Abstract
Normal gastric motor function requires coordination of the autonomic nervous system, enteric nervous system, and enteric smooth muscles. Intrinsic and extrinsic stimuli constantly interact and impact stomach filling and emptying. Disturbances in these complex processes may result in alterations of gastric motility and symptoms of gastroparesis or dumping syndrome. Gastric motility disorders are common in children. This chapter focuses on the etiology of gastric motor disorders and provides a brief overview of diagnostic and therapeutic options. Idiopathic and postinfectious gastroparesis are among the most common causes of gastric dysmotility in children. Other etiologies of gastroparesis include intestinal inflammatory disease (e.g., CMPA, IBD, celiac disease), endocrinopathies, dysautonomia, constipation, malnutrition, medications, and toxins. Symptoms of gastroparesis may include severe pain, nausea, or anorexia and can be debilitating. Rapid gastric emptying can result in dumping syndrome with severe upper gastrointestinal and vasomotor symptoms. Early dumping syndrome occurs due to rapid fluid shifts related to hyperosmolar load transfer to the small intestine. Late dumping syndrome symptoms are related to reactive hyperinsulinemic hypoglycemia.