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Gastrointestinal and nutritional problems in neurologically impaired children

Quitadamo, P; Thapar, N; Staiano, A; Borrelli, O; (2016) Gastrointestinal and nutritional problems in neurologically impaired children. European Journal of Paediatric Neurology , 20 (6) pp. 810-815. 10.1016/j.ejpn.2016.05.019. Green open access

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Abstract

The current increasing survival of children with severe central nervous system damage has created a major challenge for medical care. Gastrointestinal and nutritional problems in neurologically impaired children have been recently recognized as an integral part of their disease, often leading to growth failure and worsened quality of life for both children and caregivers. Nutritional support is essential for the optimal care of these children. Undernourished handicapped children might not respond properly to intercurrent diseases and suffer unnecessarily. On the other hand, restoring a normal nutritional status results in a better quality of life in many. The easiest and least invasive method to increase energy intake is to improve oral intake. However, oral intake can be maintained as long as there is no risk of aspiration, the child is growing well and the time required to feed the child remains within acceptable limits. When oral intake is unsafe, insufficient or too time consuming, enteral nutrition should be initiated. Damage to the developing central nervous system may result in significant dysfunction in the gastrointestinal tract and is reflected in impairment in oral-motor function, rumination, gastro-oesophageal reflux (GER), with or without aspiration, delayed gastric emptying and constipation. These problems can all potentially contribute to feeding difficulty in disabled children, carrying further challenging long-term management issues.

Type: Article
Title: Gastrointestinal and nutritional problems in neurologically impaired children
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ejpn.2016.05.019
Publisher version: https://doi.org/10.1016/j.ejpn.2016.05.019
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Neurological impairment, Malnutrition, Enteral nutrition, Percutaneous endoscopic gastrostomy, Dysphagia, Gastro-esophageal reflux, Constipation
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery-pp.ucl.ac.uk/id/eprint/1518091
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