Introduction

Nutrition is one of the important risk factors for the occurrence of functional gastrointestinal disorders in children. These disorders, including functional dyspepsia (FD) and irritable bowel syndrome (IBS), are increasingly prevalent in the pediatric population. Understanding dietary patterns in affected children is crucial for developing preventive and therapeutic strategies.

Aims & Methods

The aim is to study eating behavior disorders in children with functional gastrointestinal disorders and to analyze the diet of children with combined functional gastrointestinal pathology.
Materials and methods: 110 children aged 6 to 18 with functional gastrointestinal disorders were examined. Patients were divided into two groups: 44 with a combination of symptoms of functional dyspepsia and irritable bowel syndrome and 66 with functional dyspepsia. The control group consisted of 30 practically healthy children. The diagnosis of functional dyspepsia and irritable bowel syndrome was established on the basis of clinical symptoms according to the Rome IV criteria (2016). In order to detect a violation of the nutritional regime, children were interviewed according to a questionnaire developed by us. They also studied the food preferences of schoolchildren using the Youth Adolescent Food Frequency Questionnaire, adapted to the model of children's nutrition in Ukraine.

Results

The frequency of eating disorders (absence of breakfast or full lunch at school, reduced number of meals) in children with functional disorders is higher than in healthy children. In children with overlap syndrome, these disorders were detected statistically significantly more often than in children with isolated functional dyspepsia. In children with functional disorders, the frequency of consumption of vegetables, cereals and cereal products is lower than in healthy children, and the consumption of meat, sausages and confectionery, fast food, chips, nuts, seeds, energy and sweet carbonated drinks, and fruit juices is higher. In children with a combination of functional dyspepsia and irritable bowel syndrome, the frequency of consumption of vegetables, cereals, and grain products is lower, and the consumption of confectionery, fast food, energy and sweet carbonated drinks is higher than in children with functional dyspepsia.
We conducted an analysis of nutrition in children with a combined pathology of functional dyspepsia (FD) and irritable bowel syndrome (IBS) (see table below).

Conclusion

Violation of the regime and quality of nutrition is a risk factor for the formation of functional gastrointestinal disorders in children, which must be taken into account in treatment.

References

Chouliaras G, Kondyli C, Bouzios I, Spyropoulos N, Chrousos GP, Roma-Giannikou E. Dietary Habits and Abdominal Pain-related Functional Gastrointestinal Disorders: A School-based, Cross-sectional Analysis in Greek Children and Adolescents. J Neurogastroenterol Motil 2019; 25:113-122. https://doi.org/10.5056/jnm17113
Alatas, F. S., Salsabila, K., Amalia, N., & Hanafi, G. (2022). Functional gastrointestinal disorders and nutritional status in junior high school students. Paediatrica Indonesiana, 62(4), 243-8. https://doi.org/10.14238/pi62.4.2022.243-8
Katsagoni CN, Karagianni V-M, Papadopoulou A. Efficacy of Different Dietary Patterns in the Treatment of Functional Gastrointestinal Disorders in Children and Adolescents: A Systematic Review of Intervention Studies. Nutrients. 2023; 15(12):2708. https://doi.org/10.3390/nu15122708

Introduction

Idiopathic gastroparesis (IG) remains a challenging condition, with few effective therapeutic options available. Despite recent European and international consensuses, some management modalities are still different in the French practice (1).

Aims & Methods

We aimed to develop French recommendations on the diagnosis and management of IG in adults and paediatric patients, highlighting the similarities and differences with recent consensuses. A Delphi process was conducted among a panel of 16 French neurogastroenterology experts, including gastroenterologists and paediatricians. A first list of statements was drafted with a literature summary. After revisions and clarifications, 3 voting rounds were conducted and consensus statements were identified (defined as ≥ 80% agreement).

Results

Consensus was reached for 39 out of 46 statements. Definition and diagnostic modalities were similar to recent guidelines. IG was defined as symptoms associated with delayed gastric emptying (GE), in the absence of a mechanical obstruction. The panel agreed that nausea and vomiting are cardinal symptoms, with postprandial distress symptoms frequently overlapping. Variable presentations according to age were highlighted in paediatric patients.
Delayed GE can be confirmed by either scintigraphy or a GE breath test, using a solid meal, and a 4-hour measurement. Food retention at endoscopy was not considered a diagnostic criterion. Pyloric EndoFlip was not considered a diagnostic or pretherapeutic tool. A blood test and screening for Helicobacter pylori were supported before diagnosing IG.
Regarding the management, like in recent guidelines, the panel supported a first-line therapy using dietary advice and dopamine antagonists (metoclopramide or domperidone). The panel supported the efficacy of intravenous erythromycin, but not oral erythromycin. Agreement on the efficacy of other drugs, including prucalopride, antiemetics, or neuromodulators, was not reached. The use of nutritional support was recommended if deemed necessary for refractory vomiting and malnutrition, with enteral post-pyloric nutrition recommended as the first option.
The consensus supported different strategies for the management of refractory gastroparesis. Stopping opioids, or drugs inducing delayed GE, and the treatment of associated constipation were recommended before considering more invasive procedures. The efficacy of pyloric toxin injection was not agreed upon. Gastric endoscopic pyloromyotomy and gastric electrical stimulation were considered effective therapies for refractory IG. Finally, surgical procedures were not supported.

Conclusion

This consensus shows that the diagnostic modalities for IG are similar in France as compared to international guidelines, but highlights differences in the management of refractory gastroparesis, supporting endoscopic pyloromyotomy or the implantation of gastric electrical stimulation.

References

1. Schol J, Wauters L, Dickman R, Drug V, Mulak A, Serra J, et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J. 2021 Apr;9(3):287–306.
2. Schol J, Huang IH, Carbone F, Fernandez LMB, Gourcerol G, Ho V, et al. Rome Foundation and international neurogastroenterology and motility societies’ consensus on idiopathic gastroparesis. Lancet Gastroenterol Hepatol. 2025 Jan;10(1):68–81.

Disclosure

HS received lecture fees from Enterra Medical, and Viatris.