Intestinal motility and jejunal feeding in children with chronic intestinal pseudo-obstruction

Gastroenterology. 1995 May;108(5):1379-85. doi: 10.1016/0016-5085(95)90685-1.


Background/aims: Total parenteral nutrition is responsible for most of the morbidity and mortality of childhood chronic intestinal pseudo-obstruction (CIP). The aim of this study was to determine if there are manometric patterns associated with the success of jejunal feedings in children with CIP.

Methods: Eighteen children with CIP (age range, 1-9 years; mean, 4 years; 11 boys and 7 girls) were studied. All patients required parenteral nutrition or failed to thrive while receiving gastrostomy feedings. All underwent an antroduodenal manometry before surgical placement of a jejunostomy. Continuous drip jejunal feeding with an elemental formula was subsequently initiated. Follow-up after jejunal feeding was 1.6 years (range, 6 months to 4 years). Jejunal manometry was performed 2 months to 1 year after jejunostomy.

Results: Jejunal feeding eliminated the need for parenteral nutrition in all 9 patients with migrating motor complex (MMC) and in 3 of 9 patients without MMC (P < 0.01). The MMC was present or absent in both antroduodenal and jejunal manometry in 14 of 18 children (77.7%). In 10 of 18 children (55%), duodenal and jejunal manometry showed similar qualitative abnormalities.

Conclusions: In selected children with CIP who fail gastrostomy feeding, jejunal tube feeding is an alternative to parenteral nutrition. The presence of MMCs is associated with a successful adaptation to jejunal feeding.

MeSH terms

  • Child
  • Child, Preschool
  • Chronic Disease
  • Duodenum / physiopathology
  • Enteral Nutrition*
  • Female
  • Gastrointestinal Motility*
  • Humans
  • Infant
  • Intestinal Pseudo-Obstruction / physiopathology
  • Intestinal Pseudo-Obstruction / therapy*
  • Jejunostomy
  • Jejunum / physiopathology
  • Male
  • Manometry