Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Response to Letter to the Editor on 'Approach to anaemia in gastrointestinal disease: A position paper by the ESPGHAN Gastroenterology Committee'.","authors":"Ilse J Broekaert, Amit Assa, Jernej Dolinsek","doi":"10.1002/jpn3.70165","DOIUrl":"10.1002/jpn3.70165","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1124"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731895","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":"Pyridostigmine improves feeding tolerance in pediatric intestinal pseudo-obstruction: A single-center analysis.","authors":"Teresa Capriati, Roberto De Giorgio, Fabrizio Chiusolo, Renato Tambucci, Fabio Fusaro, Tamara Caldaro, Chiara Maria Trovato, Elena Bonora, Antonella Diamanti","doi":"10.1002/jpn3.70171","DOIUrl":"10.1002/jpn3.70171","url":null,"abstract":"<p><strong>Objectives: </strong>Primary and secondary forms of pediatric intestinal pseudo-obstruction (PIPO) are severe intestinal dysmotility disorders with a high risk of mortality and poor quality of life. Nutritional supports and current management have improved in part the prognosis, although several unmet needs challenge physicians. Prokinetic drugs may facilitate enteral nutrition (EN)/oral feeding (OF) and decrease parenteral nutrition (PN). Pyridostigmine has been effectively used in adults with severe gut dysmotility; however, experience in PIPO patients is still limited.</p><p><strong>Methods: </strong>Patients intolerant to EN/OF in the previous 6 months were treated with pyridostigmine. We studied nutritional outcomes (caloric intake by EN/OF and PN as well as growth) at the beginning and after 6 and 12 months of pyridostigmine. Also, we collected clinical outcomes 12 months before and after pyridostigmine treatment.</p><p><strong>Results: </strong>A total of 10 patients were included in the data analysis. Pyridostigmine (0.44-3.4 mg/Kg/day) resulted in a significant increase in EN tolerance: median caloric intake by EN/OF was >25% at 12 months (p = 0.0156). In two patients, we achieved complete weaning from PN. In all patients, there was an amelioration of growth (increase in median weight z-score from -1.3 to -0.9) and a reduction in the number of hospitalizations and central line-associated bloodstream infections in the year following pyridostigmine treatment. Only one patient developed pyridostigmine-related bradycardia.</p><p><strong>Conclusions: </strong>This study showed that pyridostigmine supported the nutritional management by improving EN/OF tolerance and reducing PN dependence. Our data provide a basis for future, ad hoc designed clinical trials testing pyridostigmine in PIPO.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"967-974"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775675","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":"Acid suppression after esophageal atresia repair: Some infants do benefit.","authors":"Suhail Zeineddin, Gwyneth A Sullivan, J Benjamin Pitt, Michela Carter, Seth D Goldstein, Brian C Gulack","doi":"10.1002/jpn3.70173","DOIUrl":"10.1002/jpn3.70173","url":null,"abstract":"<p><strong>Background: </strong>Acid suppression is used to protect against anastomotic strictures after esophageal atresia/tracheoesophageal fistula (EA/TEF) repair, but recent studies have contested this benefit. We aimed to compare rates of anastomotic stricture following EA/TEF repair among patients who received and did not receive acid suppression in a nationwide sample.</p><p><strong>Methods: </strong>We queried the Pediatric Health Information System for infants undergoing EA/TEF repair between 2010 and 2022. Acid suppression was defined as receipt of an H2 blocker or proton pump inhibitor on the day of discharge or longer than 30 inpatient days. Complex EA/TEF repair was defined as delayed repair (>7 days), G-tube placement before repair, prolonged hospitalization (>60 days), or multiple inpatient fluoroscopies. Stricture dilation defined the outcome.</p><p><strong>Results: </strong>Of 1445 infants included from 47 hospitals, 257 (17.8%) required dilation by 1 year. Of the 688 (47.6%) infants who met criteria for complex EA/TEF, 126 (18.6%) required a dilation. Prolonged acid suppression was given in 977 (67.6%) infants. At 1 year, stricture rate was similar in infants with simple EA/TEF, with or without acid suppression (17.5% vs. 17.0%, p = 0.90), however, in infants with complex EA/TEF, stricture rates were lower among those who received acid suppression compared to those who did not (15.3% vs. 26.0%, p = 0.001).</p><p><strong>Conclusion: </strong>In patients with complex EA/TEF, those who received postoperative acid suppression had a lower incidence of stricture. While it is reasonable to reduce the use of acid suppression after simple EA/TEF repair, infants with complex EA/TEF should receive acid suppression to reduce the risk of stricture.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"960-966"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784506","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":"Iron pill gastritis.","authors":"Erin Mauney, Fabiola R Curcio, Caitriona McGovern","doi":"10.1002/jpn3.70178","DOIUrl":"10.1002/jpn3.70178","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1118-1119"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760384","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":"Noninvasive monitoring with bowel ultrasound (NIMBUS) in paediatric inflammatory bowel disease: Feasibility in a single centre.","authors":"Zachary Green, Christopher Towriss, James J Ashton, R Mark Beattie, Alison Evans, Amar Wahid, Martin Edwards","doi":"10.1002/jpn3.70159","DOIUrl":"10.1002/jpn3.70159","url":null,"abstract":"<p><strong>Objectives: </strong>Bowel ultrasound (BUS) is increasingly utilised for monitoring inflammatory bowel disease (IBD), a condition with stringent treatment targets to prevent complications. This study assessed the feasibility of BUS in paediatric IBD and its correlation with established monitoring markers.</p><p><strong>Methods: </strong>A prospective study was conducted at a specialist paediatric IBD centre, including children aged 2-18 years with IBD diagnosed via modified Porto criteria. BUS parameters were based on paediatric ultrasound scoring systems, with imaging performed by a single paediatric radiologist. Biomarker data (faecal calprotectin, C-Reactive Protein, Erythrocyte Sedimentation Rate, White Cell Count, Ferritin and Albumin), and paediatric disease activity indices were recorded at time of BUS and again after a median follow-up of 2.8 months (interquartile range 1.8-4.1). Treatment changes were recorded, and ultrasound findings were correlated with clinical outcomes and inflammatory markers.</p><p><strong>Results: </strong>Forty patients were included, 27 with ulcerative colitis (UC) or UC-type IBD-unclassified. BUS was feasible, with 98% retention (n = 39) and 96.5% measurable parameters (301/312). Poor-quality imaging occurred in 10.3%. In UC, bowel wall thickness (BWT, rho = 0.503, p = 0.039) and loss of haustration (rho = 0.490, p = 0.039) correlated with faecal calprotectin; no correlations were found for Crohn's disease or the total cohort. Activity index scores did not correlate with BUS parameters.</p><p><strong>Conclusions: </strong>BUS shows potential as a noninvasive tool for assessing IBD activity in paediatric patients, especially in colitis where BWT correlates with calprotectin. However, image acquisition challenges highlight the need for expertise. Further studies across diverse cohorts are necessary to establish BUS's utility in paediatric IBD monitoring.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov (21/12/2022): NCT05673278, https://clinicaltrials.gov/study/NCT05673278, IRAS ID: 8497/OCT/2022, Date of first enrolment: 01/05/2023.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1014-1023"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of the ileal pouch in pediatric inflammatory bowel disease and familial adenomatous polyposis.","authors":"Anitta Philip, Allyson Wyatt, Jose R Rodriguez, Brad Pasternak, Lisa McMahon, Kalyani Patel, Richard Kellermayer","doi":"10.1002/jpn3.70175","DOIUrl":"10.1002/jpn3.70175","url":null,"abstract":"<p><p>Ileal pouch-anal anastomosis is a surgical intervention in patients with medically refractory inflammatory bowel disease and familial adenomatous polyposis syndrome. Reported outcomes in children have been limited by both the retrospective nature and sample size of the investigations. In addition, there is a lack of consensus on surveillance guidelines in this patient population. Delay or lack of surveillance may increase the risk of complications (pouchitis, Crohn's disease-like inflammation, dysplasia, etc.). This narrative review aims to summarize the most recent literature (2013-2023) on short-term, long-term, and quality of life (QoL) outcomes in pediatric ileal pouch (J-pouch) patients. A proposed surveillance guidance is also provided.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"913-921"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition practices of children with paediatric intestinal pseudo-obstruction in Europe-A survey by the network for intestinal failure rehabilitation and transplantation in Europe.","authors":"Alessandra Mari, Keith James Lindley, Anat Guz-Mark, Johannes Hilberath, Iva Hojsak, Lorenzo Norsa, Merit Tabbers, Rut Anne Thomassen, Elvira Verduci, Jutta Kӧglmeier","doi":"10.1002/jpn3.70161","DOIUrl":"10.1002/jpn3.70161","url":null,"abstract":"<p><strong>Objectives: </strong>Paediatric intestinal pseudo-obstruction (PIPO) is the most severe disorder of gut motility in childhood. Consensus on how and if patients should be fed (solid or bite and dissolve oral diet, gastric, jejunal, or parenteral feeding) is lacking. Our aim was to investigate the current nutrition practices among European referral centers, to aid in developing a future evidence-based consensus guideline.</p><p><strong>Methods: </strong>An electronic questionnaire was circulated via the Network of Intestinal Failure Rehabilitation and Transplantation in Europe. Data collected between October 2023 and March 2024 included patient demographics, disease phenotype based on the European Society for Paediatric Gastroenterology, Hepatology and Nutrition PIPO criteria, and type of feeding.</p><p><strong>Results: </strong>Data from 84 patients from 9 centers (8 European and 1 Israeli) were received. A total of 73 children fulfilled PIPO criteria and were included; 48 (65.8%) females, 55 (75%) became symptomatic within the first year of life; 9 (12.3%) ate a normal solid diet, 64 (87.7%) required permanent nutrition support; 2 (2.7%) were on exclusive tube enteral nutrition (EN), 9 (12.3%) on exclusive parenteral nutrition (PN), 53 (72.6%) on a combination of PN and oral diet (normal/bite and dissolve/normal but minimal intake) and/or EN. Use of exclusive PN is more common in adolescents compared to younger children. 19 (26%) eventually re-established enteral/oral intake: 8 (42.1%) after stoma formation, 7 (36%) following prokinetic induction, 1 (5.2%) after intestinal transplantation.</p><p><strong>Conclusions: </strong>Nutrition practices in children with PIPO vary widely. Only 12.3 3% of children can tolerate an increase in EN after medical and surgical interventions.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"952-959"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675089","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":"Long-term effects of ustekinumab in children with inflammatory bowel disease: A systematic review.","authors":"Breno Oliveira Marques, Ana Beatriz Ferreira Gusmão, Ana Luiza Ferreira Gusmão, Bianca Ferraz de Almeida Silva, Gabrielle Silva Sousa, Jessica Sabrina Gonçalves Fernandes, Nikolas Brayan da Silva Bragas, Natalia Oliveira E Silva","doi":"10.1002/jpn3.70163","DOIUrl":"10.1002/jpn3.70163","url":null,"abstract":"<p><p>Ustekinumab, a monoclonal antibody used in adults, is increasingly employed in children and adolescents with refractory inflammatory bowel disease (IBD). This review aimed to analyze its long-term efficacy and safety in the pediatric population. To this end, a systematic review was registered under PROSPERO (CRD42024555896). Articles indexed in PubMed/Medline, Cochrane Library, and Web of Science up to May 30, 2024, were screened. Quality was assessed using the Newcastle-Ottawa Scale. From 563 articles, 11 observational studies were included, analyzing 444 pediatric IBD patients. Remission rates varied: 47% at Week 16, 57%-59% at Week 26, and 40%-64% at Week 52. In addition, clinical improvements included better Z-scores, body mass index, reduced inflammation, and healing of mucosal and perianal disease. Five studies standardized doses by weight: 260 mg (<55 kg), 390 mg (55-85 kg), and 520 mg (>85 kg), with maintenance doses typically 90 mg every 8-12 weeks. Some patients received concomitant therapies (e.g., methotrexate, corticosteroids, and 5-aminosalicylic acid). While adverse effects were reported, including worsening psoriasis, cutaneous and neurological reactions, infections, elevated transaminases, and lymphopenia. Severe adverse events were rare, though anaphylaxis and one death from acute diarrhea were reported. Overall, ustekinumab shows promising clinical and laboratory outcomes in pediatric IBD. However, long-term studies are essential to solidify evidence regarding remission rates and adverse effects.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1045-1059"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698893","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":"Letter to Editor: Approach to anaemia in gastrointestinal disease: A position paper by the ESPGHAN Gastroenterology Committee.","authors":"Laura Gianolio, Richard K Russell","doi":"10.1002/jpn3.70164","DOIUrl":"10.1002/jpn3.70164","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1122-1123"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707781","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":"A protocol to guide diagnosis and management of water bead ingestions.","authors":"Patrick T Reeves, A Francois Trappey, Robert Smalley, Kevin Pieroni, Justin DeVito","doi":"10.1002/jpn3.70140","DOIUrl":"10.1002/jpn3.70140","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1125-1127"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731894","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}