Many pediatric patients with gastroparesis do not receive dietary education

Authors: ESEONU, DEBRA - Baylor University Medical Center; DONGARWAR, DEEPA - University Of Texas Health Science Center; SALIHU, HAMISU - Baylor College Of Medicine; CHUMPITAZI, BRUNO - Children'S Nutrition Research Center (CNRC); SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)

Submitted to: BioMed Central (BMC) Gastroenterology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/28/2023
Publication Date: 7/17/2023
Citation: Eseonu, D., Dongarwar, D., Salihu, H., Chumpitazi, B.P., Shulman, R.J. 2023. Many pediatric patients with gastroparesis do not receive dietary education. BioMed Central (BMC) Gastroenterology. 23. Article 240. https://doi.org/10.1186/s12876-023-02865-6.
DOI: https://doi.org/10.1186/s12876-023-02865-6

Interpretive Summary: Slow stomach emptying (gastroparesis) can cause severe stomach symptoms that often impact the ability to eat and result in poor nutrition. Changes to the diet are recommended as a first step in treating children and adults with slow stomach emptying. However, we do not know how often children and their parents get nutritional advice when the child has this problem. We reviewed the records of numerous children with slow stomach emptying to find out how often they got dietary advice from their doctor and/or from a dietitian. Approximately 6 out of 10 children received advice from their doctor. However, of those, only 1 in 4 got dietary advice from a dietitian. We identified some factors that appeared to predict whether dietary advice would be given. The results of the study show that we must work harder to ensure that children with slow stomach emptying get the dietary advice they need to reduce their symptoms and prevent poor nutrition.

Technical Abstract: Gastroparesis is delayed gastric emptying in the absence of obstruction; dietary modifications are first-line treatment. However, we do not know the factors related to provision of dietary recommendations. We sought to determine how often pediatric patients with gastroparesis receive dietary education (from a gastroenterology provider vs dietitian), the recommendations given, and factors related to these outcomes. We performed a retrospective chart review of children 2- to 18-years-old managed by pediatric gastroenterology providers at our institution. Patient demographics and clinical data, dietary advice given (if any), and dietitian consultation (if any), practice location, and prokinetic use were captured. An adjusted binomial regression model identified factors associated with dietary education provision, dietitian consultation, and diet(s) recommended. Of 161 patients who met criteria, 98 (60.8%) received dietary education and 42 (26.1%) met with a dietitian. The most common recommendation by gastroenterology providers and dietitians was diet composition adjustment (26.5% and 47.6%, respectively). Patients with nausea/vomiting were less likely to receive dietary education or be recommended to adjust diet composition. Patients with weight loss/failure to thrive were more likely to receive dietitian support. Patients seen in the community vs medical center outpatient setting were more likely to be recommended a low-fat diet. Only a little over half of children with gastroparesis receive dietary education and use of a dietitian's expertise is much less frequent. Symptoms and clinical setting appear related to what, where, and by whom guidance is provided.