Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Term infant formula macronutrient composition: An update for clinicians.","authors":"Catherine Larson-Nath, Anam Bashir, Rachel E Herdes, Bridget Kiernan, Joanne Lai, Nicole Martin, Nicole Misner, Akash Pandey, Kanika Puri, Wenjing Zong, Debora Duro","doi":"10.1002/jpn3.70002","DOIUrl":"10.1002/jpn3.70002","url":null,"abstract":"<p><p>Protein, carbohydrates, and fats comprise the macronutrient components of infant formulas. While all infant formulas in the United States meet specific nutrition standards, the macronutrient composition of formulas is diverse. Each macronutrient in the formula may play a role in treating or managing the disease. In addition, many formulas are marketed as resembling the composition of human milk or improving symptoms such as colic and irritability. For these and other reasons, families are often interested in different formula properties. When choosing a formula for their infant families, they may reach out to clinicians for advice. Therefore, clinicians need to understand the macronutrient composition of the formulas their patients are using. This manuscript discusses the macronutrient composition of term infant formulas and indications of the use of different macronutrient components.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"751-759"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391179","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":"Effects of lipid-based nutrient supplements on gut markers in stunted children: Secondary analysis of a randomised trial.","authors":"Hannah Pesu, Joseph Mbabazi, Rolland Mutumba, Otto Savolainen, Peter R Johnsen, Hanne Frøkiær, Mette F Olsen, Christian Mølgaard, Kim F Michaelsen, Christian Ritz, Suzanne Filteau, André Briend, Ezekiel Mupere, Henrik Friis, Benedikte Grenov","doi":"10.1002/jpn3.70023","DOIUrl":"10.1002/jpn3.70023","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the effects of lipid-based nutrient supplements (LNS) containing milk protein (MP) and/or whey permeate (WP) on markers of intestinal inflammation and enterocyte mass among stunted children. Furthermore, to explore whether gut status modifies effects of LNS on growth and micronutrient status.</p><p><strong>Methods: </strong>In a 2 × 2 factorial trial 12-59 months-old Ugandan children with stunting were randomized to four LNS formulations (100 g/day for 12 weeks) containing MP or soy protein and WP or maltodextrin, or to no supplementation. Linear mixed-effects models were used to explore faecal myeloperoxidase (f-MPO) and plasma citrulline (p-cit) as outcomes and modifiers of the intervention effects (ISRCTN13093195).</p><p><strong>Results: </strong>Of 750 children, mean ± SD age was 32.0 ± 11.7 months and height-for-age Z-score was -3.02 ± 0.74. Neither MP nor WP had effects on p-cit or f-MPO. f-MPO decreased over time among controls (ratio of change 0.54, 95% confidence interval [CI]: 0.35, 0.84), but not among those given LNS (0.99, 95% CI: 0.79, 1.23) (p = 0.016). In contrast, LNS had no effect on p-cit (p = 0.27). The effect of LNS on cobalamin (B12) status was reduced in children with p-cit <20 µmol/L; whereby there was 20% (95% CI: 2, 35) lower increase in plasma cobalamin and 59% (95% CI: 13, 125) smaller decrease in plasma methylmalonic acid. p-cit or f-MPO did not modify the effects of LNS on growth or other micronutrient markers.</p><p><strong>Conclusion: </strong>LNS had no effect on enterocyte mass and possibly increased intestinal inflammation. The effect of LNS on cobalamin status was reduced in those with low enterocyte mass.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"889-898"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542295","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":"Magnetic endoscopic imaging in pediatric colonoscopy: A positive impact on procedure completion rate and procedure times.","authors":"Andrew Liman, Ronald Lal, Osamu Winget Yasui, Roberto Gugig, Monique T Barakat","doi":"10.1002/jpn3.70011","DOIUrl":"10.1002/jpn3.70011","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of magnetic endoscopic imaging (MEI) on pediatric colonoscopy.</p><p><strong>Methods: </strong>We analyzed demographics, procedure completion, procedure times, complications, and whether or not MEI was used for all colonoscopies between April 27, 2023, and January 18, 2024. MEI was available for every case but used at the endoscopist's discretion. Attendings were surveyed on the frequency and duration of interventions during fellow-performed colonoscopies.</p><p><strong>Results: </strong>We analyzed 310 colonoscopies, 113 (36%) of which used MEI. The average patient age was 13.8 years (range 5 months to 23 years). For the aggregate sample and attending-performed cases, there were fewer males in the groups that used MEI (p < 0.01). There were no other statistically significant differences in demographics or procedure indication when MEI was used. Terminal ileum (TI) intubation rate was higher when MEI was used in the aggregate sample (p = 0.02) and for fellow-performed cases (p = 0.04). TI intubation times and total procedure times were quicker when MEI was used in the aggregate sample and in both strata of attending-performed cases and fellow-performed cases (p < 0.001). One complication was reported in an attending-performed case that did not use MEI. Of the 145 fellow-performed procedures, 98 (68%) had completed surveys, 36 (36%) of which used MEI. There was no statistically significant difference in the number (p = 0.89) or duration (p = 0.96) of attending interventions when MEI was used.</p><p><strong>Conclusion: </strong>MEI use was associated with higher TI intubation rates, faster TI intubation, and shorter total procedure times. MEI may be a valuable adjunctive tool for pediatric endoscopists.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"926-933"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449210","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 prevalence of constipation in children with new diagnosis of inflammatory bowel disease: A retrospective study.","authors":"Sabrina Cenni, Antonio Colucci, Simona Salomone, Daniela Pacella, Marianna Casertano, Pietro Buono, Massimo Martinelli, Erasmo Miele, Annamaria Staiano, Caterina Strisciuglio","doi":"10.1002/jpn3.70005","DOIUrl":"10.1002/jpn3.70005","url":null,"abstract":"<p><strong>Objectives: </strong>Functional constipation (FC) is a common problem in childhood and the first-line therapy is macrogol. The role of FC in the onset of inflammatory bowel disease (IBD) is poorly understood. Our main aim was to investigate the prevalence of FC in children before the diagnosis of IBD.</p><p><strong>Methods: </strong>This is a cross-sectional observational study in pediatric IBD-patients. We collected data on demographics, clinical and endoscopic characteristics at IBD diagnosis, and on the presence of FC and its treatment before IBD diagnosis.</p><p><strong>Results: </strong>A total of 238 children with IBD, 104 (44%) with Crohn disease (CD), 130 (56%) with ulcerative colitis (UC) and 4 (0.016%) with IBD Unclassified (IBD-U) were enrolled. The mean age was 174 ± 47 months, 56% were male. Forty-seven out of 238 (19.7%) had a FC history before the IBD diagnosis and 31 out of these 47 patients (65%) received macrogol therapy. In the FC group, we found a delay in the diagnosis of IBD compared to the group with no FC [median (interquartile range [IQR]): 5 months (2.5-9.5) and 2 months (0-4), respectively, p ≤ 0.001]. The difference in terms of endoscopic localization was statistically significant in UC patients presenting FC (p = 0.026) with a prevalence of proctitis and left side colitis (30% and 15%, respectively).</p><p><strong>Conclusion: </strong>In conclusion our study highlighted a prevalence of constipation in pediatric IBD patients at diagnosis of 19.7%, which must be taken into account to avoid diagnostic delay and which is associated with limited extent of disease in UC pediatric patients.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"799-806"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399405","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":"Nutritional management and outcomes of malnourished children under 2 years with intestinal failure.","authors":"Estela Cristina Pavanelli, Joao Seda Neto, Beatriz Camilo Farah, Roberta Luiza Longo, Natália Canale Person, Catiana Mitica Gritti, Carine Dias Ferreira de Jesus, Camila Mascarenhas Teixeira de Carvalho, Massami Hayashi, Catherina Oliveira Gameiro, Jackeline Farias Brufato, Gabrielle Marques Blini, Rodrigo Vincenzi","doi":"10.1002/jpn3.70018","DOIUrl":"10.1002/jpn3.70018","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the evolution of nutritional status, parenteral nutrition (PN) composition, and PN dependence index (PNDI) in children under 2 years old with intestinal failure (IF) and malnutrition.</p><p><strong>Methods: </strong>This retrospective cohort included patients admitted between November 1, 2016, and August 31, 2021, with IF, age ≤24 months, and weight-for-age (Wt/A) <-2 standard deviation with a follow-up of 12 months. Data collected included demographic, anthropometric, biochemical, and nutritional information. The PNDI was compared between enteral autonomy (EA) and nonenteral autonomy (non-EA) groups.</p><p><strong>Results: </strong>Thirty patients (16 males, 53.33%) were included, and short bowel syndrome (SBS) was the leading cause of IF (n = 27, 90%). The mean age at admission was 7.23 ± 3.90 months, and 36.66% of the patients had a conjugated bilirubin (CB) level >2 mg/dL; 87% had a Wt/A z-score <-3 and 90% had a height-for-age (Ht/A) z-score <-3. At 5 months, the mean Wt/A z-score improved to -1.82. At admission, median protein, lipid, and glucose intake on PN were 3, 1.6, and 17.27 g/kg/day, respectively. In the PNDI analysis, the EA group had a mean index of 141% versus 158% for the non-EA group at admission, with no statistical differences. From the sixth month onward, the EA group showed a significantly lower PNDI (50% vs. 108% for non-EA patients; p = 0.032). Both groups demonstrated adequate nutritional recovery.</p><p><strong>Conclusion: </strong>Adequate multidisciplinary care can reverse severe malnutrition, and the PNDI may be a predictor of EA.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"880-888"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441358","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":"Protein and energy digestibility in preterm infants fed fortified human milk.","authors":"Susanne Soendergaard Kappel, Per Torp Sangild, Gitte Zachariassen, Julie Hvid Andersen, Kirsten Kørup Rasmussen, Palle Bekker Jeppesen, Lise Aunsholt","doi":"10.1002/jpn3.70000","DOIUrl":"10.1002/jpn3.70000","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of the present study is to determine whether the apparent nutrient digestibility differs between very preterm infants fortified with bovine colostrum (BC) compared to those fortified with a conventional fortifier (CF), building on previous findings that BC was associated with looser stools and reduced need for laxatives in very preterm infants (VPI).</p><p><strong>Methods: </strong>We conducted a 24-h digestibility balance study in 10 VPIs to assess the retention of protein, energy, and wet-weight following the intake of fortified human milk and collection of faecal excretions. Infants (n = 5) were matched by gestational age and birthweight.</p><p><strong>Results: </strong>In the 10 infants, the mean gestational age and birthweight were 28 ± 1 weeks and 899 ± 182 g, respectively. Infants fortified with BC had a higher faecal energy loss compared with infants fortified with CF (BC: 178 [range 111-205] vs. CF: 153 [96-235] kJ/kg, p < 0.05). No differences (p > 0.05) were found for wet-weight intake (421 [360-427] vs. 494 [328-500] kJ/kg), relative absorption of protein (60 [33-75] vs. 50 [33-75]%) or absolute protein absorption (249 [159-310) vs. 281 [210-347]).</p><p><strong>Conclusion: </strong>Nutrient absorption was similar between groups although higher energy loss indicates reduced overall digestibility of BC versus CF, however, with a large variation within each group. Studies on more infants are required to confirm these results. A 24-h digestibility balance study can successfully be used to assess nutrient and energy retention in preterm infants.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"855-860"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123084","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":"Proctocolitis or TikTok-olitis: The dangers of social media influence on home constipation management.","authors":"Ashley Polachek, Grant Flindt, Lauren Lazar, Sarah Barlow","doi":"10.1002/jpn3.70027","DOIUrl":"10.1002/jpn3.70027","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"941-942"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623412","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":"Validation of the Toronto Upper Gastrointestinal Cleaning Score in children.","authors":"Łukasz Dembiński, Lorenzo Norsa, Sian Copley, Marcin Dziekiewicz, Thomas Gestels, Maureen Lawson, Cecilia Mantegazza, Gøri Perminow, Jonas Povilavicius, Monica Ronconi, Anna-Maria Schneider, Tobias Schwerd, Wojciech Sitarski, Kristina Skram, Geistė Tubutytė, Saskia Vande Velde, Dotan Yogev, Shira Yuval, Aleksandra Banaszkiewicz","doi":"10.1002/jpn3.70022","DOIUrl":"10.1002/jpn3.70022","url":null,"abstract":"<p><strong>Objectives: </strong>Gastroscopy is used to examine the upper gastrointestinal (GI) tract, but no validated method yet exists to assess the quality of mucosal visualization in children. Utilizing validated endoscopic scales can enhance study quality and standardization across centers. This study aimed to validate the existing Toronto Upper Gastrointestinal Cleaning Score (TUGCS) in pediatric patients.</p><p><strong>Methods: </strong>This was a multicenter, prospective, single-masked study conducted in 10 European pediatric gastroenterology centers. Endoscopists with varying degrees of experience assessed the quality of mucosal visualization in prerecorded gastroscopies using the TUGCS. Each endoscopist assessed the studies two times in random order, with an interval of at least 2 weeks. The correlations of individual and total scores were statistically compared between themselves, between assessors, and between assessment attempts. Internal consistency was also checked with Cronbach's α.</p><p><strong>Results: </strong>Seventeen endoscopists participated in the study. The TUGCS demonstrated high consistency within raters, with a score of 0.64 (95% confidence interval [CI]: 0.34-0.84), and an excellent test-retest reliability of 0.97 (95% CI: 0.94-0.99). The scale also showed high internal consistency, with a Cronbach's α of 0.95. The correlation between different items ranged from 0.60 to 0.77, and the correlation between individual items and the total score ranged from 0.66 to 0.88. No significant differences in the assessment were found based on the raters' experience performing endoscopy, specialization, age, or gender. The endoscopists found TUGCS easy to learn and potentially useful, especially in clinical trials.</p><p><strong>Conclusions: </strong>The TUGCS was demonstrated as a reliable and validated method for assessing the visualization quality of the upper GI mucosa in pediatric patients.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"934-940"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483556","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":"EndoFLIP distensibility index correlates with histologic findings in children with eosinophilic esophagitis.","authors":"Erik Almazan, Tom Z Liang, Brenna Hohl, Brett J Hoskins, Jacqueline E Birkness-Gartman, Kenneth Ng","doi":"10.1002/jpn3.70013","DOIUrl":"10.1002/jpn3.70013","url":null,"abstract":"<p><strong>Background and aims: </strong>The Eosinophilic Esophagitis Histology Scoring System (EoEHSS) is useful for diagnosing and characterizing eosinophilic esophagitis (EoE). A limitation of the EoEHSS is that lamina propria fibrosis scores are infrequently determined due to challenges in sampling lamina propria. Low distensibility index (DI) measured by endoluminal functional lumen imaging probe (EndoFLIP) is associated with fibrostenotic severity in pediatric patients with EoE. We investigated the correlation between DI and the EoEHSS to understand whether EndoFLIP could be a useful complementary tool for evaluating EoE-associated remodeling in children.</p><p><strong>Methods: </strong>We reviewed the medical records of patients <21 years of age who underwent an esophagogastroduodenoscopy (EGD) with biopsy and EndoFLIP between October 2017 and July 2023 with histologic diagnoses of normal/reactive, reflux, or EoE. EoEHSS scores and luminal parameters were compared between groups. DI measured at 30 mL inflation was compared with EoEHSS scores.</p><p><strong>Results: </strong>One hundred twenty-six EGDs with biopsy and EndoFLIP were performed on 112 patients. There were 80 normal/reactive, 32 reflux, and 14 EoE biopsies. At 30 mL inflation, DI was lowest in the EoE group (p = 0.03). DI at 30 mL inflation negatively correlated with the EoEHSS overall grade score, as well as grade and stage scores for eosinophil abscesses, eosinophil surface layering, dilated intercellular spaces, and basal zone hyperplasia (all p < 0.05). DI at 30 mL inflation also negatively correlated with the eosinophilic inflammation stage score (p < 0.05).</p><p><strong>Conclusion: </strong>DI measured by EndoFLIP at 30 mL inflation shows a negative correlation with composite EoEHSS scores and subscores, suggestive of remodeling. EndoFLIP may complement the EoEHSS in evaluating EoE-associated esophageal remodeling.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"824-831"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441268","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":"Feeding intolerance in adolescents with disorders of gut-brain interaction.","authors":"Hannibal Person, Jason Soden, Alexandra N Carey, Anil Darbari, Julie Khlevner","doi":"10.1002/jpn3.12468","DOIUrl":"10.1002/jpn3.12468","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"747-750"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441355","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}