Clinical Presentation, Response to Therapy, and Outcome of Gastroparesis in Children

Rodriguez, Leonel*; Irani, Katayun; Jiang, Hongyu; Goldstein, Allan M.

Journal of Pediatric Gastroenterology & Nutrition: August 2012 - Volume 55 - Issue 2 - p 185–190
doi: 10.1097/MPG.0b013e318248ed3f
Original Articles: Gastroenterology

Objectives: The aims of the present study was to define the clinical features, response to therapy, and outcome of pediatric gastroparesis.

Methods: Retrospective review of 230 children with gastroparesis. Demographics, gastric emptying times, symptoms, response to medications, and outcome were determined for each of 3 groups (infants, children, and adolescents).

Results: Mean age was 9 years, with boys predominating among infants and girls among adolescents. Postviral gastroparesis occurred in 18% and mitochondrial dysfunction (MD) in 8%. Symptoms varied with age, with children experiencing more vomiting and adolescents reporting more nausea and abdominal pain. The addition of promotility drugs was an effective therapy. Overall rates of symptom resolution were 22% at 6 months, 53% at 18 months, and 61% at 36 months, with median time to resolution of 14 months. Factors associated with symptom resolution included younger age, male sex, postviral gastroparesis, shorter duration of symptoms, response to addition of promotility therapy, and absence of MD. In multivariate analysis, longer duration of symptoms and MD both predicted lower rates of resolution, whereas younger age and response to addition of promotility therapy predicted a higher rate.

Conclusions: Pediatric gastroparesis is a complex condition with variable symptomatology and outcome depending on multiple parameters. Understanding the clinical features and response to therapy will improve our diagnosis and treatment of this disorder.

*Department of Medicine, Children's Hospital

Department of Pediatric Surgery, Massachusetts General Hospital

Department of Biostatistics Core, Children's Hospital Boston, Harvard Medical School, Boston, MA.

Address correspondence and reprint requests to Leonel Rodriguez, MD, MS, Department of Medicine, Division of Gastroenterology, Center for Motility and Functional Gastrointestinal Disorders, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115 (e-mail: leonel.rodriguez@childrens.harvard.edu).

Received 21 June, 2011

Accepted 3 October, 2011

The authors report no conflicts of interest.

© 2012 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,