Presentation
CONCLUSIONS: Abnormalities in GI motility may be an early presenting sign of disorders of OXPHOS in children. [ncbi.nlm.nih.gov]
CONCLUSION: Abnormalities in GI motility may be an early presenting sign of disorders of OXPHOS in children. [nature.com]
Gastrointestinal abnormalities may be an early presenting sign of mitochondrial disease (Chitkara, 2003). [mitoaction.org]
The presenting faculty reported the following: Dr. [consultant360.com]
Entire Body System
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Fatigue
Muscle weakness or fatigue of the muscles of mastication can directly interfere with the physical intake of adequate calories. [mitoaction.org]
Reference: Burnet R B, Chatterton B: Gastro-Intestinal Symptoms and Gastric Emptying Studies in Chronic Fatigue Syndrome; AHMF Conference 2001. [digestivedistress.com]
[…] symptoms include: A change in normal bowel habits Blood on or in the stool that is either bright or dark Unusual abdominal or gas pains Very narrow stool A feeling that the bowel has not emptied completely after passing stool Unexplained weight loss Fatigue [my.clevelandclinic.org]
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Developmental Delay
Developmental delay was a problem for 74% of all subjects, often in association with anatomic and behavioral problems. [journals.lww.com]
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Cerebral Palsy
Prevalence of feeding problems and oral motor dysfunction in children with cerebral palsy: a community survey. J Pediatr 1996; 129:877–82. 5. Martinez DA, Ginn-Pease ME, Cainano DA. [journals.lww.com]
Gastrointestinal
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Nausea
Read More about Gastropareis Cyclic vomiting syndrome (CVS) Cyclic vomiting syndrome (CVS) is a disorder with recurrent episodes of severe nausea and vomiting interspersed with symptom free periods. CVS occurs in all ages. [aboutgimotility.org]
Most people with gastroparesis experience nausea and vomiting. Many have abdominal discomfort or pain, which can range from bothersome to debilitating. [iffgd.org]
Delayed gastric emptying most commonly gives rise to abdominal discomfort after meals, nausea and vomiting. The two most common causes of delayed gastric emptying are gastric outlet obstruction and gastroparesis. [medicinenet.com]
Symptoms depend on which area of the digestive tract that is involved, and may include: Abdominal pain or swelling Difficulty swallowing Reflux (or back up of food in the throat) Burping Regurgitation A feeling of early fullness Nausea Vomiting Weight [columbiadoctors.org]
Unfortunately, erythromycin has many potential side effects including nausea and may not be well tolerated. [journal.diabetes.org]
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Abdominal Pain
It also provides global relief of IBS symptoms (eg, abdominal pain/discomfort, diarrhea, and urgency) in patients with IBS with diarrhea. [pharmacytimes.com]
This leads to symptoms such as central abdominal pain, bloating, and diarrhea. Delayed emptying and stagnation of fluids in the small intestine may lead to bacterial overgrowth syndromes, resulting in diarrhea and abdominal pain. [journal.diabetes.org]
Mitochondrial disease should be part of the differential diagnosis for individuals with dysmotility, chronic diarrhea, constipation or chronic abdominal pain (Chitkara, 2003). [mitoaction.org]
These symptoms range from nausea, vomiting, belching, reflux (stomach acid washing into the mouth), early satiety (a feeling of fullness after a few bites of food), abdominal pain or bloating, a change in bowel habits, and weight loss. [digestivedistress.com]
Symptoms depend on which area of the digestive tract that is involved, and may include: Abdominal pain or swelling Difficulty swallowing Reflux (or back up of food in the throat) Burping Regurgitation A feeling of early fullness Nausea Vomiting Weight [columbiadoctors.org]
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Failure to Thrive
Associated symptoms may include failure to thrive and/or coagulopathy. [mitoaction.org]
Failure to thrive. Pediatr Clin N Am 1988; 35:1187–206. 3. Burklow KA, Phelps AN, Rudolph C, et al. Classifying complex pediatric feeding disorders J Pediatr Gastroenterol Nutr 1998; 27:143–47. 4. Reilly S, Skuse D, Poblete X. [journals.lww.com]
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Persistent Vomiting
In children with chronic illness, persistent vomiting or retching, and refusal to eat, unrecognized but treatable gastrointestinal motor and/or sensory disturbances may contribute to the symptoms. [journals.lww.com]
Psychiatrical
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Psychomotor Retardation
Children with psychomotor retardation display a high rate of oral dysfunction ( 4 ) with associated aversive experiences (aspiration and choking), food refusal after prolonged airway intubation or tube feeding, and persistent vomiting and retching despite [journals.lww.com]
Neurologic
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Behavior Problem
Developmental delay was a problem for 74% of all subjects, often in association with anatomic and behavioral problems. [journals.lww.com]
Workup
The workup and treatment of diarrhea is similar in patients with or without diabetes. [journal.diabetes.org]
Microbiology
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Giardia Lamblia
Bassotti G, Pelli MA, Ribacchi R, Miglietti M, Cavalletti ML, Rossodivita ME, Giovenali P, Morelli A: Giardia lamblia infestation reveals underlying Whipple's disease in a patient with longstanding constipation. [link.springer.com]
Treatment
Hyman Abstract Background In chronically ill children who refuse to eat, surgery to correct anatomic problems and behavioral treatments to overcome oral aversion often succeed. A few patients fail with standard treatments. [doi.org]
A few patients fail with standard treatments. [journals.lww.com]
Tegaserod is the only agent indicated by the FDA for the treatment of women with IBS with constipation, and alosetron is the only FDA-approved treatment for women with IBS with diarrhea. [pharmacytimes.com]
If these treatments don't relieve pain, surgery might be needed to repair the sphincter muscle. [my.clevelandclinic.org]
This must be done because treatment of pseudo-obstruction and true obstruction are very different. [ddc.musc.edu]
Prognosis
Prognosis Primary intestinal motility disorders or disorders that are not secondary to malignancy or debilitating pathology have a good prognosis. [emedicine.medscape.com]
Ultrasonography or computed tomography showing characteristic changes in a patient who uses little or no alcohol confirms the diagnosis. 24 CLINICAL FEATURES, COURSE, AND PROGNOSIS Most patients with nonalcoholic fatty liver disease are asymptomatic. [aafp.org]
Etiology
But the etiology of the intestinal motility disorders cannot be fully explained by physiological causes alone. [pennmedicine.org]
Gastric Emptying Study Center Medically Reviewed on 6/14/2018 References Medically reviewed by Venkatachala Mohan, MD; Board Certified Internal Medicine with subspecialty in Gastroenterology REFERENCE: "Gastroparesis: Etiology, clinical manifestations [medicinenet.com]
Hyperglycemia and poor glycemic control play a substantial role in gastroparesis, both as an etiologic factor and a clinical manifestation. [consultant360.com]
GASTRIC MUCOSAL ISCHEMIA : Ischemia of mucosa causes increased permeability ------ Gastric Ulcers Etiology: Lots of things; shock, burns, sepsis, trauma. [kumc.edu]
Sometimes an empiric trial of antibiotics and/or pancreatic enzymes is warranted because pancreatic exocrine insufficiency and bacterial overgrowth may be the etiology. [journal.diabetes.org]
Epidemiology
Epidemiology According to some epidemiologic reports, as many as 30 million Americans have intestinal motility disorders. [emedicine.medscape.com]
EPIDEMIOLOGY A constellation of GI symptoms occurs commonly in persons with diabetes and may be caused by autonomic dysfunction, as well as by other factors. [consultant360.com]
Pathophysiology
The aims of the study were to: 1) investigate motility and gastric sensory abnormalities and 2) describe treatment that was individualized based on pathophysiology in children who failed surgery and behavioral treatments. [doi.org]
Familial mitochondrial encephalomyopathy (MERRF): Genetic, pathophysiological, and biochemical characterization of a mitochondrial DNA disease. Cell 1988; 55 :601–610. 11. Zheng, X, Shoffner, JM, Lott, MT, et al. [nature.com]
The pathophysiology of these gastrointestinal symptoms, clarified in recent studies, and the clinical features and treatment of these problems in diabetic patients are reviewed. FULL TEXT [annals.org]
PATHOPHYSIOLOGY There are a number of different causes of gastroparesis ( Table I3 ), yet the underlying pathophysiology remains unclear. [consultant360.com]
Prevention
Achalasia – prevents the sphincter from opening and allowing food to enter the stomach. Gastro-esophageal reflux disease (GERD) – caused by the stomach’s acidic contents leaking backwards up into the esophagus. [winthrop.org]
Aspiration of food is prevented: Respiration is inhibited from this point forward. Epiglottis is NOT important in preventing aspiration. Rather it is adduction vocal cords that prevents food getting into trachea.. [kumc.edu]
Learn More about Constipation Outlet obstruction type constipation (pelvic floor dyssynergia) The external anal sphincter, which is part of the pelvic floor normally stays tightly closed to prevent leakage. [iffgd.org]
This sensation of rectal filling enables us to consciously or unconsciously squeeze the external anal sphincter to prevent incontinence until we can reach a toilet. [drossmangastroenterology.com]
Can gastrointestinal disease be prevented? Many diseases of the colon and rectum can be prevented or minimized by maintaining a healthy lifestyle, practicing good bowel habits, and submitting to cancer screening. [my.clevelandclinic.org]