Gastric motility abnormalities in pediatric gastroesophageal reflux disease: A comprehensive review of mechanisms and therapeutic implications
Abstract
Gastroesophageal reflux disease (GERD) is a common pediatric gastrointestinal disorder associated with significant morbidity, especially when persistent or severe. Although the primary underlying mechanism for GERD is lower esophageal sphincter dysfunction, there is accumulating evidence that disturbances in gastric motility significantly contribute. Described gastric motor abnormalities in GERD include delayed emptying, antral hypomotility, impaired gastric accommodation, abnormal intragastric meal distribution, disordered gastric myoelectrical activity, duodeno-gastro-esophageal reflux, and altered migrating motor complexes. These disturbances are hypothesized to contribute to GERD by increasing intragastric pressure, delaying gastric emptying, and facilitating retrograde flow of gastric contents into the esophagus, acting through complementary mechanisms. The relationship between gastric dysmotility and GERD symptoms remains unclear, leading to uncertainty regarding its clinical significance. Furthermore, there is uncertainty about the role of investigations such as gastric emptying scintigraphy, 13C-breath tests, and advanced motility techniques in routine practice. Therapeutic approaches for correcting motility disturbances, including prokinetic medications and neuromodulation, show promise but have limited evidence for their effectiveness in children. Future research should better delineate the role of gastric dysmotility in GERD, refine indications for gastric motility investigations, and evaluate the benefits of targeted motility-based therapies to optimize management strategies in pediatric GERD.
Related
- Gut Microbiota-Driven Neuroimmune Crosstalk in Ulcerative Colitis: From Mechanisms to Therapeutic Implications
- Exerkines in Cardiovascular–Kidney–Metabolic Syndrome: An Integrative Framework for Mechanisms and Therapeutic Implications—A Narrative Review
- Inflammation After Transcatheter Aortic Valve Implantation: Mechanisms, Risk Stratification, and Therapeutic Implications
- Oxidative Stress in Chronic Rhinosinusitis with Nasal Polyps: Pathophysiological Mechanisms, Biomarkers, and Therapeutic Implications
- Epithelial-mesenchymal transition plasticity in breast cancer: regulatory mechanisms and therapeutic implications
BibTeX
@article{devanarayana2026gastric,
title = {{Gastric motility abnormalities in pediatric gastroesophageal reflux disease: A comprehensive review of mechanisms and therapeutic implications}},
author = {Niranga Manjuri Devanarayana and Shaman Rajindrajith},
journal = {World Journal of Clinical Pediatrics},
year = {2026},
month = nov,
doi = {10.5409/wjcp.122141},
url = {https://doi.org/10.5409/wjcp.122141},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Gastric motility abnormalities in pediatric gastroesophageal reflux disease: A comprehensive review of mechanisms and therapeutic implications
AU - Niranga Manjuri Devanarayana
AU - Shaman Rajindrajith
PY - 2026
DA - 2026/11/03
JO - World Journal of Clinical Pediatrics
DO - 10.5409/wjcp.122141
UR - https://doi.org/10.5409/wjcp.122141
AB - Gastroesophageal reflux disease (GERD) is a common pediatric gastrointestinal disorder associated with significant morbidity, especially when persistent or severe. Although the primary underlying mechanism for GERD is lower esophageal sphincter dysfunction, there is accumulating evidence that disturbances in gastric motility significantly contribute. Described gastric motor abnormalities in GERD include delayed emptying, antral hypomotility, impaired gastric accommodation, abnormal intragastric meal distribution, disordered gastric myoelectrical activity, duodeno-gastro-esophageal reflux, and altered migrating motor complexes. These disturbances are hypothesized to contribute to GERD by increasing intragastric pressure, delaying gastric emptying, and facilitating retrograde flow of gastric contents into the esophagus, acting through complementary mechanisms. The relationship between gastric dysmotility and GERD symptoms remains unclear, leading to uncertainty regarding its clinical significance. Furthermore, there is uncertainty about the role of investigations such as gastric emptying scintigraphy, 13C-breath tests, and advanced motility techniques in routine practice. Therapeutic approaches for correcting motility disturbances, including prokinetic medications and neuromodulation, show promise but have limited evidence for their effectiveness in children. Future research should better delineate the role of gastric dysmotility in GERD, refine indications for gastric motility investigations, and evaluate the benefits of targeted motility-based therapies to optimize management strategies in pediatric GERD.
SN - 2219-2808
ER -