Dipasquale V, Morello R, Romano C. Gastrointestinal and nutritional care in pediatric neuromuscular disorders. World J Clin Pediatr 2023; 12(4): 197-204 [PMID: 37753494 DOI: 10.5409/wjcp.v12.i4.197]
Corresponding Author of This Article
Valeria Dipasquale, MD, PhD, Doctor, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University Hospital “G. Martino”, Via Consolare Valeria 1, Messina 98124, Italy. dipasquale.valeria@libero.it
Research Domain of This Article
Nutrition & Dietetics
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Sep 9, 2023; 12(4): 197-204 Published online Sep 9, 2023. doi: 10.5409/wjcp.v12.i4.197
Gastrointestinal and nutritional care in pediatric neuromuscular disorders
Valeria Dipasquale, Rossella Morello, Claudio Romano
Valeria Dipasquale, Rossella Morello, Claudio Romano, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University Hospital “G. Martino”, Messina 98124, Italy
Author contributions: Dipasquale V, Morello R and Romano C equally contributed to the article.
Conflict-of-interest statement: All the authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Valeria Dipasquale, MD, PhD, Doctor, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University Hospital “G. Martino”, Via Consolare Valeria 1, Messina 98124, Italy. dipasquale.valeria@libero.it
Received: March 27, 2023 Peer-review started: March 27, 2023 First decision: June 14, 2023 Revised: July 4, 2023 Accepted: August 9, 2023 Article in press: August 9, 2023 Published online: September 9, 2023
Abstract
Neuromuscular diseases (NMDs) affect the development and growth of the neuromuscular system in children. The pathology can occur anywhere along the neuromuscular pathway, from the brain to the nerves to the muscle fibers. These diseases have a profound impact on the quality of life not only of children but also of their families. The predominant manifestation in NMDs is hypotonia, which leads to muscle weakness and fatigue, reduced mobility, and decreased physical performance. However, multiple organ systems can be affected, with resulting orthopedic, cardiac, infectious, respiratory, and nutritional problems. Children with NMD present an increased risk for several dietary and feeding difficulties because of their neuromuscular diagnosis, presentation, and severity. These problems include chronic gastrointestinal issues (constipation, dysphagia, gastroesophageal reflux, and diarrhea), dysphagia, malnutrition, and body composition alterations. As a result, compared to the overall pediatric population, infants and children with NMD are more likely to be malnourished, ranging from failure to thrive to overweight or obesity. Disease-specific guidelines vary in level of detail and recommendations for dietary management. Overall, nutritional data available are sparse, with the exception of Duchenne muscular dystrophy, spinal muscular atrophy, and congenital muscular dystrophy. The purpose of this review is to describe the spectrum of nutritional challenges in children with NMD and to summarize the main dietary and gastrointestinal recommendations for each neuromuscular disorder to provide guidance for daily clinical practice.
Core Tip: Pediatric neuromuscular disorders (NMDs) can be associated with a range of nutritional issues, such as insufficient or excessive weight gain, difficulty in swallowing, constipation, diarrhea, vomiting, gastroesophageal reflux disease, and micronutrient deficiencies. We herein discuss the spectrum of nutritional challenges in children with NMD and summarize the currently available dietary and gastrointestinal recommendations for each neuromuscular disorder to provide guidance for daily clinical practice.
