Prokinetic agents in childen with poor appetite

Of the feeding disorders in children, poor appetite is probably one of the most common complaints notified by parents. Since gastric motility disorders may be the cause of this symptom, the aim of our study was to investigate the effect of prokinetics on children with poor appetite and delayed gastric emptying.

Poor appetite was graded by VAS at start and end of treatment. Delayed gastric emptying was assessed by 99mTechnetium tincolloid scintigraphy. Malnutrition was defined according to Waterlow criteria. After initial assessment behavioural feeding recommendations were provided and trimebutine given for 6 months. Scintigraphy was repeated during treatment. Anthropometrical measurements and daily energy intake calculations were performed monthly

21 children (M/F: 12/9) with a mean age of 7 +/- 3 years were studied. At the end of treatment, weight and height standard deviation scores improved significantly (-1.0 +/- 0.6 vs. -0.8 +/- 0.7, p = 0.008 and -1.1 +/- 1.0 vs. -0.8 +/- 0.9, p=0.003, respectively) and malnutrition rate decreased from 81% to 66.7%. Improvement of gastric emptying was shown in 11 out of 16 children but was not statiscally significant (P = 0.059). The visual analogue scale scores of appetite showed significant improvement with therapy (7.5 +/- 1.3 vs. 5.3 +/- 2.0, p = 0.012).

Children with poor appetite who have delayed gastric emptying might benefit from prokinetic agent therapy combined with behavioural feeding recommendations.