Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Pediatric surgical gastrostomy revision in the modern era, patterns, and potential modifiable factors: A retrospective analysis.","authors":"Tayana A Jean Pierre, Steven J Staffa, Terry L Buchmiller","doi":"10.1002/jpn3.70591","DOIUrl":"https://doi.org/10.1002/jpn3.70591","url":null,"abstract":"<p><strong>Objectives: </strong>Long-term use of gastrostomy tubes (G-Tubes) presents a potential risk for surgical gastrostomy revision (SGR) with re-siting of the tract. This study describes the patterns of SGR to ascertain if this may be a potentially modifiable event. We hypothesize that gradual tract compression or migration may contribute to the need for SGR.</p><p><strong>Methods: </strong>A retrospective review of patients who had SGR from January 2010 to January 2024 was conducted. Data collected included demographics, anthropometric measurements at SGR, diagnosis at initial gastrostomy placement (IGP), indication for SGR, G-Tube length pre- and post-SGR. Descriptive and inferential statistics were applied.</p><p><strong>Results: </strong>We included 111 patients. The median age at IGP was 0.3 years (interquartile range [IQR]: 0-2 years). The median age at SGR was 5 years (IQR: [1.6, 15.7]; range: 0-36 years). Overlapping indications for SGR included: excessive leaking in 77%, gastric prolapse in 36%, and tract migration to the costal margin with somatic growth in 33%. Tract compression was contributory to SGR as the G-Tube length had to be increased by an average of 0.7 cm in 75% of cases at SGR. A higher G-Tube length at SGR was positively correlated with higher weights (r = 0.78, p < 0.0001) and older age (r = 0.68, p = 0.0001).</p><p><strong>Conclusion: </strong>Migration toward the costal margin over years due to growth was documented; hence, locating the gastrostomy as inferior as possible at IGP is supported. Furthermore, anticipatorily increasing the G-Tube length to prevent tract compression due to growth over the years is strongly supported as a modifiable factor to avoid reoperation.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025152","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":"Clinical phenotypes of very early onset inflammatory bowel disease in Australian children: A single-centre retrospective study.","authors":"Jonathan Dudzik, Peter Lewindon","doi":"10.1002/jpn3.70595","DOIUrl":"https://doi.org/10.1002/jpn3.70595","url":null,"abstract":"<p><strong>Objectives: </strong>Very early onset inflammatory bowel disease (VEO-IBD), diagnosed at <6 years old, includes a subset of infantile onset IBD (IO-IBD, ≤2 years). We describe presenting clinical features, phenotypes, and early management of children with VEO-IBD at a single tertiary centre.</p><p><strong>Methods: </strong>Retrospective cohort study of children with VEO-IBD diagnosed at Queensland Children's Hospital from January 2010 to March 2025.</p><p><strong>Results: </strong>In 52 children, (24 IO-IBD; 28 VEO-IBD), median Paediatric Ulcerative Colitis Activity Index on presentation was 35 (interquartile range [IQR] 15), similar in both groups (35 IO-IBD; 39.5 VEO-IBD). Ulcerative colitis (UC) was the most frequent diagnosis (50%; 38% Crohn's disease; 12% IBD-Unclassified [IBD-U]). Among children with UC/IBD-U, pancolitis was common in both groups (57.1% IO-IBD; 66.7% VEO-IBD). Paris-classified anatomic phenotype did not differ between IO-IBD and VEO-IBD. Atypical colitis, upper gastrointestinal involvement, and granulomas occurred in 23%, 38% and 35% of cases, respectively. Prior allergic/atopic diagnoses were documented in 44%. Primary sclerosing cholangitis (PSC) was identified in 8% within 12 months of IBD diagnosis. Two monogenic disorders were identified, among 38 genotyped children, with severe perianal disease and successful bone marrow transplantation. Corticosteroids were used in 67% (35/52); 86% (30/35) responded without biologic rescue; five required anti-tumour necrosis factor therapy. One child required early colectomy.</p><p><strong>Conclusions: </strong>IO-IBD and VEO-IBD demonstrated substantial overlap in presenting clinical and intestinal phenotypes. Monogenic disease was confined to IO-IBD, while early PSC was a notable secondary finding. These data support phenotype-guided genetic evaluation and further study of early hepatobiliary disease in VEO-IBD.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016957","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":"Children with sickle cell disease hospitalized for acute pancreatitis have an increased disease burden.","authors":"Olawale Oduru, Akm Fazlur Rahman, Kyanam Kabir Baig Kr, Ali Ahmed, Saskia D'Sa, Shaundra Blakemore, Chinenye R Dike","doi":"10.1002/jpn3.70590","DOIUrl":"https://doi.org/10.1002/jpn3.70590","url":null,"abstract":"<p><strong>Objectives: </strong>Children with sickle cell disease (SCD) are at increased risk of developing gallstones, a common etiology of acute pancreatitis (AP). We aimed to determine if children with SCD admitted to children's hospitals for AP will have an increased burden of AP compared to non-SCD.</p><p><strong>Methods: </strong>Retrospective study of children 0-21 years admitted with a diagnosis of AP in the Pediatric Health Information System (PHIS) database from 2012 to 2023. Descriptive statistics were used to describe baseline demographics. Categorical variables including readmissions, complications, transfusions, and procedure rates were compared between groups (SCD vs. non-SCD) using χ² or Fisher's exact test. Wilcoxon rank sum test was used to compare the median age and length of stay (LOS) between groups.</p><p><strong>Results: </strong>We analyzed 18,213 distinct participants (17,927 [non-SCD] and 286 [SCD]). Children with SCD were older; p = 0.0004 compared to non-SCD. Children with SCD had increased LOS compared to those without SCD; 4 versus 3 days, p = <0.001. Further, children with SCD received more transfusions compared to those without SCD (31% vs. 3%; p = <0.0001). Need for endoscopic interventions in SCD was 21% versus 8% in non-SCD (p < 0.0001), and cholecystectomy rates were higher in SCD, 33% compared to 11% in non-SCD (p < 0.0001).</p><p><strong>Conclusions: </strong>Children with SCD hospitalized with AP at children's hospitals are older, need more red blood cell transfusions, have an increased LOS, and need more procedures compared to children without SCD. Further studies aimed at reducing the burden of AP in children with SCD are needed.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016974","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":"Selective immunoglobulin A deficiency and coeliac disease: Immune response dynamics.","authors":"Ester Donat, Ilma Korponay-Szabó, Renata Auricchio, Marco Crocco, Victorien M Wolters, Joanna Bierła, Caroline Meijer-Boekel, Peter Gillett, Gieneke Gonera-de Jong, Gemma Castillejo, Margreet Wessels, Josefa Barrio-Torres, Henedina Antunes, Zrinjka Misak, Alina Popp, Alice Monzani, Raquel Vecino, María Roca, Carmen Ribes-Koninck","doi":"10.1002/jpn3.70589","DOIUrl":"10.1002/jpn3.70589","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the serological immune response in paediatric patients with selective immunoglobulin A deficiency (SIgAD) and coeliac disease (CeD), focusing on immunoglobulin G antibody dynamics after starting the gluten-free diet (GFD).</p><p><strong>Methods: </strong>Data from SIgAD patients with a CeD diagnosis, age less than 18 years, was retrospectively collected by the participating centres in this observational, multicentre, pan-european registry, conducted by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Coeliac Disease Special Interest group. The analysis of the dynamics of normalisation of different IgG antibodies was conducted using non-parametric Kaplan-Meier curves.</p><p><strong>Results: </strong>At diagnosis, there is no correlation between mucosal damage and serological levels and a small bowel biopsy is mandatory to confirm CeD in children with SIgAD. After starting a GFD IgG antibody levels decrease slowly in SIgAD patients with CeD, with 50% still serology positive after 3 years. It takes significantly longer for normalisation in those with IgG class anti-transglutaminase antibodies (IgG-TGA) baseline levels >×10 upper limit of normal (ULN). Early quantitative change in antibody levels was not predictive of final serological normalisation.</p><p><strong>Conclusion: </strong>Decision-making on invasive tests based exclusively on the follow-up antibody results should be avoided, given that IgG-class antibodies resolve much more slowly after commencing a GFD, especially in those patients with high baseline IgG-TGA levels.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017095","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":"Disability in pediatric inflammatory bowel diseases: A systematic review and a single center experience.","authors":"Reut Rappaport, Ouriel Hannaux, Gili Focht, Liron Marcovitch, Elana Gotkine, Ohad Atia, Esther Orlanski-Meyer, Raffi Lev-Tzion, Oren Ledder, Dotan Yogev, Eileen Crowley, Anthony Otley, Anne M Griffiths, Dan Turner","doi":"10.1002/jpn3.70596","DOIUrl":"https://doi.org/10.1002/jpn3.70596","url":null,"abstract":"<p><strong>Objectives: </strong>Toward development of a pediatric IBD disability index (PIDI), we aimed to review the literature on disability in pediatric inflammatory bowel disease (PIBD) and to estimate disability rates in a pediatric inception cohort.</p><p><strong>Methods: </strong>A systematic review identified studies reporting disability in PIBD and in adult randomized controlled trials (RCTs) with disability as the primary outcome. In parallel, seven disability-related IMPACT-III items were retrieved at 4 and 12 months after diagnosis from a prospectively followed inception cohort of PIBD. Items were scored 0-100 (≤75 mild, ≤50 moderate, and ≤25 severe disability), supported by a validation sub-study.</p><p><strong>Results: </strong>Thirteen pediatric studies were included of which 10 used the functional disability inventory, a generic disability tool not developed for PIBD. Any disability was found in 55% and 100% in the two studies that reported rates. Three adult RCTs used generic patient-reported measures of participation in daily activities and showed modest, inconsistent improvement in disability with heterogenous interventions. The inception cohort included 80 children, of whom 38% had any disability at 4 months and 10% had moderate-severe disability. These rates declined to 18% and 0% at 12 months, respectively. Dietary restrictions, sports participation, travel, and school functioning were the most affected domains. At 4-months, any degree of disability was higher in those with active disease (61%) versus inactive disease (17%, p < 0.001).</p><p><strong>Conclusions: </strong>Disability literature in PIBD is scarce and lacks a pediatric-specific instrument. Functional limitations were frequent and persisted in some children despite reaching clinical remission. These findings underscore the need for standardized disability assessment in PIBD.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017082","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":"Appropriate screening strategy and timely referral in suspected pediatric inflammatory bowel disease: Impact on diagnostic delay and severity at presentation.","authors":"Francesca Borgiani, Mario Brusco, Elisa Franceschini, Maria Elena Lionetti, Simona Gatti","doi":"10.1002/jpn3.70588","DOIUrl":"10.1002/jpn3.70588","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatric-onset inflammatory bowel disease (pIBD) often presents with nonspecific symptoms, contributing to diagnostic delay (DD) and increased morbidity. Despite the importance of referral quality, diagnostic pathways in pIBD have rarely been evaluated. This study aimed to assess the appropriateness of diagnostic pathways in pIBD; to evaluate their impact on DD and early disease severity; and to identify predictors of pathway appropriateness and prolonged delay.</p><p><strong>Methods: </strong>This retrospective, single-center study included 128 patients diagnosed with pIBD (January 2015 to June 2025, regional tertiary center, Italy). Diagnostic pathways were classified as appropriate, partially appropriate, or inappropriate according to predefined criteria reflecting referral trajectory and completeness of pre-referral screening (fecal calprotectin [FC] and/or abdominal ultrasound [AUS]). DD was defined as the time from symptoms onset to endoscopy.</p><p><strong>Results: </strong>Pathways were inappropriate in 60.9%, partially appropriate in 21.9%, and appropriate in 17.2%. The median DD was 3.9 months, with no significant differences among groups. Acute severe colitis (ASC) (odds ratio [OR] = 32.2) and tenesmus (OR = 5.8) were associated with appropriate pathways, fever (OR = 0.10) and oral aphthosis (OR = 0.05) with inappropriate ones (p < 0.05). Shorter DD was independently associated with ASC (B = -6.13 months), hematochezia (B = -3.48), fever (B = -4.25), and weight loss (B = -3.42) (p < 0.05). FC and AUS were performed before referral in 60.2% and 42.2% of patients, respectively, and together in 32.8%.</p><p><strong>Conclusions: </strong>Inappropriate pathways and lack of pre-referral screening are highly prevalent. Severe intestinal presentations favor appropriate investigations. Systemic or extraintestinal manifestations are more frequently associated with inappropriate pathways. Standardized screening and referral protocols may optimize pIBD management.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012529","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":"Biliary-type pain in children with chronic abdominal pain: A cross-sectional, observational study.","authors":"Antonio Colucci, Flora Fedele, Massimo Martinelli, Marianna Casertano, Erasmo Miele, Caterina Strisciuglio, Annamaria Staiano","doi":"10.1002/jpn3.70578","DOIUrl":"10.1002/jpn3.70578","url":null,"abstract":"<p><strong>Objectives: </strong>Functional gallbladder disorders are well-recognized entities in adults with standardized diagnostic criteria since the Rome III criteria. The existence of these disorders in children is still debated. The primary aim was to estimate the prevalence of disorders of gut-brain interaction (DGBIs) with abdominal pain, particularly biliary pain (BP), in children using adult criteria. The secondary aim was to assess their quality of life.</p><p><strong>Methods: </strong>This cross-sectional, observational study (March-November 2023) included children aged 4-18 years with chronic abdominal pain. Children with organic pathologies or comorbidities were excluded. Patients completed the ROMA IV questionnaire for DGBIs and the Pediatric Quality of Life Inventory (PedsQL4) Generic Core questionnaires for health-related quality of life, and were assessed for whether they fulfilled adult Rome IV criteria for BP.</p><p><strong>Results: </strong>Among 120 children (median age: 9.4 years; M/F: 49/71), 90 (75%) were diagnosed with DGBIs. An overlap of multiple functional disorders was found in 34 children (28.3%). Functional dyspepsia (25.8%) was the most common. Eleven patients (9.2%) met the adult ROMA IV criteria for BP, and seven (63.3%) showed an overlap with another DGBIs. The median PedsQL4 score was 70.6 (39.1-97.8). No statistically significant differences were found when the cohort was divided by gender (p = 0.5). Patients with possible BP did not report a lower quality of life (total median score: 78.3 [45.6-95.6] vs. 69.6 [39.1-97.8]; p = 0.2).</p><p><strong>Conclusions: </strong>In a cohort of children with chronic abdominal pain, 9.2% of the cases met adult Rome IV criteria for BP. However, a high risk of overlap with different DGBIs was observed.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012538","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":"Children's and caregivers' experiences, information needs, and willingness to change lifestyle in metabolic dysfunction-associated steatotic liver disease care: A multicenter study across Europe.","authors":"Anne-Sophie R Stroes, Natalia Zavhorodnia, Claudia Mandato, Antonella Mosca, Maria Mercadal-Hally, Jernej Brecelj, Corina Pienar, Wojciech Jańczyk, Christian A Hudert, Eberhard Lurz, Cigdem Arikan, Anastasia Konidari, Maarten Buytaert, Sander Lefere, Ruth De Bruyne, Hadar Moran-Lev, Guusje H J van Giesen, Anita C E Vreugdenhil, Marc A Benninga, Bart G P Koot","doi":"10.1002/jpn3.70587","DOIUrl":"10.1002/jpn3.70587","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about children's and caregivers' experiences, information needs, and willingness to change lifestyle following evaluation for metabolic dysfunction-associated steatotic liver disease (MASLD). This study assessed these aspects across European hepatology clinics.</p><p><strong>Methods: </strong>Children and caregivers completed a web-based questionnaire after the MASLD evaluation visit, assessing discomfort, information sufficiency, and willingness to change lifestyle using mainly 5-point Likert scales.</p><p><strong>Results: </strong>The cohort included 249 children (13 ± 3 years) from 12 countries.</p><p><strong>Discomfort: </strong>Before the visit, most children reported \"no\" or \"slight\" nervousness, anxiety, or worry, whereas 7%-9% reported \"very\" or \"extreme\" discomfort and 14% felt negative. Nervousness was slightly higher at first visits than follow-up visits. During the visit, 4% were \"very\" or \"extremely\" nervous and 62% felt highly supported by the physician. After the visit, 7% still felt negative, although anxiety remained low (68% \"no\" or \"slight\"). Caregiver assessments (n = 203) cross-validated these findings.</p><p><strong>Information: </strong>Over half (51%) reported \"no\" or \"slight\" pre-visit knowledge, yet 81% rated information during the visit as \"very\" or \"extremely\" sufficient. Pre-visit knowledge was higher at follow-up. Caregivers rated information sufficiency higher than children and more often intended to seek information (57% vs. 23%, p < 0.001). Lifestyle: 44% reported high willingness to change lifestyle post-visit, consistent with caregiver expectations.</p><p><strong>Conclusions: </strong>MASLD evaluation was associated with low burden overall, although a small subset experienced high discomfort. Baseline knowledge about the visit was low. Perceived information sufficiency was high, however, only 44% reported high willingness to change lifestyle post-visit. Better information tools are needed to improve screening acceptability and lifestyle motivation.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990394","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 nationwide multicenter observational study on childhood scurvy in Japan.","authors":"Yu Masuda, Ryohei Fukatsu, Ryosuke Miyamoto, Hitoshi Honma, Yoshinori Ito, Hiromichi Shoji, Masanobu Kawai, Yuri Etani, Toshiaki Shimizu, Akihisa Okumura","doi":"10.1002/jpn3.70592","DOIUrl":"10.1002/jpn3.70592","url":null,"abstract":"<p><strong>Objectives: </strong>Although scurvy is rare in developed countries, cases in children with selective diets due to neurodevelopmental disorders have been increasingly reported in Japan. In this nationwide multicenter observational study, we aimed to clarify the clinical characteristics and diagnostic challenges faced by children with scurvy in Japan.</p><p><strong>Methods: </strong>We conducted a two-step nationwide multicenter observational study. An initial screening survey was sent to 407 training hospitals certified by the Japan Pediatric Society to identify institutions that had encountered children with scurvy between 2014 and 2023. A second, detailed questionnaire was sent to institutions that had managed children with scurvy, as well as those identified through a literature search, to collect data on clinical features, diagnostic processes, treatments, and outcomes.</p><p><strong>Results: </strong>Forty-seven children with scurvy, from 35 hospitals were included in the final analysis. The median age was 3.6 years, 70% were male, and only 36% had a body mass index standard deviation score below -2.0. A selective diet was observed in 96% of patients; 72% had autism spectrum disorder (ASD), and 13% had no underlying disease. The most common presenting symptom was gait disturbance (88%), whereas weight loss was observed in only 21% of patients. Additionally, 30% were misdiagnosed, and 38% underwent potentially harmful examinations. Pretreatment serum ascorbic acid levels were below the detection limit in 77%.</p><p><strong>Conclusions: </strong>In Japan, scurvy in children was predominantly associated with a selective diet, particularly among those with ASD. Careful dietary assessment is important to avoid diagnostic delay and irreversible complications.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990371","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":"Children with antral hypomotility and enteric neuropathy are more likely to improve with gastric electrical stimulation.","authors":"Eduardo Castillo-Leon, Amina Usman, Raul E Sanchez, Neetu Bali Puri, Karla K H Vaz, Desale Yacob, Md Rejuan Haque, Karen A Diefenbach, Carlo Di Lorenzo, Peter L Lu","doi":"10.1002/jpn3.70594","DOIUrl":"https://doi.org/10.1002/jpn3.70594","url":null,"abstract":"<p><strong>Objectives: </strong>Gastric electrical stimulation (GES) improves symptoms and quality of life in children with refractory nausea and vomiting, but predictors of response remain unclear. This study evaluated whether antroduodenal manometry (ADM) results predict response to GES.</p><p><strong>Methods: </strong>We completed a prospective cohort study of patients <21 years old who underwent GES placement at our institution (2011-2024) with a prior ADM. Data were gathered at baseline, after the 1-week temporary stimulation trial, and at 2, 6, and 12 months after GES placement. Patients completed the Symptom Monitor Worksheet (SMW) and Pediatric Quality of Life Inventory (PedsQL). ADM findings were categorized as normal, postprandial antral hypomotility, or neuropathic pattern of small bowel motility based on initial interpretation and/or expert review. Clinical response was defined as a > 1 point improvement in average SMW score from baseline to last follow-up. Linear mixed-effects regression assessed changes in SMW and PedsQL by ADM category.</p><p><strong>Results: </strong>Forty-seven patients (mean age of 13.7 ± 4.5 years, 70.2% female) were included, and 82.9% had gastroparesis. ADM was abnormal in 28 (59.5%), 15 (31.2%) had postprandial antral hypomotility, and 16 (34%) had neuropathic pattern of small bowel motility, with three patients having both. Patients with postprandial antral hypomotility (p = 0.002) and neuropathic pattern of small bowel motility (p = 0.01) had statistically significant improvement in SMW scores, while those with normal ADM did not (p = 0.15). All groups improved in PedsQL. Clinical response occurred in 26.3% of patients with normal ADM versus 64.2% with abnormal ADM (odds ratio::4.85, 95% confidence interval: 2.5%-97.5%, 1.2-22.7).</p><p><strong>Conclusions: </strong>Children with postprandial antral hypomotility or neuropathic pattern of small bowel motility on ADM are more likely to experience symptomatic improvement from GES.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990412","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}