Pediatric Gastroenterology, Hepatology & Nutrition最新文献

{"title":"Efficacy of Acotiamide in Pediatric Patients with Functional Dyspepsia.","authors":"Keinosuke Hizuka, Shin-Ichiro Hagiwara, Ryutaro Saura, Yu Masuda, Ayaha Hata, Takatoshi Maeyama, Yuri Etani","doi":"10.5223/pghn.2025.28.3.176","DOIUrl":"10.5223/pghn.2025.28.3.176","url":null,"abstract":"<p><strong>Purpose: </strong>Functional dyspepsia (FD) is a chronic disorder characterized by upper abdominal symptoms in the absence of an identifiable organic cause. Although the efficacy of acotiamide has been demonstrated in adults with FD, its effectiveness in pediatric patients remains unclear. This study aimed to evaluate the efficacy of acotiamide in pediatric patients with FD.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 33 patients with FD, aged <16 years, who received acotiamide at a single children's hospital between August 2013 and March 2022.</p><p><strong>Results: </strong>Symptomatic improvement was observed in 57.6% (19/33) of patients one month after acotiamide administration. The improvement rates were 63.6%, 20.0%, and 66.7% among patients with epigastric pain syndrome (EPS), postprandial distress syndrome (PDS), and overlap PDS-EPS, respectively. No statistically significant differences in symptomatic improvement rates were noted among the subtypes (<i>p</i>=0.213). Two patients discontinued acotiamide because of abdominal pain, but no serious adverse events were reported.</p><p><strong>Conclusion: </strong>Acotiamide demonstrated efficacy in pediatric FD, which is consistent with previously reported outcomes in adults. Acotiamide may be a beneficial treatment option for pediatric FD across all subtypes.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 3","pages":"176-184"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Response Durability of Infliximab for Pediatric Inflammatory Bowel Disease in Japan: A Single Center Experience.","authors":"Naoya Tsumura, Ken Kato, Ryosuke Yasuda, Shinichiro Yoshioka, Hidetoshi Takedatsu, Tatsuki Mizuochi","doi":"10.5223/pghn.2025.28.3.166","DOIUrl":"10.5223/pghn.2025.28.3.166","url":null,"abstract":"<p><strong>Purpose: </strong>The long-term efficacy and safety of infliximab (IFX) in Japanese children with inflammatory bowel disease (IBD) remain unclear. This study aimed to examine the long-term outcomes of IFX treatment in Japanese children with IBD.</p><p><strong>Methods: </strong>We retrospectively recruited patients aged <16 years who were diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) at Kurume University Hospital in Japan between 2011 and 2022 and examined the effectiveness and safety of IFX. We characterized the responses to IFX as primary response, primary nonresponse (PNR), secondary loss of response (sLOR), or still receiving IFX.</p><p><strong>Results: </strong>Among the 77 enrolled patients with UC (median age, 10 years) and 48 with CD (median age, 12 years), 55 (27 with UC and 28 with CD) received IFX treatment. IFX treatment was significantly more common in patients with CD (58.3%) than in those with UC (35.1%; <i>p</i>=0.016). The PNR was significantly greater in patients with UC (18.5%) than in those with CD (0.0%; <i>p</i>=0.023), as was the sLOR (UC, 51.9%; CD, 21.4%; <i>p</i>=0.026). The likelihood of continuing IFX treatment during follow-up (median, 38 months) was significantly higher in patients with CD (71.4%) than in those with UC (29.6%; <i>p</i>=0.003). Adverse events resulting in the discontinuation of IFX occurred in 3.6% of the patients; one patient with CD developed leukemia, and the other had a serious infusion reaction.</p><p><strong>Conclusion: </strong>The long-term durability of IFX in Japanese pediatric patients with IBD was inadequate in UC compared with CD. Serious adverse events in 3.6% of patients required discontinuation.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 3","pages":"166-175"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning Pediatric Patients with Inflammatory Bowel Disease: Key Considerations for Adult Gastroenterologists.","authors":"Ahmed Alwassief, Qasim L Abbas, Said Al Busafi, Tawfiq T Al Lawati, Khalid Al Shmusi","doi":"10.5223/pghn.2025.28.3.141","DOIUrl":"10.5223/pghn.2025.28.3.141","url":null,"abstract":"<p><p>The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 3","pages":"141-147"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyslipidemia in Children and Adolescents: Current Insights and Updated Treatment Approaches.","authors":"Sung Eun Kim","doi":"10.5223/pghn.2025.28.3.148","DOIUrl":"10.5223/pghn.2025.28.3.148","url":null,"abstract":"<p><p>The increasing incidence of dyslipidemia among children and adolescents has emerged as a significant public health concern due to its associated risk of long-term cardiovascular complications. The prevalence of dyslipidemia has increased in parallel with rising obesity rates, highlighting the importance of early intervention. In this narrative review, we explore the epidemiology, screening, diagnosis, and treatment of dyslipidemia in pediatric populations, focusing on recent advancements and updates in clinical management. Key diagnostic criteria and risk assessment strategies are discussed, emphasizing the role of lipid profile screening in high-risk groups. Lifestyle and dietary interventions are key for managing dyslipidemia, while pharmacological treatments including statins, cholesterol absorption inhibitors, and emerging therapies are reviewed in cases requiring further intervention. Updated guidelines and evidence-based recommendations from Korean and other international institutions are consolidated to provide a comprehensive overview. These findings underscore the necessity of a multidisciplinary approach combining early detection, tailored treatment, and lifestyle modifications to mitigate the long-term health risks associated with dyslipidemia in younger individuals.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 3","pages":"148-159"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety, Depressive Symptomatology, and Perfectionism Traits and Their Relationship with Disorders of Gut-Brain Interaction in Children.","authors":"Andreea Cristiana Milea Milea, Carmen Jovaní Casano, Mónica Rubio Sánchez, Jesús Lucas Garcia","doi":"10.5223/pghn.2025.28.3.185","DOIUrl":"10.5223/pghn.2025.28.3.185","url":null,"abstract":"<p><strong>Purpose: </strong>Disorders of the gut-brain interaction (DGBIs), formerly known as functional gastrointestinal disorders, are a set of recurrent or chronic digestive symptoms that are not explained by structural or biochemical alterations. The pathophysiology of these disorders is not completely known, but it is believed that different environmental, genetic, social, or psychological factors may generate them. Therefore, the sphere of mental health must be taken into consideration. Our objective was to determine the prevalence of disorders of the gut-brain interaction, anxiety, depressive symptomatology, and perfectionist traits in children and adolescents aged 10-14 years and to analyze the relationship between psychological features and abdominal pain.</p><p><strong>Methods: </strong>This cross-sectional descriptive-analytical observational study included 447 students (51.9% female) aged between 10-14 (median age=12.26) years from four schools in the province of Castellón.</p><p><strong>Results: </strong>Notably, 37.1% of the students had some type of DGBI. Children with depressive symptoms had 4.69 times higher odds of presenting with some type of DGBI, and children with anxiety had 2.86 times higher odds of presenting with some type of DGBI. Students who exhibited only socially prescribed perfectionism had 2.07 times higher odds of presenting with some type of DGBI.</p><p><strong>Conclusion: </strong>Children aged 10-14 years who had depressive symptomatology, perfectionist personality traits (specifically socially prescribed perfectionism), and anxiety (only in children over 12 years) were more likely to have DGBIs.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 3","pages":"185-198"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updated KidZ Health Castle Formula for Multichannel Intraluminal Impedance-pH Monitoring Probe Positioning.","authors":"Hanne Delcourt, Koen Huysentruyt, Kristel Van de Maele, Yvan Vandenplas","doi":"10.5223/pghn.2025.28.3.160","DOIUrl":"10.5223/pghn.2025.28.3.160","url":null,"abstract":"<p><strong>Purpose: </strong>The KidZ Health Castle Formula (KHC-F) was developed to improve the positioning of multichannel intraluminal impedance-pH probes (MII-pH). We hypothesized that the updated formula KHC-Fv2 would performs better than the original formula. This study aimed to evaluate the reliability of KHC-Fv2.</p><p><strong>Methods: </strong>A prospective cohort study was conducted to assess MII-pH probe positioning in patients aged 1 month to 18 years. Margins of error within 1 cm above or below the target position, as determined using KHC-Fv2 and compared with fluoroscopy, were accepted.</p><p><strong>Results: </strong>Eighty-four children were included in the study. The mean difference between the KHC-Fv2 and target positions was +0.25 cm cranially. The KHC-Fv2 insertion length fell within the accepted difference of ±1 cm of the target position in 67.9% of the children. This percentage increased in infants under 1 year of age (79.5%) or shorter than 100 cm (74.0%) in height.</p><p><strong>Conclusion: </strong>KHC-Fv2 demonstrated strong agreement with correct positioning and significantly reduced the need for a second radiologic control after probe repositioning, particularly in infants or children shorter than 100 cm.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 3","pages":"160-165"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Evaluating the Association between Anemia and the Severity of Liver Disease in Children with Cirrhosis: A Cross-Sectional Study from 2015 to 2020.","authors":"Seyed Mohsen Dehghani, Iraj Shahramian, Hamideh Salehi, Leila Kasraian, Maryam Ataollahi, Masoud Tahani","doi":"10.5223/pghn.2025.28.3.199","DOIUrl":"https://doi.org/10.5223/pghn.2025.28.3.199","url":null,"abstract":"<p><p>[This corrects the article on p. 286 in vol. 27, PMID: 39319282.].</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 3","pages":"199-200"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study.","authors":"Nehal El Koofy, Sawsan Hassan Okasha, Hala Mounir Agha, Noha Ali, Ahmed Said Behairy, Hanan Mina Fouad, Rehab Hamdy Zawam","doi":"10.5223/pghn.2025.28.2.101","DOIUrl":"10.5223/pghn.2025.28.2.101","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.</p><p><strong>Methods: </strong>We recruited children of both sexes aged 3-15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.</p><p><strong>Results: </strong>We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II-III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O₂ saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (<i>p</i>=0.04) and low O₂ saturation (<i>p=</i>0.03) were identified as risk factors for POPH.</p><p><strong>Conclusion: </strong>POPH was detected in 30.9% of our study group. High-grade varices and low O₂ saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 2","pages":"101-112"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Abdominal Ultrasound Training Program: Standard Views.","authors":"Soon Chul Kim","doi":"10.5223/pghn.2025.28.2.67","DOIUrl":"10.5223/pghn.2025.28.2.67","url":null,"abstract":"<p><p>The use of abdominal ultrasound is becoming a necessity, rather than an option, for pediatricians. Incorporating abdominal ultrasound training into resident training programs for pediatricians provides a direct pathway for physicians to effectively utilize point-of-care ultrasound (POCUS) in their clinical practice after board certification. This study proposed a detailed system to support this initiative by establishing 22 standard views of pediatric abdominal ultrasound and emphasizing a structured training regimen with repeated practice to achieve proficiency. This approach offers a streamlined method for trainees to become experts rapidly. After board certification, this foundational training serves as the basis for advanced learning, allowing clinicians to tailor POCUS techniques according to their specific areas of practice.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 2","pages":"67-75"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Endoscopy in Asia Pacific: Report from the Asian Pan-Pacific Society for Pediatric Gastroenterology Hepatology and Nutrition.","authors":"Andy Darma, Katsuhiro Arai, Jia-Feng Wu, Nuthapong Ukarapol, Shin-Ichiro Hagiwara, Seak Hee Oh, Suporn Treepongkaruna","doi":"10.5223/pghn.2025.28.2.76","DOIUrl":"10.5223/pghn.2025.28.2.76","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric gastrointestinal (GI) endoscopy significantly contributes to the diagnosis and management of GI diseases in children. Global data on pediatric GI endoscopy in the Asia-Pacific region are limited. We aimed to report the findings of a regional survey on pediatric endoscopy in the Asia-Pacific region.</p><p><strong>Methods: </strong>A questionnaire-based survey involving GI endoscopy centers in 13 Asia-Pacific countries (June to November 2021). The questionnaires included annual procedure volumes (from basic diagnostics to advanced therapeutic endoscopy), endoscopists, sedation procedures, and national training programs.</p><p><strong>Results: </strong>A total of 162 GI endoscopy centers completed the survey. All centers performed basic endoscopies (esophagogastroduodenoscopy and ileocolonoscopy); however, 45.1% and 59.1% of the centers performed less than 50 esophagogastroduodenoscopies and ileocolonoscopies per year, respectively. Small bowel evaluation (capsule endoscopy or balloon-assisted enteroscopy) was performed in 59.3% of the centers. Foreign body removal, polypectomy, and percutaneous endoscopic gastrostomy were performed in 89.5%, 85.8%, and 52.5% of centers, respectively. Endoscopic hemostatic interventions, which are life-saving procedures, included glue injection (30.9%), hemostasis of nonvariceal bleeding (65.4%), and endoscopic variceal ligation (70.4%). Pediatric GI endoscopy is performed not only by pediatric gastroenterologists but also by adult gastroenterologists in 21-50% of centers for many kinds of procedures. Sedation was provided by anesthesiologists in 65.4% of the centers. Most centers offer both adult and pediatric endoscopy training.</p><p><strong>Conclusion: </strong>The study highlights regional disparities in pediatric GI endoscopy services. It emphasizes the need for expanded pediatric GI training and improved access to therapeutic endoscopy, particularly for life-saving procedures.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"28 2","pages":"76-85"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}