Gastroparesis in childhood: fiction or daily problem?

Abstract

Gastroparesis, or delayed gastric emptying without obstruction, is a chronic disorder caused by stomach pump failure. The prevalence and etiology of gastroparesis in children has not been extensively examined, though postviral gastroparesis (rotavirus) is thought to be the most com mon identifiable cause in children. Typical symptoms of gastroparesis are abdominal fullness or bloating, early satiety, epigastric pain and distress, heartburn, anorexia, nausea, vomiting and weight loss. Several methods have been proposed for quantification of gastric emptying: abdominal ultrasonography, radiographic contrast techniques, gastric emptying scintigraphy, electrogastrography and breath testing for gastroparesis. Initial therapy should be guided by underlying diseases, if existent. Treatment is based on psychological and dietary support and pharmacotherapy. Pharmacotherapy includes prokinetic and antiemetic agents. From a paediatric perspective, prokinetic erythromycin is more efficient, has mild and transient side effects after long-term, low-dose administration. Gastric electrical stimulation seems to be the most promising therapeutic option available at present.