric intestinal pseudo-obstruction.

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Conflict of interest statement

All authors did not receive any honorarium, grant, or other form of payment to produce the manuscript.

Figures

Figure 1
Figure 1
Behavioral and dietetic strategies to support the management of infantile GERD.
Figure 2
Figure 2
Dietary management of gastroparesis. Dietary management of gastroparesis will vary depending on the degree of disease severity. An Algorithm to support the decision/progression for oral diet (orange), enteral feeding (gastric Vs jejunal) (green) or parenteral nutrition (blue), or a combination of all nutritional approaches for management of a patient with gastroparesis.
Figure 3
Figure 3
Dietary management of PIPO, adapted from Pescarin et al. [47]. Algorithm for dietary management of PIPO. Orange/green = no delated gastric emptying. Blue = delayed gastric emptying. Management may involve either oral, enteral (gastric Vs jejunal), parental nutrition (full Vs partial) or a combination of approaches. Patients tolerance may change over time.
Figure 4
Figure 4
Optimal position for stool passage.
See this image and copyright information in PMC

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