Clin Exp Pediatr. 2022;65(1):21-28. Published online September 10, 2021
· Clinical manifestations of upper gastrointestinal (UGI) tract involvement in Crohn's disease (CD) are common but often clinically underestimated.
· Diagnosing CD by confirming inflammation of the UGI tract histologically is challenging because macroscopic and microscopic findings overlap with those of other diseases.
· Ongoing efforts are needed to enable a standardized assessment of UGI CD in the future.
Question: Are functional gastrointestinal disorders (FGIDs) common in Italy? If so, what are the associated risk factors? Finding: In this cross-sectional study of 1,594 adolescents, the prevalence of FGIDs was 30.9% and was mainly associated with smartphone addiction. Meaning: Smartphone use and dietary habits should be monitored in children with FGIDs.
Clin Exp Pediatr. 2021;64(9):471-472. Published online December 28, 2020
Functional gastrointestinal disorders are common disorders characterized by persistent and recurrent gastrointestinal symptoms. Pathophysiological mechanisms have been suggested, including intestinal microbiota, altered intestinal permeability and motility, dietary effects, sensory abnormalities, and brain-gut dysregulation. Lifestyle factors such as diet, sleep, affect, and physical activity might function as moderators.
Question: What are the prevalence and clinical characteristics of celiac disease (CD) in children in Bahrain? Finding: We found a significant increase in CD prevalence over the last decade (P=0.0001). A male predominance was noted. Atypical presentations were common. Most patients had poor adherence to a gluten-free diet. Meaning: CD is an underdiagnosed condition. Atypical symptoms should be considered to prevent missing patients with CD.
· Norovirus is the most common virus in Korean children with acute gastroenteritis.
· Escherichia coli and Salmonella spp. are the most common cause of bacterial gastroenteritis in Korean children, with a detection rate of 3%–20%.
· Uncommon bacterial and parasitic gastroenteritis require attention because of increasing international exchange and overseas travel.
Question: What is the value of the diagnostic code in identifying cases of biliary atresia in a large administrative database? Finding: The diagnostic code’s accuracy and sensitivity are acceptable for identifying algorithm-defined cases. A history of pale stool and a presumed diagnosis of biliary atresia prior to referral added value. Meaning: The addition of clinical data to the diagnostic code significantly increased the diagnostic yield.
Question: Can noninvasive biomarkers identify esophageal varices among children with esophageal cirrhosis? Finding: The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index, platelet count to spleen size ratio, and risk score differed significantly between the patients with and those without esophageal varices. Meaning: These biological parameters can predict esophageal varices among pediatric patients and indicate the need for esophagogastroduodenoscopy.
Although Helicobacter pylori infection rate in children is unclear due to diversity and limitation of diagnostic tests unlike in adults, investigation the childhood prevalence is important for predicting H. pylori-related diseases in the future. H. pylori infection occurred in early childhood, and declined during 30 years in our study.
Change in risk factors of H. pylori transmission and consensus for eradication therapy in children might further reduce the infection rate.
Question: ecurrent abdominal pain (RAP) is a chief complaint among pediatrics and is associated with reduced quality of life, for both parent and child, and economic burden. Does probiotics reduce the frequency of RAP among children? Finding: This study reported the effects of Lactobacillus reuteri probiotics among children with RAP as a result of multiple etiologies. Meaning: The administration of probiotic supplements is significantly associated with pain relief among RAP children presented with functional abdominal pain, irritable bowel syndrome, and functional dyspepsia.
Question: Which clinical findings suggest esophageal structure in children with dysphagia? Finding: The presence of solid dysphagia, malnutrition, and a comorbid condition is suggestive of esophageal stricture in children with dysphagia. Meaning: Patients with findings suggestive of noncaustic esophageal stricture should receive early referral to pediatric gastroenterology units.
Although the precise pathogenesis of inflammatory bowel disease (IBD) is unclear, dietary factors seem to play a significant role. Dietary modifications including enteral nutrition and the Crohn disease exclusion, specific carbohydrate, and anti-inflammatory diets show a potential ability to downregulate gut inflammation. These nutritional interventions have various degree of efficacies with limited side effects profile for treating pediatric IBD, but data from randomized prospective studies are lacking, and further studies are warranted.
Inflammatory bowel disease (IBD) is a chronic relapsing immune-mediated disease of the intestinal tract. Although its prevalence is reportedly lower in Asia than in Western countries, the rapid increase in the incidence of IBD has drawn attention to its etiology, including genetic susceptibility and environmental factors. Specifically, recent studies concerning dietary treatments and intestinal microbiota suggest that these factors may...
Background: Immunomodulatory properties of interferon (IFN) have been documented. It may induce autoimmune diseases such as autoimmune thyroiditis with hypo- or hyperthyroidism. In addition, it may impair thyroid hormone synthesis through affecting iodide organification in thyroid gland.
Purpose: The aim of this study was to describe thyroid function tests disturbances in children with chronic hepatitis C (CHC) receiving pegylated interferon-alpha (PEG...
