Gastroesophageal Reflux Disease and Foregut Dysmotility in Children with Intestinal Failure

Area of Science:

• Pediatric Gastroenterology
• Gastrointestinal Motility Disorders

Background:

• Gastrointestinal (GI) dysmotility is prevalent in children with intestinal failure (IF), encompassing short bowel syndrome (SBS) and pediatric intestinal pseudo-obstruction (PIPO).
• This condition significantly increases morbidity and diminishes the quality of life for affected children.
• Impaired GI motility in IF stems from primary disorders affecting gut function or reduced gut mass.

Purpose of the Study:

• To review the pathogenesis of GI dysmotility in pediatric IF.
• To discuss diagnostic workup and management strategies for these patients.

Main Methods:

• This is a review article.
• It synthesizes current knowledge on the pathophysiology of GI dysmotility in IF.

Main Results:

• Abnormalities in GI anatomy, hormone secretion, and neural supply contribute to dysmotility in IF.
• Manifestations include rapid transit, ineffective peristalsis, delayed gastric emptying, and reflux.
• Understanding these mechanisms informs tailored nutritional and pharmacological interventions.

Conclusions:

• Effective management of GI dysmotility in pediatric IF requires understanding its underlying pathophysiologic mechanisms.
• Individually tailored approaches can improve quality of life and enhance enteral tolerance.