Objective To analyze difference of enteric microorganism in children with cerebral palsy and epilepsy with different diets, and to explore the its effect on gastrointestinal dysfunction.

Methods Forty-one cerebral palsy children with epilepsy were screened as study subjects. All enrolled subjects were divided into observation group (n=23) and control group (n=18) based on the patients' basic dietary status. Stool samples from the children were collected and subjected to 16S rRNA gene amplification and high-throughput sequencing, and bacterial abundance analysis was performed based on the samples. Principal component analysis (PCA) was performed on the genus-based composition and relative abundance, and the overall microbiota distribution of the samples according to group was mapped.

Results The children in the control and observation groups showed significant differences in height, body weight and Gross Motor Function Classification System (GMFCS) classification (P < 0.05). Gastrointestinal dysfunction occurred in both groups, constipation was the most commonly occurring symptom, followed by abdominal distension and diarrhea. The incidence of vomiting, abdominal distension, diarrhea, gastrointestinal bleeding and constipation in the observation group was higher than that in the control group, and the difference was statistically significant (P < 0.05). The top 5 dominant phyla in the control group in terms of abundance were Firmicutes, Bacteroidetes, Actinobacteria, Proteobacteria and Fusobacteria. In the observation group, the top 5 dominant phyla in terms of abundance were Firmicutes, Actinobacteria, Bacteroidetes, Proteobacteria and Verrucomicrobia. Among them, the abundance of phylum Bacteroides, Actinomyces, Clostridium phylum and Verrucomicrobial phylum showed significant difference between the two groups (P < 0.01). In terms of the dominant genera, four of the top five genera in the control group overlapped with the observation group, namely Prevotella, Bacillus, Bifidobacterium and Paramecium, of which the abundance of Bacillus, Bifidobacterium and Paramecium were significantly higher in the observation group than those in the control group, while the abundance of Prevotella was lower than that in the control group (P < 0.05). PCA showed a significant difference in the structure of the intestinal flora in the observation group compared with the control group (P=0.002).

Conclusion Compared with children with a normal diet, children with cerebral palsy and epilepsy with a liquid diet have increased level of symbiotic pathogen in their gut microbiota and decreased intestinal barrier protective bacteria, which increases the risk of gastrointestinal dysfunction in children with cerebral palsy and epilepsy.