Siriraj Medical Journal (Aug 2020)
Gastrointestinal Motility Disorders in Children
Abstract
From 1991 to 2000, thirty patients with gastrointestinal motility disorders were diagnosed in Department of Pediatrics, Siriraj Hospital. They were divided into 3 groups ; in group 1, 15 patients had normal psychomotor development with chronic intestinal pseudo-obstruction (CIP) or intestinal dysmotility; in group 2, 9 patients had psychomotor retardation with CIP or intestinal dysmotility and in group 3, 6 patients had gastroparesis. Three cases in group 1 had underlying causes including megacystis-microcolon-intestinal-hypoperistalsis syndrome (MMIHS), SLE, and Strongyloid infestation. MMIHS was diagnosed during pregnancy. This patient did not respond to any medications and died at 5 months. Nine cases in group 2 and 1 case in group 1 were diagnosed as CIP due to their persistent symptoms of obstruction and radiologically demonstrated dilated intestine with air /fluid levels. The main presenting symptoms were abdominal distention (27 cases), constipation (14 cases), abdominal pain (13 cases), vomiting (9 cases), diarrhea (9 cases), and refusal of feeds (3 cases). X-ray studies were the most useful investigation to diagnose the disorders. All patients received cisapride as a prokinetic drug in order to improve the motility of the GI tract. A good response was obtained in14 cases, a fair response in 15 cases and a poor response in 1 case. GI motility disorder is not uncommon in Thai children. The severity of the motility disorder varied from mild to severe. The majority of cases had a good prognosis except in the cases with psychomotor retardation.
