People with spinal muscular atrophy (SMA) may suffer from abdominal problems such as diarrhea, bloating, spitting up, vomiting after meals, bad breath, regurgitation, and abdominal distention.

Because these symptoms vary with the type of SMA and its severity, it is important that parents and healthcare assistants assess the nutritional status of the child regularly. In extreme situations, these symptoms may contribute to undernutrition.

The probability of having an underlying condition such as acid reflux or gastroesophageal reflux disease (GERD) increases with the frequency of abdominal problems. Some children may even refuse to eat when they develop discomfort with swallowing, which may lead to undernutrition.

Abdominal distention and bloating are a consequence of infrequent bowel movements, which is also a consequence of SMA abdominal issues: abnormal gastrointestinal movements, reduced intake of fiber in the diet, insufficient fluid intake, and low muscle tone of the abdominal wall.

Evaluation of abdominal problems

The sooner abdominal problems are identified, the better the outcome for the child. Motility studies, such as scintigraphy, may help document delayed gastric emptying, which may be the cause of the symptoms. Scintigraphy is a diagnostic test performed to diagnose conditions such as GERD using a two-dimensional picture of a body radiation source obtained through the use of radioisotopes. By using a camera that senses radioactivity, a picture that corresponds to the location of the radiation is obtained.

Management of abdominal problems

The use of probiotics such as acidophilus or lactobacillus may help maintain a healthy gastrointestinal flora, especially after antibiotic treatment or in case of prolonged use of acid inhibitors for the treatment of GERD.

As nutrition-related problems in SMA influence not only the general well-being but also the respiratory conditions of people with SMA, there is a need for a multidisciplinary approach with a team of physicians, speech therapists or occupational therapist, dietitians, and pediatric surgeons to improve the survival and quality of life of SMA patients.

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