Gastrointestinal Dystonia in children and young people with severe nurological impairment & palliative care needs: a systematic review
Warlow, Timothy Yates, Jill Taylor, Naomi Villanueva, Gemma Koodiyedath, Bindu McElligott, Fiona Holt, Susie Anderson, Anna-Karenia
Warlow, Timothy
Yates, Jill
Taylor, Naomi
Villanueva, Gemma
Koodiyedath, Bindu
McElligott, Fiona
Holt, Susie
Anderson, Anna-Karenia
Abstract
Background: Increasing numbers of young people with severe neurological impairment are suffering from gastrointestinal symptoms, which may result in nutritional failure and ultimately death. Gastrointestinal dystonia is a recently described clinical diagnosis amongst patients with severe neurological impairment, and no systematic review of existing evidence currently exists.
Aim: To conduct a systematic review of existing evidence for the management of gastrointestinal dystonia in children and young people with severe neurological impairment and palliative care needs.
Method: A systematic review assessing pharmacological and non-pharmacological treatments was undertaken using standard Cochrane methodology. We searched Cochrane CENTRAL, MEDLINE, EMBASE, and PsycInfo. All databases were searched from inception, and no language restrictions were used.
Results: 1580 references were identified. After abstract screening, 56 references were reviewed at full text, and a case report and case series were identified for inclusion. Low-quality, indirect evidence exists for the management of gastrointestinal dystonia, including symptom management, hydration and nutrition decisions, and end-of-life care.
Conclusions: There is a paucity of existing evidence directly relating to gastrointestinal dystonia, but low-quality indirect evidence from studies of children with severe neurological impairment and gastrointestinal symptoms exist, which may begin to inform clinical practice.
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Date
2025-10
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Warlow T, Yates J, Taylor N, Villanueva G, Koodiyedath B, McElligott F, Holt S, Anderson AK. Gastrointestinal Dystonia in Children and Young People with Severe Neurological Impairment & Palliative Care Needs: A Systematic Review. Children (Basel). 2025 Oct 9;12(10):1359. doi: 10.3390/children12101359.