The rising cost of hospital care for children with gastroparesis: 2004–2013

Lu, Peter L.; Moore‐Clingenpeel, Melissa; Yacob, Desale; Lorenzo, Carlo Di; Mousa, Hayat

doi:10.1111/nmo.12869

Cited by 32 publications

(38 citation statements)

References 10 publications

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“…It remains unclear whether this is true for children and whether it is simply due to improved awareness and more clinically diagnosed cases . A nationwide inpatient database study of over 4000 children with gastroparesis (median age 8 years, IQR 2‐14) noted a dramatic increase in the financial burden of hospitalization for pediatric gastroparesis during years 2004‐2013 . This study found that, unlike in adults, hospitalizations for functional gastrointestinal (GI) disorders have simultaneously increased, suggesting that the rise in gastroparesis admissions may not be simply secondary to changing awareness and diagnostic practices.…”

Section: Resultsmentioning

confidence: 97%

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: Resultsmentioning

confidence: 97%

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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show abstract

“…While the prevalence among children is unknown, the past decade has seen a dramatic increase in gastroparesis-associated hospitalizations. [25] In children 70% of gastroparesis is idiopathic or post-viral, with the remaining 30% due to medications or post-surgery. Various pathophysiologic causes have been proposed, including abnormalities of extrinsic gastric innervation, loss of interstitial cells of Cajal (ICCs), hypoganglionosis, and inflammatory degeneration of myenteric neurons.…”

Section: Gastroparesismentioning

confidence: 99%

Pediatric enteric neuropathies: diagnosis and current management

Westfal¹,

Goldstein

2017

Current Opinion in Pediatrics

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Purpose of Review Neurointestinal diseases are increasingly recognized as causes of significant gastrointestinal morbidity in children. This review highlights the most common pediatric enteric neuropathies and their diagnosis and management, emphasizing insights and discoveries from the most recent literature available. Recent Findings The embryologic and histopathologic causes of enteric neuropathies are varied. They range from congenital aganglionosis in Hirschsprung disease, to autoimmune-mediated loss of neuronal subtypes in esophageal achalasia and Chagas disease, to degenerative neuropathies in some cases of chronic intestinal pseudo-obstruction and gastroparesis. Increased awareness of the clinical presentation and diagnostic evaluation of these conditions is essential as it allows for earlier initiation of treatment and improved outcomes. Most current therapies, which include medical management, neurostimulation, and operative intervention, aim to minimize the symptoms caused by these conditions. The evidence base for many of these treatments in children is poor, and multi-institutional prospective studies are needed. An innovative therapy on the horizon involves using neuronal stem cell transplantation to treat the underlying pathology by replacing the missing or damaged neurons in these diseases. Summary While recent advances in basic and clinical neurogastroenterology have significantly improved our awareness and understanding of enteric neuropathies, the efficacy of current treatment approaches is limited. The development of novel therapies, including pharmacologic modulators of neurointestinal function, neurostimulation to enhance gut motility, and neuronal cell-based therapies, is essential to improve the long-term outcomes in children with these disorders.

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“…It occurs in up to 4% of adults, but no prevalence data are available in children . A nationwide database survey did document a dramatic increase in hospitalizations for pediatric gastroparesis during years 2004–2013 . Confirming the diagnosis of gastroparesis can be challenging, as testing protocols vary and there are no standardized, age‐based pediatric normative data for comparison .…”

Section: Overview Of Common Pediatric Gi Motility Disordersmentioning

confidence: 99%

“…7 A nationwide database survey did document a dramatic increase in hospitalizations for pediatric gastroparesis during years 2004-2013. 9 Confirming the diagnosis of gastroparesis can be challenging, as testing protocols vary and there are no standardized, age-based pediatric normative data for comparison. 10 As pharmacological treatment options are very limited, nutrition interventions are often essential components of therapy.…”

Section: Gastroparesismentioning

confidence: 99%

Nutrition Management in Pediatric Gastrointestinal Motility Disorders

2019

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Gastrointestinal (GI) motility disorders are associated with suboptimal nutrition in children, mainly because of malabsorption and symptoms limiting dietary intake. Apart from medical therapy, nutrition support has a crucial role in maintaining growth and improving clinical outcomes in children. Based on recent data and guidelines, this review provides an overview of nutrition assessment and specific interventions for common pediatric GI disorders including gastroesophageal reflux disease, esophageal motility disorders, gastroparesis, chronic intestinal pseudo‐obstruction, and constipation. Several approaches including diet modification, enteral nutrition (gastric vs post‐pyloric, temporary vs permanent access, bolus vs continuous), and parenteral nutrition need to be tailored based on patient's nutrition and clinical assessment.

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The rising cost of hospital care for children with gastroparesis: 2004–2013

Cited by 32 publications

References 10 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

Pediatric enteric neuropathies: diagnosis and current management

Nutrition Management in Pediatric Gastrointestinal Motility Disorders

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