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December 1, 2016 - A screening test for non-alcoholic fatty liver disease (NAFLD)--a serious condition that may have lifelong health consequences--is recommended for all obese children aged nine to eleven years, according to clinical practice guidelines developed by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and published in the Journal of Pediatric Gastroenterology and Nutrition (JPGN). Official journal of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the NASPGHAN, the JPGN is published by Wolters Kluwer. The new guidelines, endorsed by the American Academy of Pediatrics, also outline recommendations for diagnosis, treatment, and follow-up care of children and adolescents with NAFLD. The recommendations were developed by a multidisciplinary Expert Committee on NAFLD, commissioned by the NASPGHAN. Dr. Miriam B. Vos of Emory University and Children's Healthcare of Atlanta is lead author of the new report, which is available on the JPGN website. Recommendations for Screening, Treatment and Follow-up of NAFLD in Children Nonalcoholic fatty liver disease refers to a range of conditions in which fatty deposits occur in the liver. It can progress to a more severe form, called nonalcoholic steatohepatitis (NASH), with inflammation and/or scarring of the liver. "NAFLD has rapidly evolved into the most common liver disease seen in the pediatric population and is a management challenge for the general pediatric practitioners, subspecialists, and health systems," Dr. Vos and coauthors write. Studies suggest that NAFLD may be present in 0.7 percent of two- to four-year-olds, and up to 38 percent of obese children and adolescents. The disease is commonly associated with other obesity-related conditions: diabetes and sleep apnea. While the long-term health impact of NAFLD remains unclear, affected children may be at increased risk for end-stage liver disease, type 2 diabetes, strokes, heart attacks, and liver cancer later in life. In adults, NAFLD has recently become the most common reason for liver transplant. The Expert Committee performed a comprehensive research review to make evidence-based recommendations for management of pediatric NAFLD. Key recommendations include: The Expert Committee highlights important areas for further research, emphasizing the need for high-quality pediatric studies of strategies for prevention, screening, diagnosis, and treatment. Dr. Vos and colleagues hope their recommendations will provide useful guidance for all professionals involved in assessing and managing NAFLD--providing an evidence-based approach that remains flexible and adjustable for individual patients and circumstances. Click here to read "NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children." Article: "NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children. (doi: 10.1097/MPG.0000000000001482) About The Journal of Pediatric Gastroenterology and Nutrition The Journal of Pediatric Gastroenterology and Nutrition provides a forum for original papers and reviews dealing with pediatric gastroenterology and nutrition, including normal and abnormal functions of the alimentary tract and its associated organs, including the salivary glands, pancreas, gallbladder, and liver. Particular emphasis is on development and its relation to infant and childhood nutrition. Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world. Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY). Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www. , follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.


Dughera L.,Digestive Motility and Endoscopy | Rotondano G.,Gastroenterology and Digestive Endoscopy | De Cento M.,Anesthesiology | Cassolino P.,Emergency Surgery | Cisaro F.,Pediatric Gastroenterology
Gastroenterology Research and Practice | Year: 2014

From June 2002 to March 2013 26 patients that underwent Stretta procedure (16 females, 10 males) reached to date an eight-year follow-up. Primary end point of the study was to verify the durability of the procedure at this time. All patients underwent clinical evaluation by upper endoscopy, oesophageal pressure, and pH studies. For each patient 8-year data were compared to those recorded at baseline and at 4 years. There was a significant decrease in both heartburn and GERD HRQL scores at 4 years (P = 0.001) and at 8 years (P = 0.003) as well as a significant increase of QoL scores at each control time (mental SF-36 and physical SF-36, P = 0.001). After 4 and 8 years, 21 patients (80.7%, P = 0.0001) and 20 patients (76.9%, P = 0.0001) were completely off PPIs. Median LES pressure did not show significant amelioration at 4 and 8 years and mean oesophageal acid exposure significantly improved at 4 years (P = 0.001) but returned to baseline values after 8 years. This further follow-up study of ours from four to eight years confirms that RF energy delivery for GERD provides durable improvement in symptoms and in quality of life and reduces antireflux drugs consumption. © 2014 Luca Dughera et al.


Fatima A.,Pediatric Gastroenterology | Gibson D.P.,Oakland University
Pediatrics | Year: 2014

Henoch-Schönlein purpura (HSP) is the most common vasculitis in children. It is a disorder of the inflammatory cascade leading to immunoglobulin A deposition and leukocytoclastic vasculitis of small vessels of skin, kidneys, joints, and gastrointestinal (GI) tract. A wide variety of GI manifestations are seen in ∼50% to 75% of patients with HSP. Diffuse colicky abdominal pain is the most common GI symptom. The small bowel is the most frequently involved GI site. Intussusception is rare but is the most common surgical complication. We report the case of a 2-year-old girl with a 5-day history of abdominal pain followed by a palpable purpuric rash. Her urinalysis, complete blood cell count, and tests of renal function were normal. An acute abdominal series was unremarkable initially, and abdominal ultrasound imaging showed ascites and thickened small bowel loops. She was diagnosed with HSP. The abdominal pain worsened, and an abdominal computed tomography scan demonstrated distal small bowel wall thickening and pneumatosis intestinalis in the descending colon. She was started on total parenteral nutrition and antibiotics and placed on bowel rest. She was given 2 mg/kg of intravenous immunoglobulin. Her abdominal pain gradually improved over the next week, and a repeat computed tomography scan showed significant improvement of the small bowel wall thickening and pneumatosis. The purpuric rash improved, and her abdominal pain resolved. We report a case of HSP and pneumatosis intestinalis, an association that has not been reported previously.


News Article | February 28, 2017
Site: www.eurekalert.org

Bethesda, MD (Feb. 27, 2017) -- Patients with obesity need a multidisciplinary approach to achieve a healthy weight, and the American Gastroenterological Association (AGA) believes that gastroenterologists are in a unique position to lead the care team. To provide gastroenterologists with a comprehensive, multi-disciplinary process to guide and personalize innovative obesity care for safe and effective weight management, including a model for how to operationalize business issues, AGA has created an Obesity Practice Guide. The program includes an obesity program to help gastroenterologists manage their patients with obesity, as well as a framework focused on the business operational issues related to the management of obese patients, which are published in Clinical Gastroenterology and Hepatology, the clinical practice journal of the American Gastroenterological Association. "The epidemic of obesity continues at alarming rates with a high burden to our economy and society," said Sarah Streett, MD, an author of both papers, chair of the AGA Institute Practice Management and Economics Committee, and clinical associate professor and director of IBD Stanford University School of Medicine, CA. "The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity." POWER: Practice Guide on Obesity and Weight Management, Education and Resources1 Obesity is a major modifiable cause of diseases of the digestive tract that routinely goes unaddressed. Gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, which means gastroenterologists have an opportunity to address obesity and provide effective therapy for their patients. Patients who are overweight or obese are often seen by gastroenterologists due to gastroesophageal reflux disease (GERD) and its associated risks of Barrett's esophagus and esophageal cancer, gallstone disease, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, and colon cancer. As internists, specialists in digestive disorders and endoscopists, gastroenterologists are in a unique position to play an important role in the multidisciplinary treatment of obesity. "We created the practice guide on obesity and weight management to help gastroenterologists develop a multidisciplinary team and obesity care model for their practice, including patient goal setting, readiness assessment, evaluation, and treatment with diet, medication, and bariatric endoscopy and surgery," said Andres Acosta, MD, PhD, lead author of the paper and assistant professor of medicine, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), division of gastroenterology and hepatology, Mayo Clinic, Rochester, MN. "It is our hope that by working in a team-based approach, gastroenterologists can guide and personalize obesity care for safe and effective weight management for our patients." The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), The Obesity Society (TOS), and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) contributed content to the POWER program, which was endorsed with input by the American Society for Gastrointestinal Endoscopy (ASGE), American Society for Metabolic and Bariatric Surgery (ASMBS), American Association for the Study of Liver Diseases (AASLD), Obesity Medicine Association (OMA) and Academy of Nutrition and Dietetics (AND). Episode-of-Care Framework for the Management of Obesity: Moving Towards High Value, High Quality Care2 The treatment of obesity needs a collaborative approach involving multiple stakeholders. AGA established an obesity episode of care model to develop a framework to support value-based management of patients with obesity, focusing on the provision of non-surgical and endoscopic services. The framework will help gastroenterology practices assess their ability to participate in and implement an episode of care for obesity, and understand the essentials of coding and billing for these services. The goal of episode framework is to provide gastroenterologists with strategies to obtain compensation for high value care, in a flexible format that can be adapted to the resources of both large and small practices. It is essential that data coordination take place between all members of the multi-disciplinary team who are providing therapeutic services to the patient to ensure high value continuity of care. The American Society for Metabolic and Bariatric Surgery (ASMBS), American Psychological Association (APA), American Pharmacists Association (APhA), and Academy of Nutrition and Dietetics (AND) contributed to the obesity episode of care framework. 1 Acosta A, Streett S et al.. White Paper AGA: POWER -- Practice Guide on Obesity and Weight Management, Education and Resources. Clinical Gastroenterology and Hepatology (2017), doi: 10.1016/j.cgh.2016.10.023. http://www.cghjournal.org/article/S1542-3565(16)30988-0/fulltext 2 Brill JV et al. White Paper AGA: An Episode-of-Care Framework for the Management of Obesity: Moving Towards High Value, High Quality Care. Clinical Gastroenterology and Hepatology (2017), doi: 10.1016/j.cgh.2017.02.002. http://www.cghjournal.org/article/S1542-3565(17)30146-5/pdf The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to more than 16,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. http://www. . The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit http://www. . Like AGA and Clinical Gastroenterology and Hepatology on Facebook. Join AGA on LinkedIn. Follow us on Twitter @AmerGastroAssn. Check out our videos on YouTube.


News Article | November 7, 2016
Site: www.eurekalert.org

November 7, 2016 - Even after a year on a gluten-free diet, nearly 20 percent of children with celiac disease continue to have intestinal abnormalities (enteropathy) on repeat biopsies, reports a study in the Journal of Pediatric Gastroenterology and Nutrition, official journal of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. The journal is published by Wolters Kluwer. Symptom status and laboratory results do not predict which children will have persistent celiac enteropathy despite a gluten-free diet, according to the new research by Dr. Maureen Leonard of MassGeneral Hospital for Children, Boston. "These findings suggest that a revisitation of monitoring and management criteria of celiac disease in childhood," Dr. Leonard comments. New Questions on Assessing Response to Gluten-Free Diet in Celiac Disease The researchers reviewed the records of 103 children and adolescents with celiac disease treated at two medical centers. Patients with celiac disease have a characteristic pattern of intestinal damage caused by exposure to gluten, contained in wheat and other grains. The main treatment for celiac disease is a gluten-free diet--careful elimination of all gluten-containing foods from the diet. The children in the study had followed a gluten-free diet for an average of 2.4 years. About 90 percent were rated as having "excellent" adherence to their diet. The children also underwent intestinal endoscopy and biopsy (sampling of intestinal tissue) at least two times: when celiac disease was diagnosed and after at least one year on a gluten-free diet. The main reasons for repeat biopsy were persistent or new symptoms or abnormal laboratory test results. The study focused on the rate of persistent celiac enteropathy: gluten-induced damage to intestinal cells. Current guidelines for celiac disease treatment rely on laboratory tests to assess healing, rather than follow-up endoscopy and biopsy. The repeat biopsy results showed persistent celiac enteropathy in 19 percent of children. The presence of enteropathy could not be predicted by the presence of symptoms or by levels of IgA tissue transglutaminase antibodies (IgA tTG)--the main laboratory test used for monitoring celiac disease. At the time of the second biopsy, IgA tTG was elevated in 43 percent of children with persistent enteropathy and 32 percent with normal biopsies. In the past, children with celiac disease had routine follow-up biopsies to monitor healing in response to a gluten-free diet. In more recent years, laboratory tests such as IgA tTG have been used instead of biopsies. The study was prompted by growing evidence that many adults with celiac disease have persistent enteropathy, despite having no symptoms and normal IgA tTG levels. The results suggest that 1 out of 5 children with celiac disease may have persistent enteropathy, despite following their recommended gluten-free diet. Dr. Leonard and colleagues write: "While the long-term effects are not known, persistent enteropathy may predispose pediatric patients with celiac disease to future complications and suboptimal growth." While current guidelines do not recommend repeat biopsy, Dr. Leonard and colleagues note that it is the only way to confirm that celiac enteropathy has resolved. "These findings suggest the need not only for a baseline endoscopy to confirm the diagnosis of celiac disease but also consideration of a repeat biopsy to evaluate for remission," the researchers add. They call for further studies to confirm their findings, to better understand the response to a gluten-free diet, and to evaluate further treatment options. Click here to read "Value of IgA tTG in Predicting Mucosal Recovery in Children with Celiac Disease on a Gluten Free Diet." Article: "Value of IgA tTG in Predicting Mucosal Recovery in Children with Celiac Disease on a Gluten Free Diet" (doi: 10.1097/MPG.0000000000001460) About The Journal of Pediatric Gastroenterology and Nutrition The Journal of Pediatric Gastroenterology and Nutrition provides a forum for original papers and reviews dealing with pediatric gastroenterology and nutrition, including normal and abnormal functions of the alimentary tract and its associated organs, including the salivary glands, pancreas, gallbladder, and liver. Particular emphasis is on development and its relation to infant and childhood nutrition. Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world. Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY). Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www. , follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.


News Article | November 7, 2016
Site: www.sciencedaily.com

Even after a year on a gluten-free diet, nearly 20 percent of children with celiac disease continue to have intestinal abnormalities (enteropathy) on repeat biopsies, reports a study in the Journal of Pediatric Gastroenterology and Nutrition, official journal of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. The journal is published by Wolters Kluwer. Symptom status and laboratory results do not predict which children will have persistent celiac enteropathy despite a gluten-free diet, according to the new research by Dr. Maureen Leonard of MassGeneral Hospital for Children, Boston. "These findings suggest that a revisitation of monitoring and management criteria of celiac disease in childhood," Dr. Leonard comments. New Questions on Assessing Response to Gluten-Free Diet in Celiac Disease The researchers reviewed the records of 103 children and adolescents with celiac disease treated at two medical centers. Patients with celiac disease have a characteristic pattern of intestinal damage caused by exposure to gluten, contained in wheat and other grains. The main treatment for celiac disease is a gluten-free diet -- careful elimination of all gluten-containing foods from the diet. The children in the study had followed a gluten-free diet for an average of 2.4 years. About 90 percent were rated as having "excellent" adherence to their diet. The children also underwent intestinal endoscopy and biopsy (sampling of intestinal tissue) at least two times: when celiac disease was diagnosed and after at least one year on a gluten-free diet. The main reasons for repeat biopsy were persistent or new symptoms or abnormal laboratory test results. The study focused on the rate of persistent celiac enteropathy: gluten-induced damage to intestinal cells. Current guidelines for celiac disease treatment rely on laboratory tests to assess healing, rather than follow-up endoscopy and biopsy. The repeat biopsy results showed persistent celiac enteropathy in 19 percent of children. The presence of enteropathy could not be predicted by the presence of symptoms or by levels of IgA tissue transglutaminase antibodies (IgA tTG) -- the main laboratory test used for monitoring celiac disease. At the time of the second biopsy, IgA tTG was elevated in 43 percent of children with persistent enteropathy and 32 percent with normal biopsies. In the past, children with celiac disease had routine follow-up biopsies to monitor healing in response to a gluten-free diet. In more recent years, laboratory tests such as IgA tTG have been used instead of biopsies. The study was prompted by growing evidence that many adults with celiac disease have persistent enteropathy, despite having no symptoms and normal IgA tTG levels. The results suggest that 1 out of 5 children with celiac disease may have persistent enteropathy, despite following their recommended gluten-free diet. Dr. Leonard and colleagues write: "While the long-term effects are not known, persistent enteropathy may predispose pediatric patients with celiac disease to future complications and suboptimal growth." While current guidelines do not recommend repeat biopsy, Dr. Leonard and colleagues note that it is the only way to confirm that celiac enteropathy has resolved. "These findings suggest the need not only for a baseline endoscopy to confirm the diagnosis of celiac disease but also consideration of a repeat biopsy to evaluate for remission," the researchers add. They call for further studies to confirm their findings, to better understand the response to a gluten-free diet, and to evaluate further treatment options.


Ram J.,Jawaharlal Institute of Postgraduate Medical Education & Research | Sukhija J.,Jawaharlal Institute of Postgraduate Medical Education & Research | Thapa B.R.,Pediatric Gastroenterology | Arya V.K.,Jawaharlal Institute of Postgraduate Medical Education & Research
Middle East African Journal of Ophthalmology | Year: 2012

Purpose: To compare the outcomes of pediatric cataract surgery with intraocular lens (IOL) implantation in an eye camp setting and tertiary care center. Materials and Methods: Children aged 5-16 years with visually significant cataract underwent phacoaspiration with IOL implantation in an eye camp (eye camp group) or tertiary care center (TCC group). All surgeries incorporated contemporary microsurgical techniques with implantation of polymethyl-methacrylate (PMMA) IOL. Major postoperative complications were managed at a tertiary care center. Postoperative complications, visual acuity and compliance were evaluated using the Chi-square test. A P value less then 0.05 was considered as statistically significant. Results: The cohort comprised 59 children in the eye camp group and 48 children in the TCC group. Thirty two of fifty nine (54.23%) eyes in the eye camp group and 30/48 (62.5%) eyes in the TCC group achieved 20/40 or better best corrected visual acuity (BCVA) postoperatively. Postoperatively, 36 (61%) eyes in the eye camp group and 22 (45.83%) eyes in the TCC group required Nd: YAG laser capsulotomy or a pars plana membranectomy. (P> 0.05) The most striking feature was loss to follow up. In the eye camp group, loss to follow was 20% at one year, 49% at two years, 62% at 3 years and 67% at 4 years compared to 12.5, 21, 27 and 33% respectively in the TCC group (P<0.05, all cases). Conclusions: The outcomes of camp and tertiary care center (hospital) based pediatric cataract surgery were similar. However, the major drawback of camp based surgery was loss to follow up which eventually affected the management of amblyopia and postoperative complications.


Maffei H.V.L.,Pediatric Gastroenterology | Vicentini A.P.,São Paulo State University
Journal of Pediatric Gastroenterology and Nutrition | Year: 2011

OBJECTIVES:: The aim of the study was to evaluate, over 24 months, the intake of dietary fiber (DF) and the bowel habit (BH) of constipated children advised a DF-rich diet containing wheat bran. PATIENTS AND METHODS:: BH and dietary data of 28 children with functional constipation defined by the "Boston criteria" were obtained at visit 1 (V1, n = 28) and at 4 follow-up visits (V2-V5, n = 80). At each visit the BH was rated BAD (worse/unaltered; improved but still complications) or RECOVERY (REC) (improved, no complications; asymptomatic), and a food intake questionnaire was applied. DF intake was calculated according to age (year)+5 to 10 g/day and bran intake according to international tables. Nonparametric statistics were used. RESULTS:: Median age (range) was 7.25 years (0.25-15.6 years); 21 children underwent bowel washout (most before V1/V2), and 14 had the last visit at V3/V4. DF intake, bran intake, and the BH rate significantly increased at V2 and remained higher than at V1 through V2 to V5. At V1, median DF intake was 29.9% below the minimum recommended and at the last visit 49.9% above it. Twenty-four children accepted bran at 60 visits, at which median bran intake was 20 g/day and median proportion of DF due to bran 26.9%. Children had significantly higher DF and higher bran intake at V2 to V5 at which they had REC than at those at which they presented BAD BH. DF intake >age+10 g/day was associated with bran acceptance and REC. At the last visit 21 children presented REC (75%); 20 of them were asymptomatic and 18 were off washout/laxatives. CONCLUSIONS:: High DF and bran intake are feasible in constipated children and contribute to amelioration of constipation. Copyright © 2010 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology.


Karabulut G.S.,Istanbul University | Beser O.F.,Pediatric Gastroenterology | Erginoz E.,Istanbul University | Kutlu T.,Pediatric Gastroenterology | And 2 more authors.
Journal of Neurogastroenterology and Motility | Year: 2013

Background/Aims: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders and when compared to the vast knowledge pertaining to adults with IBS, very little is known about IBS in children and adolescents. We aimed to explore the prevalence of IBS, identify symptoms and contributing factors and also to examine the efficacy of trimebutine maleate in children and adolescents. Methods: The study involved 345 children and adolescents (4-18 years) and parents were requested to fill in a questionnaire, Rome III criteria was used to diagnose IBS. To exclude organic disease, all patients underwent medical investigations. Half of the randomly selected IBS patients were treated with trimebutine maleate while the rest of IBS patients were not. The IBS patients were reevaluated at the end of 3 weeks. Results: The prevalence of IBS according to Rome III criteria in children and adolescents was 22.6% and IBS with constipation was the predominant subtype. Back pain (OR, 6.68), headache (OR, 4.72) and chronic fatigue (OR, 3.74) were significantly higher in IBS group. The prevalence of IBS in both parents and depression in mothers was greater for the patient group than the healthy controls (P < 0.0001). The prevalence of functional dyspepsia in IBS group was 80.8% and was significantly higher than control group. Clinical recovery was seen in 94.9% of the trimebutine maleate group versus spontaneous recovery in 20.5% of the non-medicated group. The difference was significant (P < 0.0001). Conclusions: IBS is a common disorder in children and adolescents. IBS is closely associated with somatic and familial factors. Trimebutine maleate is effective for pediatric IBS patients. (J Neurogastroenterol Motil 2013;19:90-93) ©2013 The Korean Society of Neurogastroenterology and Motility.


De Greef E.,Pediatric Gastroenterology | Vandenplas Y.,Pediatric Gastroenterology | Hauser B.,Pediatric Gastroenterology | Devreker T.,Pediatric Gastroenterology | Veereman-Wauters G.,Pediatric Gastroenterology
Acta Gastro-Enterologica Belgica | Year: 2013

The pathophysiology of inflammatory bowel disease is still incompletely understood. While the development of the immune system and the establishment of the microflora take place during infancy young patients often have a more severe and extensive disease. The differences in composition and concentration of intestinal microbiota and aberrant immune responses towards the luminal bacteria prompted the concept of an 'ecological' approach to control the disease course. Probiotics, living, non pathogenic micro organisms with a beneficial effect on the host, and prebiotics, oligosaccharides promoting the growth of the beneficial microflora, have been studied to this effect. Results have so far been disappointing for Crohn's disease but encouraging for ulcerative colitis. An overview of studies using probiotics in adults or children and a perspective on specific pediatric issues is provided in this review.

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