Enhanced Gastroduodenal Motility in Children

Hitch, David C.; Vanhoutte, Jean J.; Torres-Pinedo, Ramón

doi:10.1001/archpedi.1982.03970400017005

Cited by 6 publications

(8 citation statements)

References 14 publications

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“…Metoclopramide has been extensively studied in different age groups including infants, and it was found to improve symptoms and significantly increase fractional emptying. [151][152][153][154] However, this drug was labeled by the FDA with a black-box warning due to risks of extrapyramidal symptoms including tardive dyskinesia. Chronic use is still very common in children.…”

Section: Treatmentmentioning

confidence: 99%

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

Kovacic

Elfar

Rosen

et al. 2019

Neurogastroenterology Motil

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Background Due to scarcity of scientific literature on pediatric gastroparesis, there is a need to summarize current evidence and identify areas requiring further research. The aim of this study was to provide an evidence‐based review of the available literature on the prevalence, pathogenesis, clinical presentation, diagnosis, treatment, and outcomes of pediatric gastroparesis. Methods A search of the literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines with the following databases: PubMed, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Web of Science. Two independent reviewers screened abstracts for eligibility. Key Results Our search yielded 1085 original publications, 135 of which met inclusion criteria. Most articles were of retrospective study design. Only 12 randomized controlled trials were identified, all of which were in infants. The prevalence of pediatric gastroparesis is unknown. Gastroparesis may be suspected based on clinical symptoms although these are often non‐specific. The 4‐hour nuclear scintigraphy scan remains gold standard for diagnosis despite lack of pediatric normative comparison data. Therapeutic approaches include dietary modifications, prokinetic drugs, and postpyloric enteral tube feeds. For refractory cases, intrapyloric botulinum toxin and surgical interventions such as gastric electrical stimulation may be warranted. Most interventions still lack rigorous supportive data. Conclusions Diagnosis and treatment of pediatric gastroparesis are challenging due to paucity of published evidence. Larger and more rigorous clinical trials are necessary to improve outcomes.

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Section: Treatmentmentioning

confidence: 99%

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

Kovacic

Elfar

Rosen

et al. 2019

Neurogastroenterology Motil

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“…In adult patients, Meto has been shown to shorten gastric emptying as determined by "Tc scintigraphy and barium fluoroscopy, as well as to improve symptomatic assess ments of gastric emptying in adults with gas tric outlet syndrome [7,10,[12][13][14]. In chil dren, Meto has also been shown effective in increasing gastric emptying, enhancing gas troduodenal peristalsis, and decreasing the frequency of regurgitation and gastroesopha geal reflux [6,8,9,11].…”

Section: Discussionmentioning

confidence: 99%

Metoclopramide Promotes Enteral Feeding in Preterm Infants with Feeding Intolerance

Meadow¹,

Bui²,

Strates³

et al. 1989

Dev Pharmacol Ther

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We hypothesized that the feeding difficulties experienced by premature infants are related to immature peristaltic activity and that a bowel accelerant might promote feeding in prematures. We administered metoclopramide (Meto) to 14 infants admitted to the Intensive Care Nursery at The University of Chicago between January 1, 1984, and January 1, 1987. Each infant had failed enteral feeding on at least two separate occasions. At the time of initiation of Meto, the group of infants tolerated only 11.7 ± (SEM) 3.6 cm^3/kg/day enterally. Feeding tolerance improved steadily after Meto was initiated, and by 29 days the infants tolerated 134 ± 12.6 cm^3/kg/day enterally. The average slope of the post-Meto feeding regression lines was +4.21 ± 0.94 cm^3/kg/day/day, significantly greater than -0.67 ± 0.59 cm^3/kg/day/day pre-Meto. The percentage of feedings followed by significant gastric residual volumes was 33.1 ± 4.6% pre-Meto, compared to 6.9 ± 2.5% post-Meto. No child receiving Meto developed any extrapyramidal neurologic symptoms, worsening of hepatic function, or necrotizing enterocolitis. Meto may have a role in the treatment of premature infants with enteral feeding intolerance.

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“…Metoclopramide is a dopamine antagonist. It increases the LES pressure, increases the amplitudes of smooth muscle contractions, and coordinates gastric, pyloric, and duodenal muscle activity [39,40]. The usual dosage is 0.3 to 0.5 mg/kg/day.…”

Section: Therapeutic Methodsmentioning

confidence: 99%

Gastroesophageal Reflux in Infants and Children

El-Mouzan

1991

Ann Saudi Med

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Enhanced Gastroduodenal Motility in Children

Cited by 6 publications

References 14 publications

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

Update on pediatric gastroparesis: A review of the published literature and recommendations for future research

Metoclopramide Promotes Enteral Feeding in Preterm Infants with Feeding Intolerance

Gastroesophageal Reflux in Infants and Children

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