BMC Gastroenterol. 2023 Jul 17;23(1):240. doi: 10.1186/s12876-023-02865-6.

Debra Eseonu ¹, Deepa Dongarwar ², Hamisu Salihu ³, Bruno P Chumpitazi ^3 4, Robert J Shulman ^5 6

Author information

¹Baylor Scott and White Medical Center, 1901 SW H K Dodgen Loop, Temple, TX, 76502, USA.

²University of Texas Medical School at Houston, 6431 Fannin St, Houston, TX, 77030, USA.

³Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.

⁴USDA/ARS Children's Nutrition Research Center, 1100 Bates Ave, Houston, TX, 77030, USA.

⁵Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA. rshulman@bcm.edu.

⁶USDA/ARS Children's Nutrition Research Center, 1100 Bates Ave, Houston, TX, 77030, USA. rshulman@bcm.edu.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.