From the FDA Drug Label
For the Relief of Symptoms Associated with Diabetic Gastroparesis (Diabetic Gastric Stasis) If only the earliest manifestations of diabetic gastric stasis are present, oral administration of metoclopramide may be initiated. To Facilitate Small Bowel Intubation Pediatric patients (6 to 14 years of age) – 2. 5 to 5 mg metoclopramide base; (under 6 years of age) – 0. 1 mg/kg metoclopramide base.
The FDA drug label does not answer the question about post viral gastroparesis on a 6 yo male, as it only discusses diabetic gastroparesis and does not provide information on post-viral gastroparesis. 1
From the Research
Post viral gastroparesis in a 6-year-old male typically requires a multifaceted approach focusing on symptom management and nutritional support, as outlined in the 2023 update on the clinical management of gastroparesis 2. The initial treatment should include dietary modifications with small, frequent, low-fat meals and adequate hydration.
- Medications may include domperidone (0.3-0.5 mg/kg three times daily, maximum 30 mg/day) or metoclopramide (0.1-0.2 mg/kg three to four times daily, maximum 10 mg/dose) for prokinetic effects, though metoclopramide should be used cautiously due to potential neurological side effects.
- Antiemetics such as ondansetron (0.15 mg/kg per dose, maximum 8 mg) can help control nausea and vomiting.
- For pain management, low-dose tricyclic antidepressants like amitriptyline (0.2-0.5 mg/kg at bedtime) may be beneficial. Nutritional support is crucial; if oral intake is insufficient, consider nasojejunal feeding or parenteral nutrition in severe cases.
- Regular monitoring of weight, growth, and hydration status is essential, as emphasized in the clinical guideline for the management of gastroparesis 3. Most post-viral gastroparesis in children resolves within weeks to months, but some cases may persist longer, as noted in a study on postviral gastroparesis 4. The condition occurs when a viral infection damages the vagus nerve or gastric pacemaker cells, disrupting normal stomach contractions and delaying gastric emptying, which explains the symptoms of early satiety, nausea, vomiting, and abdominal pain. The management of post-viral gastroparesis should prioritize symptom relief, nutritional support, and improvement of gastric emptying, with a focus on the most recent and highest quality evidence, such as the 2023 update on the clinical management of gastroparesis 2.