Pediatric Gastrointestinal Disease Research Articles

Second-generation colon capsule in small bowel and colon disorders in pediatrics

Aim of the study was to assess the diagnostic yield of second-generation colon capsule in pediatric gastrointestinal diseases. Five patients with different symptoms of gastrointestinal diseases were included in the study. Among them were: suspicion on diffuse polyposis, intestinal bleeding, lymphangiectasia and inflammatory bowel disease. Image interpretation was made by experienced capsule users, previously trained on small bowel capsule and first generation colon capsule. Lesions or abnormal changes of the mucosa identified on capsule endoscopy served as indications for colonoscopy or esophagogastroduodenoscopy with biopsy or polypectomy if needed. Standard white light endoscopy was made in all children without any adverse events. Second-generation colon capsule allows diagnosing Crohn's disease in small intestine and colon, limphangiectasia of the ileum, single rectosigmoid polyp and diffuse polyposis of the colon. Second-generation colon capsule can be used as non-invasive screening method in children without serious complications, thus allowing to differentiate indications for traditional white light endoscopy, which is usually made under general anesthesia in pediatrics.

Mucosal mast cell counts in pediatric eosinophilic gastrointestinal disease

Mucosal mast cell counts in pediatric eosinophilic gastrointestinal disease

Recent Achievements in Stem Cell Therapy for Pediatric Gastrointestinal Tract Disease

The field of stem cell research has been rapidly expanding. Although the clinical usefulness of research remains to be ascertained through human trials, the use of stem cells as a therapeutic option for currently disabling diseases holds fascinating potential. Many pediatric gastrointestinal tract diseases have defect in enterocytes, enteric nervous system cells, smooth muscles, and interstitial cells of Cajal. Various kinds of therapeutic trials using stem cells could be applied to these diseases. This review article focuses on the recent achievements in stem cell applications for pediatric gastrointestinal tract diseases.

Pediatric Gastrointestinal Diseases in Nigeria: Histopathologic Analysis of 74 Cases

BACKGROUND: Children are vulnerable to a vast number of diseases including gastrointestinal disorders, which may be associated with life threatening complications that sometimes result in mortality especially if left untreated. OBJECTIVE: To establish the age and sex distribution of children in the study population as well as the histopathological characteristics of gastrointestinal diseases that occurred in those children who were aged 14years and below in Sagamu, Southwestern Nigeria. MATERIALS AND METHODS: Demographic data such as age, sex, and clinical summary of children in the study population were extracted from the medical records of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State from January 2003 to December 2009. Based on this information, a review of paraffin embedded blocks and slides as well as histopathological reports of gastrointestinal diseases that occurred in those children aged 14years and below was undertaken at the Morbid Anatomy Department of the hospital. RESULTS: Seventy–four cases of gastrointestinal diseases were seen in children aged 14years and below. The majority (39.2%) of gastrointestinal diseases were accounted for by appendiceal lesions. Hirschsprung’s disease, intussusceptions, enterocolitis and jejunal atresia accounted for 29.7%, 10.8%, 6.8% and 4.1% of cases respectively. Adenocarcinoma of the intestine was the predominant gastrointestinal tumour, occurring in 5 out of 7 children. Two cases of non-Hodgkin lymphoma were also seen. The ages of the children ranged from 2 to 14 years, with a mean age of 8.6years and a peak age incidence of gastrointestinal disease in the 10-14year age group. Male children were more commonly affected with the exception of appendiceal lesions, which occurred more in females (M:F ratio= 1.6:1.0). Acute suppurative appendicitis was the most prevalent lesion of the appendix, occurring in 13 out of 29 appendiceal lesions. Moderately differentiated to poorly differentiated histological types were seen in the tumours- 3 adenocarcinomas and 2 mucinous carcinomas. Burkitt’s and Mucosal-associated types of non– Hodgkin lymphomas were the two histological types of lymphoma seen primarily in the stomach and small intestine respectively. CONCLUSION: Appendiceal lesion was the predominant paediatric gastrointestinal disease found in the study population with preponderance for female children. Adenocarcinoma was the most common gastrointestinal tumour found, while, Hirschsprung’s disease, intussusception, enterocolitis, jejunal atresia and non-Hodgkin lymphoma contributed to only a minority of the gastrointestinal diseases found in the study population.

High-Technology Gastroenterology Disorders in Children

Although improvements in managing pediatric gastrointestinal diseases have occurred over time, the use of technical adjuncts to aid in management has greatly improved the survival and quality of life for these patients. This has increased the scope of presenting disorders, unique and challenging adverse effects, complications, and technical difficulties for which emergency care providers must be familiar. This article will include a review of gastrointestinal tubes and their complications and presurgical and postsurgical considerations for gastroschisis, omphalocele, and Hirschsprung disease. In addition, with increasing pediatric survival from organ transplantation, pretransplantation and posttransplantation issues will be discussed, specifically for liver and small bowel transplantation. Pediatric patients with short bowel syndrome are being encountered more frequently and use multiple high technical adjuncts to aid in their survival. These adjuncts, as well as a review of short bowel syndrome, will be discussed.

Probiotics stimulate enterocyte migration and microbial diversity in the neonatal mouse intestine.

Beneficial microbes and probiotics show promise for the treatment of pediatric gastrointestinal diseases. However, basic mechanisms of probiosis are not well understood, and most investigations have been performed in germ-free or microbiome-depleted animals. We sought to functionally characterize probiotic-host interactions in the context of normal early development. Outbred CD1 neonatal mice were orally gavaged with one of two strains of human-derived Lactobacillus reuteri or an equal volume of vehicle. Transcriptome analysis was performed on enterocyte RNA isolated by laser-capture microdissection. Enterocyte migration and proliferation were assessed by labeling cells with 5-bromo-2'-deoxyuridine, and fecal microbial community composition was determined by 16S metagenomic sequencing. Probiotic ingestion altered gene expression in multiple canonical pathways involving cell motility. L. reuteri strain DSM 17938 dramatically increased enterocyte migration (3-fold), proliferation (34%), and crypt height (29%) compared to vehicle-treated mice, whereas strain ATCC PTA 6475 increased cell migration (2-fold) without affecting crypt proliferative activity. In addition, both probiotic strains increased the phylogenetic diversity and evenness between taxa of the fecal microbiome 24 h after a single probiotic gavage. These experiments identify two targets of probiosis in early development, the intestinal epithelium and the gut microbiome, and suggest novel mechanisms for probiotic strain-specific effects.

Recent Updates on Vitamin D and Pediatric Gastrointestinal Diseases

The clinical importance of vitamin D has been recently highlighted, due to non-skeletal effects of vitamin D and the fact that vitamin D receptors are observed in many kinds of cells. Vitamin D deficiency or insufficiency results in the development of gastrointestinal diseases, including obesity, hepatitis B, chronic hepatitis C, and inflammatory bowel disease in children. The prevalence of vitamin D insufficiency in 188 Korean adolescents, aged 12-13 years, was 98.9% for boys and 100% for girls. This article reviews recent publications, regarding vitamin D deficiency and childhood gastrointestinal diseases, and introduces new treatment and prevention guidelines for vitamin D deficiency. (Pediatr Gastroenterol Hepatol Nutr 2012; 15: 138∼144)

Gastrointestinal Microbiota and Some Children Diseases: A Review

The bacterial colonization is defined immediately after birth, through direct contact with maternal microbiota and may be influenced during lactation. There is emerging evidence indicating that quantitative and qualitative changes on gut microbiota contribute to alterations in the mucosal activation of immune system leading to intra- or extra-intestinal diseases. A balance between pathogenic and beneficial microbiota throughout childhood and adolescence is important to gastrointestinal health, including protection against pathogens, inhibition of pathogens, nutrient processing (synthesis of vitamin K), stimulation of angiogenesis, and regulation of host fat storage. Probiotics can promote an intentional modulation of intestinal microbiota favoring the health of the host. This paper is a review about modulation of intestinal microbiota on prevention and adjuvant treatment of pediatric gastrointestinal diseases.

Neonatal necrotizing enterocolitis

Neonatal necrotizing enterocolitis Akhil Maheshwari1, Laura L Corbin2, Robert L Schelonka21Division of Neonatology and Center for Neonatal and Pediatric Gastrointestinal Disease, Department of Pediatrics, University of Illinois at Chicago, IL, 2Division of Neonatology, Department of Pediatrics, Oregon Health and Sciences University, Portland, OR, USAAbstract: Necrotizing enterocolitis is the most common gastrointestinal emergency in preterm neonates and a major cause of morbidity and mortality in premature infants born before 32 weeks of gestation or with a birth weight less than 1500 g. In this review, we discuss predisposing factors, clinical manifestations, and the quality of evidence for various preventive and therapeutic strategies.Keywords: necrotizing enterocolitis, inflammation, mucosa, pneumatosis, neonate

33rd Annual Aspen Conference on Pediatric Gastrointestinal Disease

33^rd Annual Aspen Conference on Pediatric Gastrointestinal Disease

33rd Annual Aspen Conference on Pediatric Gastrointestinal Disease

33^rd Annual Aspen Conference on Pediatric Gastrointestinal Disease

33rd Annual Aspen Conference on Pediatric Gastrointestinal Disease

33^rd Annual Aspen Conference on Pediatric Gastrointestinal Disease

Vitamin D status and supplementation in pediatric gastrointestinal disease

To evaluate vitamin D status and supplementation in the pediatric population with common gastrointestinal diseases. The literature was searched for studies on vitamin D status in children with inflammatory bowel disease (IBD), celiac disease, and liver disease. Vitamin D supplementation in healthy children was also reviewed. Those with gastrointestinal diseases are more likely to have vitamin D deficiency as a result of malabsorption. Current recommendations for supplementation may be too low to achieve optimal levels. It is important to monitor vitamin D levels in pediatric populations with gastrointestinal diseases and appropriately treat levels that are insufficient.

Stem Cell in Pediatric Gastrointestinal Tract Disease: Hirschsprung Disease

Stem cell is characterized with self-renewal and mult-potency. Many pediatric gastrointestinal diseases have defect in enterocytes, enteric nervous system, and Interstitial cell of Cajal. Various kinds of stem cell could be applied to these diseases. Here, the author introduces stem cell for pediatric gastrointestinal diseases, particularly Hirschsprung disease. (Korean J Pediatr Gastroenterol Nutr 2011; 14(Suppl 1): S42∼S46)

1378: Ultrasonography of Emergent Gastrointestinal Diseases in Pediatric Age

To understand the imaging strategy for the evaluation of emergent diseases of pediatric gastrointestinal tract and to get the knowledge of characteristic findings for each specific disease. Many diseases including congenital anomalies can cause gastrointestinal tract emergency in pediatric age. Ultrasonography is a screening imaging modality for abdominal pathologies in pediatric patients. We will demonstrate ultrasonographic findings in important and specific diseases including various bowel obstructions, gastrointestinal bleeding, infectious condition and others. We can find specific ultrasonographic findings of many emergent gastrointestinal diseases in pediatric patients. It is very important to improve the ultrasonographic skill and experiences about pediatric gastrointestinal emergent diseases because ultrasonography can diagnose the specific disease and differentiate between surgical and non-surgical diseases. In pediatric age, ultrasonography plays an important role in diagnosis and treatment of emergent gastrointestinal diseases.

Hirschsprung's Disease in Two Siblings

Hirschsprung’s disease (HD) is one of the major pediatric gastrointestinal disease entities which is associated with an absence or lack of intrinsic ganglion cells in the myenteric and submucosal plexus in the gastrointestinal tract. It is commonly assumed to be a sex-modified multifactorial trait. The development of diagnostic and therapeutic modalities has been ongoing. Herein, we experienced two siblings who were confirmed as having HD histologically and were treated. We think further family evaluation regarding HD is needed. Also we could see a changing modality of diagnosis and treatment.

Randomised controlled trial of paediatric magnetic positioning device assisted colonoscopy: A pilot and feasibility study

Complete colonoscopy is critical for the evaluation of many paediatric gastrointestinal diseases. The aim of the study was to investigate the feasibility of magnetic positioning device for paediatric colonoscopy and to compare completion rate and procedure time with and without the device. Prospective randomised controlled trial of standard colonoscopy compared to magnetic positioning device assisted colonoscopy in children and adolescents ages 7-20 years was performed. Analysis showed that the proportion of successfully completed colonoscopies were 19/20 (95%) in the MP arm versus 17/18 (94.4%) in the SC arm, p=NS. The median time to complete colonoscopy to the cecum was 16.5 min (range 6-52 min) in the MP arm and 12 min (range 6-33 min) in the SC arm, p=NS. Our preliminary data suggest that the use of magnetic positioning device for colonoscopy is feasible in paediatric patients. These data suggest that the use of magnetic positioning device may not be of benefit for experienced endoscopists who achieved very high colonoscopy completion rates without the MP device. Further studies are needed to determine its role in paediatric colonoscopy since this device may be of more benefit for physicians in training.

Enteral Feeding

Enteral Feeding

Probiotics in paediatric gastrointestinal diseases

Probiotics have become increasingly popular and are now promoted as having a wide range of benefits. Probiotics are generally very well tolerated and safe but many of the purported uses are not yet well supported with adequate scientific evidence. Two well-established roles for probiotics in children are acute diarrhoeal illness and antibiotic-associated diarrhoea. This review summarises the evidence supporting probiotics for various gastrointestinal disorders with particular reference to their role in the management of acute diarrhoea and antibiotic-associated diarrhoea in children.

Quality of Life in Paediatric Gastrointestinal and Liver Disease: A Systematic Review

To identify and appraise all studies relating to and instruments developed to measure quality of life (QOL) in children with gastrointestinal or liver diseases. A literature search was undertaken using MEDLINE, EMBASE, CINAHL, and PsycINFO to identify relevant articles published up to the end of 2005. These were reviewed by both authors and data were extracted using a standardised form. Articles were excluded if no attempt was made to measure QOL, they did not relate to children ages <17 years, they did not relate to gastrointestinal or liver diseases, or they were review articles. Quality of life instruments identified were rated according to proposed criteria. From a total of 2379 articles identified in the initial search, a total of 2309 were excluded, leaving 70 included studies. These were assigned to the following categories: inflammatory bowel disease, n = 17; cystic fibrosis, n = 20; liver disease, n = 11; surgery, n = 15; and miscellaneous, n = 7. These studies describe the impact that these diseases have on the QOL of affected children. A total of 11 disease-specific QOL instruments and 1 generic instrument with a chronic disease module were identified, but only 5 of these fulfilled the proposed quality criteria and can be recommended for future use. Chronic gastrointestinal and liver diseases can have an enormous effect on the QOL of affected individuals and their families. A number of disease-specific paediatric QOL instruments have been developed and validated. Quality of life is an important outcome that should be incorporated into clinical practice and measured when treatments are evaluated. Future research should explore how QOL can best be improved in children in whom it is severely impaired.