Baylor Scott and White Medical Center, 1901 SW H K Dodgen Loop, Temple, TX, 76502, USA.
University of Texas Medical School at Houston, 6431 Fannin St, Houston, TX, 77030, USA.
BMC Gastroenterol. 2023 Jul 17;23(1):240. doi: 10.1186/s12876-023-02865-6.
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.
胃轻瘫是指在无梗阻的情况下胃排空延迟；饮食调整是一线治疗方法。然而，我们并不清楚提供饮食建议相关的因素。
我们试图确定胃轻瘫患儿接受饮食教育（来自胃肠病学提供者或营养师）的频率、提供的建议以及与这些结果相关的因素。我们对我院儿科胃肠病学提供者管理的 2-18 岁儿童进行了回顾性图表审查。记录了患者的人口统计学和临床数据、提供的饮食建议（如果有）以及营养师咨询（如果有）、就诊地点和促动力药物的使用情况。采用调整后的二项式回归模型确定了与提供饮食教育、营养师咨询和推荐饮食相关的因素。
在符合标准的 161 名患者中，98 名（60.8%）接受了饮食教育，42 名（26.1%）接受了营养师咨询。胃肠病学提供者和营养师最常见的建议是调整饮食结构（分别为 26.5%和 47.6%）。有恶心/呕吐症状的患者接受饮食教育或被建议调整饮食结构的可能性较小。有体重减轻/生长不良的患者更有可能接受营养师的支持。在社区就诊的患者比在医疗中心门诊就诊的患者更有可能被推荐低脂饮食。
只有略多于一半的胃轻瘫患儿接受饮食教育，而且营养师的使用频率要低得多。症状和临床环境似乎与提供指导的内容、地点和人员有关。
