Anti-TNFα Treatment in Children and Adolescents With Combined Inflammatory Bowel Disease and Autoimmune Liver Disease
Conclusions:IBD in patients with AILD can be aggressive, requiring escalation to anti-TNFα or switching to other biologics. In this series, anti-TNFα did not impair liver function and improved gut disease in most of the patients, indicating that it can be beneficial and safe. Objectives: Inflammatory bowel disease (IBD) and autoimmune liver disease (AILD) are closely associated, the former often dictating progression of the latter. Antibodies to tumor necrosis factor alpha (anti-TNFα) are effective in the management of IBD, but may cause liver injury. Methods: Retrospective review of medical record...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Expediting Drug Development for Pediatric Inflammatory Bowel Disease: A Discussion With Stakeholders
Lack of scientific consensus on efficacy endpoints and outcome assessments presents a hurdle for global drug development in pediatric inflammatory bowel disease (IBD). Multiple stakeholders participated in a meeting November 2015, sponsored by The Pediatric IBD Foundation, which is a 501c3 organization formed by parents of children with IBD whose mission is to improve the lives of children with Crohn disease and ulcerative colitis by supporting innovative research and educational programs (www.pedsibd.org). With representatives of the Food and Drug Administration, European Medicines Agency, pediatric gastroenterologists, a...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Meeting Proceedings: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Changes in Hepcidin and Hemoglobin After Anti-TNF-alpha Therapy in Children and Adolescents With Crohn Disease
ABSTRACTObjectives:Anemia is the most common systemic complication of inflammatory bowel disease, is more common in affected children than in adults, and is mediated in large part by chronic inflammation. Inflammation increases levels of the iron-regulatory protein hepcidin, which have been elevated in adults with Crohn disease.Methods:We measured serum hepcidin-25 and hemoglobin (Hgb) in 40 children and adolescents with Crohn disease at baseline and 10 weeks after initiation of anti-tumor necrosis factor (TNF)-α therapy. Measures of disease activity, inflammatory markers, and cytokines were obtained in all subjects....
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Granulocyte and Monocyte Apheresis for Induction of Remission in Children With New-Onset Inflammatory Bowel Colitis
Conclusions:In this small study GMA for induction of remission of newly onset pediatric IBD colitis was effective in 8 of 12 patients. Further controlled studies are warranted to confirm the efficacy of this treatment model. Objective: The aim of the study was to analyze the effect of granulocyte and monocyte apheresis (GMA) with mesalazine for induction of remission in pediatric patients with newly onset chronic inflammatory bowel disease (IBD) colitis. Methods: Thirteen pediatric patients with newly onset extensive IBD colitis were investigated per the ECCO/ESPGHAN IBD protocol. Of these 13, 12 received 10 treatme...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Perceived Impairment in Sports Participation in Adolescents With Inflammatory Bowel Diseases: A Preliminary Examination
ABSTRACTObjective:Physical activity (PA) is important for adolescents with inflammatory bowel diseases (IBDs) given the increased risk of developing osteoporosis and the increased risk of IBD-related complications among those with IBD and obesity. Symptoms such as fatigue, abdominal pain, nausea, and frequent bowel movements can interfere with PA. Sports participation is an important source of PA for adolescents; however, the extent to which IBD interferes with sports participation is unstudied. The present study aimed to examine demographic, health-related, physical, and psychosocial correlates of perceived impairment in ...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Incidence and Risk Factors for Perianal Disease in Pediatric Crohn Disease Patients Followed in CEDATA-GPGE Registry
Conclusions:Approximately 10% of CD patients in our cohort suffered from PD within the first 3 years of their disease. Male sex and initial corticosteroid therapy were associated with an increased risk to develop PD after diagnosis. Objectives: Perianal disease (PD) with fistula and/or abscess formation is a severe complication in Crohn disease (CD). We examined prevalence, incidence, and risk factors for PD development in a pediatric CD cohort. Methods: Patients with CD from the prospective, multicenter registry for inflammatory bowel disease from Germany and Austria (CEDATA-GPGE) were included if diagnosed at the ...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Differentiation Between Crohn Disease and Intestinal Tuberculosis in Children
Conclusions:Microbiologic confirmation of tuberculosis is possible in 40% ITB cases. Presence of blood in stool and left-sided colonic involvement are the most important features favoring CD. Objectives: The aim of the study was to evaluate clinical, endoscopic, radiologic, and histopathological features helpful in differentiating Crohn disease (CD) from intestinal tuberculosis (ITB) in children. Methods: Patients diagnosed to have CD or ITB based on standard recommended criteria were enrolled. Children with inflammatory bowel disease unclassified or suspected ITB or CD with incomplete work-up or lost to follow-up w...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

How Secure Is the Diagnosis of Ulcerative Colitis in Children, Even After Colectomy?
Conclusions:Our data suggest that later manifestation of CD is more common than previously thought (24%). Therefore, a diagnosis of UC in children should be regarded as provisional and a potential later diagnosis of CD taken into account when considering colectomy and J-pouch formation. Objectives: We reviewed all children who have undergone a colectomy for ulcerative colitis (UC) in our tertiary referral centre in a 12-year period to assess the rate of reclassification as Crohn disease (CD). In contrast to CD, a colectomy is considered to be definitive treatment for patients with UC. Distinguishing between the 2 can b...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Anti-transglutaminase 6 Antibody Development in Children With Celiac Disease Correlates With Duration of Gluten Exposure
ABSTRACTObjectives:Antibodies against transglutaminase 6 (anti-TG6) have been implicated in neurological manifestations in adult patients with genetic gluten intolerance, and it is unclear whether autoimmunity to TG6 develops following prolonged gluten exposure. We measured the anti-TG6 in children with celiac disease (CD) at the diagnosis time to establish a correlation between these autoantibodies and the duration of gluten exposure. We investigated a correlation between anti-TG6 and the presence of neurological disorders.Methods:Anti-TG6 (IgA/IgG) were measured by ELISA in sera of children with biopsy-proven CD and of c...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Daily Experiences and Challenges Among Children and Adolescents With Celiac Disease: Focus Group Results
Conclusions:The focus groups revealed a wide scope of coping issues that contribute to a deeper understanding of specific CD characteristics including daily management, participation in food-related activities, roles, strategies, and supporting or hindering factors in everyday life with CD. Objectives: Maintaining a restrictive gluten-free diet is the only treatment for celiac disease (CD). Adherence among children and adolescents presents unique challenges and is often inadequate. The International Classification of Functioning, Disability and Health: Children and Youth version (ICF-CY) model encompasses all aspects o...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Risk of Eating Disorders in Patients With Celiac Disease
Conclusions:Although being a patient with CD was associated with a significantly higher Eating Attitude Test score in individuals older than 13 years old, no clear differences were observed between individuals with CD and controls in terms of risk of ED when other screening tests were used. More studies with larger samples and prospective designs are warranted to confirm these findings. Objectives: Several cases of eating disorders (EDs) have been reported in patients with celiac disease (CD), suggesting that ED could be a comorbidity associated with CD. Few epidemiological studies have, however, assessed this potentia...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Celiac Disease Symptom Resolution: Effectiveness of the Gluten-free Diet
Conclusions:On a strict GFD, children report greater rates of both GI and EI symptom resolution as compared to adults with greater rates of improvement in GI over EI symptoms. Early recognition of CeD and close attention to diet adherence may help in symptom resolution. Objective: The aim of the study was to evaluate the efficacy of the gluten-free diet (GFD) on gastrointestinal (GI) and extra-intestinal (EI) symptom resolution and identify predictors for persistence of symptoms in all celiac patients at the University of Chicago. Methods: We conducted a retrospective chart review from 2002 to 2015. GI symptoms incl...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Safety and Efficacy of the Push Endoscopic Technique in the Management of Esophageal Food Bolus Impactions in Children
Conclusion:The present study shows that the push technique is as safe and effective as the pull technique in managing esophageal FBIs in pediatric patients. Objectives: Adult-based guidelines support the use of the pull (extraction) endoscopic technique in managing esophageal food bolus impactions (FBIs) but allow the consideration of the push (advancement) technique with caution based on available published literature. The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition guidelines mention the use of gentle endoscopic pushing for disimpaction but elaborate that this technique has not bee...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Peroral Endoscopic Myotomy in Children: First Experience With a New Triangular Knife
ABSTRACTObjectives:Peroral endoscopic myotomy (POEM) is a novel treatment modality for achalasia cardia. The procedure is technically challenging and time consuming. Recently, a new triangle tip knife (TTJ) has been introduced, which is equipped with water jet facility. In the present study, we analyzed the feasibility, safety, and efficacy of POEM in children with new triangle tip knife.Methods:We retrospectively evaluated the data of children (18 years or younger) who underwent POEM using TTJ knife at our institution. All POEM procedures were performed under general anesthesia in an endoscopy suite. Technical feasibility...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Novel Pressure-Impedance Parameters for Evaluating Esophageal Function in Pediatric Achalasia
ABSTRACTObjective:In achalasia, absent peristalsis and reduced esophagogastric junction (EGJ) relaxation and compliance underlie dysphagia symptoms. Novel high-resolution impedance manometry variables, that is, bolus presence time (BPT) and trans-EGJ-bolus flow time (BFT) have been developed to estimate the duration of EGJ opening and trans-EGJ bolus flow. The aim of this study was to evaluate esophageal motor function and bolus flow in children diagnosed with achalasia using these variables.Methods:High-resolution impedance manometry recordings from 20 children who fulfilled the Chicago Classification (V3) criteria for ac...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Unsedated In-office Transgastrostomy Esophagoscopy to Monitor Therapy in Pediatric Esophageal Disease
Monitoring therapy in esophageal inflammatory disorders such as eosinophilic esophagitis and reflux esophagitis often requires frequent endoscopic evaluation. We recently reported the effective use of unsedated in-office transnasal esophagoscopy that significantly decreased costs and anesthetic exposure associated with pediatric esophagoscopy in eosinophilic esophagitis. Here we report a series of pediatric patients with esophagitis with gastrostomy tubes who underwent unsedated transgastrostomy esophagoscopy (TGE) in an office setting. Nine patients (ages 16 months–21 years) tolerated TGE without significant adverse...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Short Communication: Gastroenterology Source Type: research

Retrospective Comparison of Fluticasone Propionate and Oral Viscous Budesonide in Children With Eosinophilic Esophagitis
ABSTRACTBackground:Eosinophilic esophagitis (EoE) is treated with dietary modification and/or pharmacologic management with swallowed topical steroids. Swallowed fluticasone propionate (FP) and oral viscous budesonide (OVB) have proven to be effective in resolving symptoms and reversing histologic changes in children and adults with EoE. There are minimal comparative studies between the 2 agents.Objective:The aim of the study was to retrospectively compare endoscopic and histologic outcomes after FP versus OVB therapy in children with EoE in our center.Methods:We performed a retrospective chart review of subjects diagnosed...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Long-term Follow-up of Adolescents Treated for Rumination Syndrome in an Inpatient Setting
Conclusions:Intensive behavioral treatment of rumination syndrome leads to long-term improvement in rumination as well as other related factors, including somatic symptoms and quality of life. Objectives: Although several studies have demonstrated the short-term benefit of the behavioral treatment of rumination syndrome, few have investigated the long-term outcomes. Studies reporting long-term benefit have involved combined pediatric and adult samples or have examined outcomes of patients involved in various types of treatment. The purpose of the present study was to examine several aspects of long-term outcome in adol...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Development of the Aim to Decrease Anxiety and Pain Treatment for Pediatric Functional Abdominal Pain Disorders
Conclusions:Findings from this study suggest that targeting both pain and anxiety may positively impact outcomes in youth with FAPD. The ADAPT intervention has the potential to provide a cost effective and practical application of cognitive behavioral therapy using an innovative combination of in-person and technology-based platforms. Overall, the ADAPT intervention is a promising and innovative intervention to improve the outcomes of youth with FAPD. Objectives: To evaluate the feasibility and acceptability of the Aim to Decrease Anxiety and Pain Treatment (ADAPT), a brief, on-line and in-person behavioral interventio...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Polyethylene Glycol 3350 With Electrolytes Versus Polyethylene Glycol 4000 for Constipation: A Randomized, Controlled Trial
ABSTRACTObjective:The long-term efficacy and safety of polyethylene glycol (PEG) in constipated children are unknown, and a head-to-head comparison of the different PEG formulations is lacking. We aimed to investigate noninferiority of PEG3350 with electrolytes (PEG3350 + E) compared to PEG4000 without electrolytes (PEG4000).Methods:In this double-blind trial, children aged 0.5 to 16 years with constipation, defined as a defecation frequency of (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Probiotics for the Prevention of Nosocomial Diarrhea in Children
This document provides recommendations developed by the ESPGHAN Working Group on Probiotics and Prebiotics on the role of probiotics in the prevention of nosocomial diarrhea in children based on a systematic review of previously completed systematic reviews and of subsequently published randomized controlled trials. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation guidelines. Recommendations were given only if at least 2 randomized controlled trials examined the same probiotic strain. Based on currently available evidence the Working Group recommends using Lac...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Review Source Type: research

Mimicking Own Mother's Milk for Preterms: Are We Getting Closer?
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - January 1, 2018 Category: Gastroenterology Tags: Invited Commentary Source Type: research

The Case for Thoughtful Prescribing of Proton Pump Inhibitors in Infants
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Letters to the Editor Source Type: research

Proton Pump Inhibitors May Not Be the First Line of Treatment for GERD in Infants
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Letters to the Editor Source Type: research

Drugs for Neuropathic Pain Are Promising in Treating Feed-induced Dystonia in Central Nervous System Disabled Children
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Letters to the Editor Source Type: research

Neuropathic Pain as Potential Source of Feed-induced Dystonia in Children With Severe Central Nervous System Disorders
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Letters to the Editor Source Type: research

Successful Use of Sirolimus in Children With Large Mesenteric Lymphatic Lesions
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Letters to the Editor Source Type: research

Fatal Central Nervous System Post-Transplant Lymphoproliferative Disease in a Patient Who Underwent Liver Transplantation for Hepatoblastoma
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Case Report Source Type: research

Recurrent Acute Pancreatitis in Children: Do not forget the “Worms”
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Video of the Month Source Type: research

Unusual Presentation of Giant Omental Cystic Lymphangioma Mimicking Hemorrhagic Ascites in a Child
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Image of the Month Source Type: research

Young Child Formula: A Position Paper by the ESPGHAN Committee on Nutrition
Young child formulae (YCF) are milk-based drinks or plant protein–based formulae intended to partially satisfy the nutritional requirements of young children ages 1 to 3 years. Although widely available on the market, their composition is, however, not strictly regulated and health effects have not been systematically studied. Therefore, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition (CoN) performed a systematic review of the literature to review the composition of YCF and consider their role in the diet of young children. The review revealed limited da...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Society Papers Source Type: research

Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report From the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee
Conclusions:This clinical report represents the first English-language recommendations for the management of pediatric AP. Future aims should include prospective multicenter pediatric studies to further validate these recommendations and optimize care for children with AP. Background: Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. Methods: The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas committee performed a MEDLINE review using sever...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Society Papers Source Type: research

Intervention for Feeding Difficulties in Children With a Complex Medical History: A Randomized Clinical Trial
Conclusions:Both therapy protocols were considered clinically effective. The difference in attrition rates between the etiological groups suggests primary differences in how service delivery should be managed. Progress for the medically complex child may be slower while medical issues are stabilized, or while the focus for parents shifts to other developmental areas. In planning services for a medically complex group, therefore, it is essential that consideration be given to medical and family needs. Objective: This study aimed to compare outcomes of different multidisciplinary feeding therapy approaches in children wi...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Clinical Trials: Nutrition Source Type: research

Male-specific Association Between Fat-Free Mass Index and Fecal Microbiota in 2- to 3-Year-Old Australian Children
The objective of this study is to explore the association between microbiota profile, body size, and body composition in young children.Methods:Fecal microbiota was examined by 16S rRNA gene sequencing, whereas body composition was assessed using the deuterium oxide dilution technique in a cohort of 37 well-nourished 2- to 3-year-old Australian children.Results:Microbiota composition (weighted UniFrac distance) was shown to be significantly associated with FFMI (fat-free mass index) z score (P = 0.027, adonis) in boys but not girls. In boys, FFMI z score was significantly correlated with the relative abundance of an OU...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Serum n-6 and n-9 Fatty Acids Correlate With Serum IGF-1 and Growth Up to 4 Months of Age in Healthy Infants
Conclusions:Our data showed interaction of n-6 fatty acids with IGF-1 during the first 4 months of life, and an association between MA and birth size when adjusted for confounding factors. Further follow-up may indicate whether these correlations are associated with later body composition. Objective: The aim of this study was to study the relationship between insulin-like growth factor-1 (IGF-1), serum phospholipid fatty acids, and growth in healthy full-term newborns during infancy. Methods: Prospective observational study of a population-based Swedish cohort comprising 126 healthy, term infants investigating cord ...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Randomized Trial of a Yogurt-type Amino Acid−based Formula in Infants and Children With Severe Cow's Milk Allergy
ABSTRACTObjectives:Evaluation of a spoon-fed amino acid−based formula (AAF) with a yogurt-type texture compared to the reference oral liquid formula (Neocate).Methods:Phase III/IV, prospective, randomized (1:1), open-label, multicenter study in infants/young children (6–36 months) with severe cow's milk protein allergy (CMA) who had consumed AAF for ≥1 month before the study. Patients received reference+test formula (Neocate with a yogurt-type texture for spoon-feeding: group 1) or reference formula (group 2) for 28 days. The study formulae were integrated into the patients’ usual daily diet. Efficacy ...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Bioactive Whey Protein Concentrate and Lactose Stimulate Gut Function in Formula-fed Preterm Pigs
ABSTRACTObjective:Formula feeding is associated with compromised intestinal health in preterm neonates compared with maternal milk, but the mechanisms behind this are unclear. We hypothesized that the use of maltodextrin and whey protein concentrates (WPCs) with reduced bioactivity owing to thermal processing are important factors.Method:Ninety-two cesarean-delivered preterm pigs were fed increasing doses of formulas for 5 days (24–120 mL · kg−1 · day−1). In experiment 1, 4 groups of pigs (n = 15–16) were fed lactose- or maltodextrin-dominant formulas (lactose/maltodextri...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Variceal Hemorrhage and Adverse Liver Outcomes in Patients With Cystic Fibrosis Cirrhosis
Conclusions:VB is an uncommon complication of CF cirrhosis and can herald the diagnosis, but does not affect ACM. Adverse liver outcomes and ACM are frequent by 10 years after cirrhosis report. Objectives: Cirrhosis occurs in 5% to 10% of cystic fibrosis (CF) patients, often accompanied by portal hypertension. We analyzed 3 adverse liver outcomes, variceal bleeding (VB), liver transplant (LT), and liver-related death (LD), and risk factors for these in CF Foundation Patient Registry subjects with reported cirrhosis. Methods: We determined 10-year incidence rates for VB, LT, LD, and all-cause mortality (ACM), and exa...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Article: Pancreatology Source Type: research

Serum Osteocalcin Levels in Children With Nonalcoholic Fatty Liver Disease
ABSTRACTObjectives:The aim of the study was to investigate the relationship between osteocalcin and nonalcoholic fatty liver disease (NAFLD) in children with obesity.Method:60 obese children with NAFLD were taken as a patient group and 60 obese children and normal liver with matching age, sex, and body mass index were taken as a control group. Anthropometric measurements, abdominal ultrasonography for diagnosis and grading of NAFLD, and laboratory investigations in the form of liver function tests, lipid profile, fasting serum glucose and insulin, and serum osteocalcin levels were done for all children. Patients with NAFLD...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Cholangiocarcinoma Among Children and Adolescents: A Review of the Literature and Surveillance, Epidemiology, and End Results Program Database Analysis
ABSTRACTObjective:Cholangiocarcinoma (CCA) is a biliary malignancy found primarily in adults. The incidence of CCA in children is unknown. The aim of this study was to describe characteristics of CCA in children and adolescents.Methods:Using the Surveillance, Epidemiology, and End Results Program (SEER 18) database, we identified incident cases of CCA diagnosed at (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Health-related Quality of Life in Adolescent Patients With Hepatitis C Genotype 1 Treated With Sofosbuvir and Ledipasvir
ABSTRACTObjective:The aim of the study was to assess the effect of treatment with ledipasvir/sofosbuvir (LDV/SOF) on the health-related quality of life (HRQL) of pediatric patients with chronic hepatitis C virus (HCV) infection.Methods:Adolescents (12–17 years) with HCV were treated with LDV/SOF (90/400 mg daily) for 12 weeks. HRQL was assessed using the PedsQLv4.0-SF15 completed by the children and caregivers before, during, and after treatment.Results:We included 100 adolescents with HCV genotype 1 infection (14.7 ± 2.0 years, 1% known cirrhosis, 80% treatment-naïve, 97% sustained virologic response...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Neonatal Exposure to Hepatitis C Virus Antigens in Uninfected Children Born to Infected Mothers
Conclusions:HCV-specific immune responses were more common in children born to HCV-infected mothers, regardless of the presence of HCV RNA. We conclude that noninfected children born to HCV-infected mothers may have been exposed to HCV antigens. Objective: Vertical transmission of hepatitis C virus (HCV) infection is uncommon and occurs in approximately 5% of births from HCV-infected mothers. The reason for the low transmission rate is unclear. We aimed to investigate whether there is evidence of HCV exposure also in the noninfected children born to HCV-infected mothers by the presence of a detectable immune response. ...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Anti-TNFα Treatment in Children and Adolescents With Combined Inflammatory Bowel Disease and Autoimmune Liver Disease
Conclusions:IBD in patients with AILD can be aggressive, requiring escalation to anti-TNFα or switching to other biologics. In this series, anti-TNFα did not impair liver function and improved gut disease in most of the patients, indicating that it can be beneficial and safe. Objectives: Inflammatory bowel disease (IBD) and autoimmune liver disease (AILD) are closely associated, the former often dictating progression of the latter. Antibodies to tumor necrosis factor alpha (anti-TNFα) are effective in the management of IBD, but may cause liver injury. Methods: Retrospective review of medical record...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Expediting Drug Development for Pediatric Inflammatory Bowel Disease: A Discussion With Stakeholders
Lack of scientific consensus on efficacy endpoints and outcome assessments presents a hurdle for global drug development in pediatric inflammatory bowel disease (IBD). Multiple stakeholders participated in a meeting November 2015, sponsored by The Pediatric IBD Foundation, which is a 501c3 organization formed by parents of children with IBD whose mission is to improve the lives of children with Crohn disease and ulcerative colitis by supporting innovative research and educational programs (www.pedsibd.org). With representatives of the Food and Drug Administration, European Medicines Agency, pediatric gastroenterologists, a...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Meeting Proceedings: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Changes in Hepcidin and Hemoglobin After Anti-TNF-alpha Therapy in Children and Adolescents With Crohn Disease
ABSTRACTObjectives:Anemia is the most common systemic complication of inflammatory bowel disease, is more common in affected children than in adults, and is mediated in large part by chronic inflammation. Inflammation increases levels of the iron-regulatory protein hepcidin, which have been elevated in adults with Crohn disease.Methods:We measured serum hepcidin-25 and hemoglobin (Hgb) in 40 children and adolescents with Crohn disease at baseline and 10 weeks after initiation of anti-tumor necrosis factor (TNF)-α therapy. Measures of disease activity, inflammatory markers, and cytokines were obtained in all subjects....
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Granulocyte and Monocyte Apheresis for Induction of Remission in Children With New-Onset Inflammatory Bowel Colitis
Conclusions:In this small study GMA for induction of remission of newly onset pediatric IBD colitis was effective in 8 of 12 patients. Further controlled studies are warranted to confirm the efficacy of this treatment model. Objective: The aim of the study was to analyze the effect of granulocyte and monocyte apheresis (GMA) with mesalazine for induction of remission in pediatric patients with newly onset chronic inflammatory bowel disease (IBD) colitis. Methods: Thirteen pediatric patients with newly onset extensive IBD colitis were investigated per the ECCO/ESPGHAN IBD protocol. Of these 13, 12 received 10 treatme...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Perceived Impairment in Sports Participation in Adolescents With Inflammatory Bowel Diseases: A Preliminary Examination
ABSTRACTObjective:Physical activity (PA) is important for adolescents with inflammatory bowel diseases (IBDs) given the increased risk of developing osteoporosis and the increased risk of IBD-related complications among those with IBD and obesity. Symptoms such as fatigue, abdominal pain, nausea, and frequent bowel movements can interfere with PA. Sports participation is an important source of PA for adolescents; however, the extent to which IBD interferes with sports participation is unstudied. The present study aimed to examine demographic, health-related, physical, and psychosocial correlates of perceived impairment in ...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Incidence and Risk Factors for Perianal Disease in Pediatric Crohn Disease Patients Followed in CEDATA-GPGE Registry
Conclusions:Approximately 10% of CD patients in our cohort suffered from PD within the first 3 years of their disease. Male sex and initial corticosteroid therapy were associated with an increased risk to develop PD after diagnosis. Objectives: Perianal disease (PD) with fistula and/or abscess formation is a severe complication in Crohn disease (CD). We examined prevalence, incidence, and risk factors for PD development in a pediatric CD cohort. Methods: Patients with CD from the prospective, multicenter registry for inflammatory bowel disease from Germany and Austria (CEDATA-GPGE) were included if diagnosed at the ...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Differentiation Between Crohn Disease and Intestinal Tuberculosis in Children
Conclusions:Microbiologic confirmation of tuberculosis is possible in 40% ITB cases. Presence of blood in stool and left-sided colonic involvement are the most important features favoring CD. Objectives: The aim of the study was to evaluate clinical, endoscopic, radiologic, and histopathological features helpful in differentiating Crohn disease (CD) from intestinal tuberculosis (ITB) in children. Methods: Patients diagnosed to have CD or ITB based on standard recommended criteria were enrolled. Children with inflammatory bowel disease unclassified or suspected ITB or CD with incomplete work-up or lost to follow-up w...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

How Secure Is the Diagnosis of Ulcerative Colitis in Children, Even After Colectomy?
Conclusions:Our data suggest that later manifestation of CD is more common than previously thought (24%). Therefore, a diagnosis of UC in children should be regarded as provisional and a potential later diagnosis of CD taken into account when considering colectomy and J-pouch formation. Objectives: We reviewed all children who have undergone a colectomy for ulcerative colitis (UC) in our tertiary referral centre in a 12-year period to assess the rate of reclassification as Crohn disease (CD). In contrast to CD, a colectomy is considered to be definitive treatment for patients with UC. Distinguishing between the 2 can b...
Source: Journal of Pediatric Gastroenterology and Nutrition - December 30, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research