Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Rescue gastro-jejunal tube.","authors":"Tawfiq Taki Al Lawati","doi":"10.1002/jpn3.70117","DOIUrl":"10.1002/jpn3.70117","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"899-900"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","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":"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":"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":"507-513"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","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":"The clinical utility and safety of rectal suction biopsy in children, a single center report.","authors":"Geoffrey Daves, Ashley Polachek, Nicholas Norris, Wenjing Zong, David M Troendle","doi":"10.1002/jpn3.70153","DOIUrl":"10.1002/jpn3.70153","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"753-756"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575715","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":"Training in the new era.","authors":"Brian A McFerron, Jennifer A Strople, Daniel Kamin, Jessica Rutsky, Joseph C Woolley, Sarah S Lusman, Daniel Mallon","doi":"10.1002/jpn3.70150","DOIUrl":"10.1002/jpn3.70150","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"479-482"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575716","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":"Children with disorders of gut-brain interaction in primary care versus hospital care: A comparison of characteristics.","authors":"Ilse N Ganzevoort, Marjolein Y Berger, Arine M Vlieger, Marc A Benninga, Michiel R De Boer, Gea A Holtman","doi":"10.1002/jpn3.70129","DOIUrl":"10.1002/jpn3.70129","url":null,"abstract":"<p><strong>Objectives: </strong>To compare characteristics of children with functional abdominal pain (FAP) or irritable bowel syndrome (IBS) between primary and hospital care.</p><p><strong>Methods: </strong>This study makes a cross-sectional comparison of baseline data from two randomised controlled trials (RCTs): one in Dutch primary care and one in Dutch hospital care, including secondary and tertiary care. This study included children aged 8-17 years old with FAP or IBS fulfilling the Rome III or IV criteria. Outcome measures were age, gender, Rome criteria diagnosis, duration of abdominal pain symptoms, pain intensity and frequency scores, school absenteeism, pain beliefs, somatisation score, anxiety and depression scores, and health-related quality of life scores.</p><p><strong>Results: </strong>A total of 367 children were compared (110 in primary care, 257 in hospital care). Children seen in primary care were younger (9.8 years, 95% confidence interval [CI]: 9.4-10.7 vs. 13.6 years, 95% CI: 12.9-14.1), had a lower abdominal pain intensity score (12.0, 95% CI: 9.0-13.0 vs. 15.0, 95% CI: 15.0-16.0), frequency score (10.5, 95% CI: 9.0-13.5 vs. 16.0, 95% CI: 14.0-17.0) and somatisation score (15.0, 95% CI: 12.0-17.0 vs. 22.0, 95% CI: 20.0-25.0) compared to hospital care. A lower proportion of children had missed school because of their abdominal pain (57.3%, 95% CI: 48.2-66.4 vs. 75.9%, 95% CI: 70.4-80.9). Other characteristics were similar between groups.</p><p><strong>Conclusions: </strong>Children in primary care may differ from those in hospital care in terms of age, pain, somatisation, and school absenteeism, suggesting potential treatment response differences. Therefore, research in primary care is needed to guide evidence-based treatment and appropriate referral decisions for general practitioners.</p><p><strong>Clinical trial registration: </strong>Primary care study: ClinicalTrials.gov NCT05636358. Hospital care study: Dutch Trial Register NL2597.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"530-539"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528445","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":"Vulnerability factors for pediatric disorders of gut-brain interaction and implications for functional impairment.","authors":"Beate Beinvogl, Elizabeth Burch, Julie Snyder, Enju Liu, Neil Schechter, Bobbie Riley, Amy E Hale, Hannah Brewer, Samuel Nurko","doi":"10.1002/jpn3.70155","DOIUrl":"10.1002/jpn3.70155","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the frequency and number of vulnerability factors for the development of pain-predominant disorders of gut-brain interaction (p-DGBI) in a well-defined cohort of pediatric patients and examine associations with pain severity and functional impairment.</p><p><strong>Methods: </strong>Retrospective cross-sectional study of patients evaluated in a multidisciplinary abdominal pain program at a pediatric tertiary care center.</p><p><strong>Results: </strong>Two hundred and fifty-two patients were included, 70.6% female, mean age 13.6 ± 3.1 years; 37.3% had functional abdominal pain (FAP), 31.7% irritable bowel syndrome (IBS), and 31.0% functional dyspepsia (FD). At least one vulnerability was reported by 91.3%, with a mean of 2.2 ± 1.1 per patient, including early life events (42.9%), mental health problems (51.2%), a family history of mental health (52.4%), or chronic pain (55.2%) conditions. Functional disability scores were higher in patients with more vulnerability factors (p = 0.004). There was no association of increased number of vulnerability factors with pain intensity A triggering event precipitating p-DGBI symptoms was reported by 63.9% of patients: gastrointestinal infections (41.0%), extra-intestinal infections (16.1%), psychological stress (15.5%), concussion (8.7%), onset of organic disease (7.5%), medication reaction (5.0%), surgery (4.3%), or physical injury (3.7%).</p><p><strong>Conclusions: </strong>Results support the biopsychosocial model suggesting that patients with p-DGBI are inherently susceptible to developing chronic pain due to biologic vulnerabilities and environmental factors. While infections remain the most reported trigger of p-DGBI symptoms, this study newly identifies other triggers. The association of increased number of vulnerability factors with worse functioning raises the question if there may be a cumulative adverse effect of multiple vulnerability factors.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"540-550"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637288","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":"Correction to \"Comparison of colonoscopic versus fluoroscopic colonic manometry catheter placement in children\".","authors":"","doi":"10.1002/jpn3.70152","DOIUrl":"10.1002/jpn3.70152","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"901"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575628","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 pediatric inflammatory bowel diseases in limited-resource settings: A position paper from the Paediatric IBD Porto Group of ESPGHAN.","authors":"Almuthe Christine Hauer, Mutaz Sultan, Andy Darma, Eyad Altamimi, Daniela Elena Serban, Amit Assa, Claudia Patricia Sánchez Franco, Lissy de Ridder, David C Wilson, Nadeem Ahmad Afzal, Jiri Bronsky, Miglena Georgieva, Marina Aloi, Vaidotas Urbonas, Víctor Manuel Navas-López, Juan Rivera Medina, Dan Turner, Jorge Amil-Dias","doi":"10.1002/jpn3.70121","DOIUrl":"10.1002/jpn3.70121","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric inflammatory bowel diseases (PIBDs), despite being more prevalent in westernized nations, show an increasing incidence worldwide. Accurate evaluation, diagnosis, therapy, and monitoring are mandatory for the adequate management of patients, as is a sensible use of expensive resources, which may be limited in some parts of the world. This limitation often poses challenges to diagnose and treat patients. As the long-term prognosis very much depends on early diagnosis and remission of active disease, it is important to consider reasonable alternatives that may help clinicians to act accordingly within resource constraints, without downgrading previously published guidelines.</p><p><strong>Methods: </strong>A group of experts from the \"Paediatric IBD Porto Group\" of European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) as well as pediatric and adult IBD experts, trained in IBD centers and having working experience in limited-resource settings (LR settings), joined efforts to suggest alternative options in settings where resources are limited, while prioritizing an acceptable cost-effectiveness ratio. Almost all recently published ESPGHAN guidelines and position papers on PIBD were evaluated, and the writing group framed proposals for adaptation in situations with limited access to more expensive resources or tools.</p><p><strong>Results: </strong>Ninety consensus-based recommendations, derived from the available evidence, were formulated. Diagnostic protocol, biochemical evaluation, imaging and endoscopy, monitoring and options for nutritional, medical and surgical treatment were addressed. Cooperation between professionals and institutions was suggested to improve quality of care and optimize use of available expertise. Patient education, counseling, mental health and transition of care were also addressed.</p><p><strong>Conclusion: </strong>Diagnosis and management of PIBD are complex and costly in medical resources, but some alternative protocols could provide acceptable results and help with accurate diagnosis and management. These recommendations and practice points may offer useful guidance in settings where resources may be limited while still providing good medical practice.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"866-898"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575710","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":"Overlapping inflammatory bowel and irritable bowel: Time to screen for parental catastrophizing.","authors":"Miranda A L van Tilburg, Rasmita Budhathoki, Amber Langshaw, Miguel Saps","doi":"10.1002/jpn3.70126","DOIUrl":"10.1002/jpn3.70126","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"580-582"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333349","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 stool symptoms in youth with abdominal pain-associated disorders of gut-brain interaction.","authors":"Jason Lach, Jennifer M Colombo, Jennifer V Schurman, Craig A Friesen","doi":"10.1002/jpn3.70205","DOIUrl":"https://doi.org/10.1002/jpn3.70205","url":null,"abstract":"<p><strong>Objective: </strong>Irritable bowel syndrome (IBS) is divided into subcategories recognizing differences in stool frequency and form. The third IBS symptom, a change in pain with stools may also introduce heterogeneity and has not been well described in youth with IBS. The current study was undertaken to assess changes in pain with stooling and the presence of nocturnal stools.</p><p><strong>Methods: </strong>We assessed 300 patients with a diagnosis of abdominal pain-associated disorder of gut-brain interaction (AP-DGBI). Patients were queried regarding Rome IV AP-DGBI criteria along with characterizing changes in pain with stooling (direction, frequency and degree of change) and the occurrence of nocturnal stools. Additionally, we reviewed the findings from 140 patients who underwent colonoscopies.</p><p><strong>Results: </strong>Regarding pain with stooling, 59% reported no difference, 26.7% reported decreased pain, and 14.3% reported increased pain. There was significant variability in both frequency and degree of change in pain. Increased pain with stools was associated with a change in stool frequency and form. Nocturnal stools were reported in 19.7% of participants. Colonic mucosal inflammation or more often low-grade mucosal eosinophilia was found more frequently in those reporting nocturnal stools (33% vs. 15.4%; p = 0.02).</p><p><strong>Conclusions: </strong>We found significant heterogeneity regarding changes in pain with bowel movements in IBS including the direction of change, degree of change and frequency of change. Increase in pain with stools appears to be a better fit with the other cardinal symptoms of IBS than is decreased pain with stooling. Nocturnal stooling was not uncommon in AP-DGBI and may be associated with low-grade eosinophilia in some patients.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958196","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}