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Gastric Motor Disorders: Gastroparesis and Dumping Syndrome

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Pediatric Neurogastroenterology

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Normal gastric motor function requires coordination of the autonomic nervous system, neurotransmitters and enteric smooth muscle cells. Alterations at any level of these complex processes may result in gastric motility disorders. Gastric motility disorders are common in children, and their treatment is often daunting. This chapter provides a detailed insight into the etiologies and pathogenesis of gastric motility disorders and an overview of the treatment modalities. Various etiologies account for the numerous clinical sequelae associated with gastric dysmotility, along with poorly understood and complex pathophysiological mechanisms. Etiological factors associated with gastroparesis vary with the child’s age. Gastric electrical and motor activity matures with gestational age. Early life experiences including environmental and nociceptive factors may delay postnatal gastro-enteric motor maturation. Post-infectious gastroparesis is common in children. It is often transient and resolves completely over several months. Neural disorders such as peripheral neuropathies, Hirschsprung’s disease, and various CNS disorders including mitochondrial encephalopathies are associated with gastroparesis. Gastroparesis seen after thoracic and upper abdominal surgeries can be due to injury of the vagal nerve. Inflammatory myopathies such as polymyositis and dermatomyositis frequently present with slow gastric emptying. Gastroparesis is seen in common gastroenterological conditions such as cow milk protein allergy, celiac disease, and inflammatory bowel diseases. Patients with various endocrine disorders, caustic ingestions and those who are critically ill commonly present with delayed gastric emptying. Rapid gastric emptying can lead to dumping syndrome characterized by the onset of gastrointestinal and vasomotor symptoms following the ingestion of a meal. Early dumping syndrome occurs as a consequence of the rapid emptying of hyperosmolar contents of the stomach into the small intestine, resulting in a fluid shift from the intravascular compartment into the intestinal lumen. Late dumping syndrome occurs due to reactive hypoglycemia from rapid release of insulin into circulation secondary to brisk absorption of glucose from the small bowel. Treatment of dumping syndrome includes lifestyle modifications and dietary measures.

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Author information

Authors and Affiliations

  1. Pediatric Gastorenterology, Hepatology and Nutrition Division, Pediatrics Department, Children’s Memorial Hospital, Northwestern University, Chicago, IL, USA

    Miguel Saps M.D.

  2. Division of Gastroenterology, Hepatology and Nutrition, Children’s Memorial Hospital, 2300 Children’s Plaza, 65, Chicago, IL, 60614-3363, USA

    Ashish Chogle M.D., M.P.H.

Authors
  1. Miguel Saps M.D.
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  2. Ashish Chogle M.D., M.P.H.
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Correspondence to Ashish Chogle M.D., M.P.H. .

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Editors and Affiliations

  1. Sainte-Justine Hospital, Department of Pediatrics, Division of Pediatric Gastroenterology, Université de Montréal, Montreal, H3T 1C5, Québec, Canada

    Christophe Faure

  2. Nationwide Children's Hospital, Division of Pediatric Gastroenterology, The Ohio State University, Columbus, 43205, Ohio, USA

    Carlo Di Lorenzo

  3. Gastroenterology and Neural Development, University College London, Institute of Child Health, Great Ormond Street Hospital for Children, London, WC1N 1EH, United Kingdom

    Nikhil Thapar

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Saps, M., Chogle, A. (2013). Gastric Motor Disorders: Gastroparesis and Dumping Syndrome. In: Faure, C., Di Lorenzo, C., Thapar, N. (eds) Pediatric Neurogastroenterology. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-709-9_21

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  • DOI: https://doi.org/10.1007/978-1-60761-709-9_21

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  • Publisher Name: Humana Press, Totowa, NJ

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