Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Pediatric inflammatory bowel disease in patients of Middle Eastern descent seen at a large urban children's hospital.","authors":"Renee Dass, Gillian Greenberg, Ronald Thomas, Kirsten Cares","doi":"10.1002/jpn3.70127","DOIUrl":"https://doi.org/10.1002/jpn3.70127","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and outcomes of endoscopic ultrasound guided anal botulinum toxin injections for pediatric constipation: A pilot study.","authors":"Brianne Shuler, Alexandra L Kilgore, Paul Tran, Taylor Montminy, Lori Silveira, Jaime Belkind-Gerson, Jacob A Mark","doi":"10.1002/jpn3.70122","DOIUrl":"https://doi.org/10.1002/jpn3.70122","url":null,"abstract":"<p><strong>Objectives: </strong>Injection of Onabotulinumtoxina (BT) into the internal anal sphincter (IAS) is commonly used for pediatric constipation. Typically, BT injections are guided by anatomic landmarks (standard technique [ST]). This pilot study assessed the accuracy of BT injection placement with ST versus endoscopic ultrasound (EUS) guidance and compared clinical outcomes.</p><p><strong>Methods: </strong>Children aged 2-18 with chronic functional constipation undergoing BT injections without anorectal anatomic or neurologic abnormalities were eligible. Fifteen children were enrolled in the intervention arm with ST placement and needle location assessment using EUS. Subsequently, EUS-guided injection was specifically placed into the IAS. Additionally, 30 children (controls) received BT by ST without EUS-guidance. A constipation severity questionnaire was administered at 2 weeks, 3 months, and 6 months postprocedure.</p><p><strong>Results: </strong>The initial needle tip location was the IAS for 30 placements (50.1%, 95% confidence interval [CI]: 38.1%-63.5%) and the external anal sphincter in 15 placements (20.3%, 95% CI: 11.8%-32.8%) of a total 59 injections assessed by EUS. Patients reported improvement at 2 weeks, 3 months, and 6 months in both study groups. Constipation scores obtained only after injections were worse in EUS versus control (22.21 vs. 13.83, p < 0.0001) at 2 weeks, with no significant difference at 3 (15.8 vs. 13.57, p = 0.127) or 6 months (13.10 vs. 13.27, p = 0.9322).</p><p><strong>Conclusions: </strong>This study shows the IAS is injected with BT only 50% of the time with standard technique based on anatomical landmarks.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of paediatric ulcerative colitis, part 2: Acute severe colitis-An updated evidence-based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organization.","authors":"Amit Assa, Marina Aloi, Stephanie Van Biervliet, Jiri Bronsky, Javier M di Carpi, Marco Gasparetto, Laura Gianolio, Hannah Gordon, Iva Hojsak, Alexandra S Hudson, Séamus Hussey, Johan Van Limbergen, Erasmo Miele, Lorenzo Norsa, Ola Olén, Gianluca Pellino, Patrick van Rheenen, Lissy de Ridder, Richard K Russell, Dror S Shouval, Eunice Trindade, Turner Dan, David C Wilson, Anat Yerushalmy-Feler, Eytan Wine","doi":"10.1002/jpn3.70096","DOIUrl":"https://doi.org/10.1002/jpn3.70096","url":null,"abstract":"<p><p>Acute severe colitis (ASC) is a relatively frequent manifestation in children with ulcerative colitis and one of the few emergencies in paediatric gastroenterology. A standardized proactive approach based on tight monitoring and timely medical and surgical interventions may improve patients' outcomes. We aimed to update the previous ASC guidelines using detailed recommendations and practice points, based on a systematic review of the literature and consensus of experts. These guidelines update is a joint effort of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organization. A systematic search was performed in Pubmed Ovid Medline, Embase and Cochrane databases using 13 predefined PICO (patient, intervention, comparison, outcomes) based questions and 30 non-PICO based questions. Grading methodology was based on the Oxford Centre for Evidence-Based Medicine-Levels of evidence. The questions were addressed by working subgroups following an iterative consensus voting process, including three online voting meetings and one face-to-face meeting. A total of 36 recommendations and 72 practice points were endorsed with a consensus rate of at least 88% for all statements, regarding initial evaluation, monitoring, medical and surgical treatment of ASC in children. Several topics have been revised since the previous 2018 guidelines and differ from corresponding published adult guidelines. These guidelines present a comprehensive overview of the management of ASC in children, offering practical recommendations and practice points aiming to standardize clinical and surgical treatment and improve outcomes of this severe scenario.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based review of the nutritional treatment of obesity and metabolic dysfunction-associated steatotic liver disease in children and adolescents.","authors":"Sara Karjoo, Amy Braglia-Tarpey, Alvin P Chan, Ana Gabriela Ayala Germán, Rachel E Herdes, Nikhil Pai, Desiree Sierra-Velez, Bridget Whitehead, Ruben E Quiros-Tejeira, Debora Duro","doi":"10.1002/jpn3.70099","DOIUrl":"https://doi.org/10.1002/jpn3.70099","url":null,"abstract":"<p><p>The growing pediatric obesity epidemic has paralleled the surge in metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis. It develops due to nutritional imbalances, microbiome dysbiosis, gene regulation, hormonal changes, and environmental factors like food deserts, low activity level, and an unhealthy lifestyle. The prevalence of MASLD and obesity is rising every year. Lifestyle changes remain the mainstay treatment for obesity and MASLD. Per the 2023 American Association for the Study of Liver Diseases Practice Guidance on MASLD, achieving ≥5% weight loss can reduce hepatic steatosis, ≥7% weight loss can reduce hepatic inflammation, and ≥10% weight loss can reduce liver fibrosis. Therefore, nutritional interventions can be a powerful tool to help correct metabolic dysfunction and promote healthy weight loss. Current endorsed nutritional interventions for weight loss or MASLD include the Mediterranean diet, low glycemic/low carbohydrate diet, plant-based diet/anti-inflammatory diet, ketogenic diet, and intermittent fasting. This review provides evidence-based insights into current nutritional interventions for children and adolescents with obesity and MASLD to help guide pediatric gastroenterologists in making the best dietary-based recommendations in clinical practice.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first pediatric study investigating the utility of a noninvasive urine-based test for acute pancreatitis diagnosis.","authors":"Tamar Orgad, Isra Abu-Rahma, David Rekhtman, Saar Hashavya, Peri Milman, Mordechai Slae, Zev Davidovics, Michael Wilschanski, Liron Birimberg-Schwartz","doi":"10.1002/jpn3.70119","DOIUrl":"https://doi.org/10.1002/jpn3.70119","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatric acute pancreatitis (AP) is a growing clinical concern with a wide spectrum of severity, from mild episodes to life-threatening conditions. Traditional diagnostic methods primarily rely on serum amylase and lipase measurements, which are invasive and can be challenging in children. This study is the first to evaluate the diagnostic accuracy of the urine trypsinogen-2 dipstick test (UTDT) as a noninvasive test for diagnosing pediatric AP.</p><p><strong>Methods: </strong>This prospective study included 28 pediatric patients (31 episodes) presenting with acute abdominal pain at a tertiary medical center from November 2022 to October 2024. AP was diagnosed based on the International Study Group of Pediatric Pancreatitis: In Search for a Cure (INSPPIRE) criteria. Urine samples were collected either within the first 24 hours (h) or later during hospitalization. UTDT sensitivity and specificity were calculated and compared to serum amylase and lipase levels.</p><p><strong>Results: </strong>Of the 31 episodes, 19 (61%) were confirmed as AP, and 12 (39%) were attributed to other causes. The UTDT had an overall sensitivity of 68% and specificity of 100%. Sensitivity increased to 87% when urine samples were collected within 24 h of admission. In non-AP cases, UTDT consistently produced negative results, with the high specificity supporting its reliability in distinguishing AP from other conditions.</p><p><strong>Conclusions: </strong>The UTDT demonstrates promise as a rapid, noninvasive diagnostic tool for pediatric AP, particularly when used early in the disease course. Its high specificity and ease of use suggest that it may serve as an alternative to invasive blood tests once validated through larger-scale studies. Further research is needed to confirm these findings and establish the role of UTDT in clinical practice.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rescue gastro-jejunal tube.","authors":"Tawfiq Taki Al Lawati","doi":"10.1002/jpn3.70117","DOIUrl":"https://doi.org/10.1002/jpn3.70117","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it time to revisit the need for pediatric polypectomy guidelines?","authors":"Brett J Hoskins, Kenneth Ng, Douglas K Rex","doi":"10.1002/jpn3.70113","DOIUrl":"https://doi.org/10.1002/jpn3.70113","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in the management of portal hypertension across European countries: A survey-study by ESPGHAN Portal Hypertension Special Interest Group.","authors":"Ioannis Roilidis, Oanez Ackermann, Ruth De Bruyne, Toni Ilhardt, Hubert van der Doef, Emer Fitzpatrick, Fotini Sotiriadou, Marianne Hørby Jørgensen, Daniela Liccardo, Maria Mercadal-Hally, Marumbo Mtegha, Angelo Di Giorgio, Tassos Grammatikopoulos","doi":"10.1002/jpn3.70115","DOIUrl":"https://doi.org/10.1002/jpn3.70115","url":null,"abstract":"<p><p>Portal hypertension (PHT) remains a significant burden in children with chronic liver disease (CLD) or portal vein thrombosis (PVT). Management strategies vary depending on the underlying cause and clinical presentation. There is a lack of consensus on various aspects of PHT, including the optimal approach to screening, prophylactic endoscopy and treatment, and pharmacological interventions. This brief communication summarizes the results of a recent questionnaire-based study conducted by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Portal Hypertension Special Interest Group to explore current practices in the management of PHT among its members. Screening for the presence of varices and the approach to primary and secondary prophylaxis differ across Europe. The survey also demasked a high variability of both pharmacological and surgical management of PHT and highlights knowledge gaps and areas for future research.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical review by the ESPGHAN special interest group on gut microbiota and modifications on the health outcomes of infant formula supplemented with postbiotics.","authors":"Hania Szajewska, Ener Cagri Dinleyici, Alfredo Guarino, Alexis Mosca, Raanan Shamir, Yvan Vandenplas","doi":"10.1002/jpn3.70112","DOIUrl":"https://doi.org/10.1002/jpn3.70112","url":null,"abstract":"<p><p>This technical review, one of five developed by the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Special Interest Group (SIG) on Gut Microbiota and Modifications (GMM), supports the creation of a Paper on the use of biotic-supplemented formulas, including those containing postbiotics. Postbiotics are defined as inanimate [i.e., dead, nonviable] microorganisms and/or their components that confer health benefits to the host. This review focuses on the clinical outcomes of infant formulas supplemented with postbiotics. The SIG-GMM conducted technical review to evaluate the clinical outcomes of postbiotic-supplemented infant formulas in healthy infants (0-12 months) published before 2024. Based on the findings of a technical review, all members of the SIG voted anonymously on statements related to clinical outcomes with a score between 0 and 9. A score higher than 6 indicated agreements. A statement was rejected if <75% of the members agreed. Twelve randomized controlled trials (RCTs) met the inclusion criteria. The postbiotics studied so far showed no difference compared to the control formula in outcomes such as anthropometric data, gastrointestinal symptoms, stool characteristics, allergy, infections, tolerability and safety. The RCTs evaluating postbiotics added to infant formula are heterogeneous due to differences in study design, variations in postbiotics and durations of interventions. The studies were powered to demonstrate and did show that there was good tolerance and adequate, safe growth comparable to nonsupplemented formula in presumed healthy infants. This technical review provides the foundation for recommendations on the use of postbiotic-supplemented infant formulas in healthy infants.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amoxicillin for critically ill children with enteral nutrition intolerance (AmoxENI study): A randomized controlled trial.","authors":"Rania G Abdelatif, Abanob A Francis, Elsayed Abdelkreem, Safaa H Ahmed","doi":"10.1002/jpn3.70105","DOIUrl":"https://doi.org/10.1002/jpn3.70105","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the efficacy of amoxicillin in treating children with enteral nutrition intolerance (ENI) in the pediatric intensive care unit (PICU).</p><p><strong>Methods: </strong>This randomized controlled trial enrolled 90 children aged 1 month to 12 years with ENI 7 days after PICU admission. On the 8th day of PICU admission, participants were equally randomized to receive either amoxicillin (10 mg/kg) or a placebo via a gastric feeding tube three times daily for 1 week. The primary outcome was achieving an enteral intake ≥ two-thirds of the energy requirement without remarkable gastrointestinal symptoms on Day 7 after study drug administration. Secondary outcomes were the increase in enteral nutrition intake and the occurrence of large gastric residual volume, vomiting, diarrhea, abdominal distention, melena/hematochezia, and skin rash.</p><p><strong>Results: </strong>The primary outcome occurred in 75.6% of participants in the amoxicillin group compared to 31.1% in the placebo group (risk ratio [RR]: 2.4; 95% confidence interval [CI]: 1.5-3.9; p < 0.001). Compared with placebo, participants who received amoxicillin demonstrated a higher increase in enteral nutrition intake (median [interquartile range]: 60% [40%-68%] vs. 24% [10%-50%], p < 0.001) as well as a lower occurrence of vomiting (2.2% vs. 35.6%; RR: 0.06, 95% CI: 0.01-0.45) and diarrhea (8.9% vs. 31.1%; RR: 0.29, 95% CI: 0.10-0.80). Both groups showed no significant differences in other outcomes.</p><p><strong>Conclusions: </strong>Amoxicillin may improve ENI in critically ill children, but further research is warranted to corroborate our findings, explore underlying pharmacological mechanisms, and evaluate clinical utility.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05828758.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}