https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(02)09678-2.pdf

Childhood obesity: public-health crisis, common sense cure

https://www.gastrojournal.org/article/S0016-5085(16)00181-5/pdf

Childhood Functional Gastrointestinal Disorders: Child/Adolescent

The National Academy of Sciences through its Institute of Medicine (IOM) has produced a major scholarly assessment of pain in America. This document is a tremendous contribution to the evolving nec...

Relieving pain in america: a blueprint for transforming prevention, care, education, and research

Objective: T o de v elop a North American Society for Pediatric Ga str oen te rol og y , He pat olo gy , and Nut ri tio n (N ASP GH AN) and Eu rop ea n Soc ie ty fo r Pe di atr ic Gas tr oen te ro log y , Hep at ol og y , and Nut rit io n (ES PGH AN ) int er nat io nal con se ns us on th e di agn os is an d ma nag em ent of gas tr oes op hag eal refl ux and gas tr oes op hag eal re flu x di sea se in th e ped ia tr ic po pu la tio n. Methods: An international panel of 9 pediatric gastroenterologists and 2 epidemiologists were selected by both societies, which de v eloped these guidelines based on the Delphi principle. Statements were based on systematic literature searches using the best-av ailable e vidence from PubMed, Cumulati ve Index to Nursing and Allied Health Literature, and bibliographies. The committee con v ened in face-to-face meetings 3 times. Consensus was achie v ed for all recommendations through nominal group technique, a structured, quantitati v e method. Articles were e v aluated using the Oxford Centre for Evidence-based Medicine Le vels of Evidence. Using the Oxford Grades of Recommendation, the quality of e vidence of each of the recommendations made by the committee was determined and is summarized in appendices. Results: More than 600 articles were re vie wed for this work. The document provides e vidence-based guidelines for the diagnosis and management of gastroesophageal reflux and gastroesophageal reflux disease in the pediatric population. Conclusions: Th is do cum ent is int end ed to be us ed in dai ly pra cti ce fo r th e de v el op me nt of fut ure cli ni cal pra ct ic e gu ide lin es and as a bas is for cli ni cal tr ia ls . JP GN 49 :49 8 – 54 7, 20 09 . Ke y Wo rd s: Cli nic al pra ct ic e gu id el ine s — Di agn os tic te sts — Ga str oes op hag ea l refl ux (GE R) — Ga str oes op hag ea l refl ux di sea se (GE RD ) — The rap eut ic mod al iti es. # 20 09 by Eu rop ea n Soc ie ty fo r Pe di atr ic Gas tr oen te ro log y , Hep at ol og y , and Nut rit io n and No rt h Am er ica n So ci ety for Pe dia tri c Ga str oen te rol og y , Hep at ol og y , an d Nu tr iti on

/pdf/pediatric-gastroesophageal-reflux-clinical-practice-359og269ui.pdf

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)

From bench to bedside

Treatment of eosinophilic gastroenteritis with montelukast.

BackgroundMontelukast, a competitive cysteinyl leucotriene-1 receptor antagonist, reduces airway eosinophilia in asthmatics. We evaluated the effect of this drug in children with eosinophilic duodenitis, defined histologically as duodenal mucosa with peak eosinophil count of more than 10 eos

Clinical efficacy and pharmacokinetics of montelukast in dyspeptic children with duodenal eosinophilia.

Objectives: To compare the Rome II diagnoses made in children with recurrent abdominal pain by physicians and by parent and child responses on the Questionnaire on Pediatric Gastrointestinal Symptoms. Rates of diagnostic agreement and reasons for disagreement were examined to determine whether changes to the Rome II criteria are needed to improve diagnostic classification. Methods: One hundred and forty-eight children and their parents or guardians completed the Questionnaire on Pediatric Gastrointestinal Symptoms during their first visit to a pediatric gastroenterology clinic. Parent- and child-report Rome II diagnoses were based on Questionnaire on Pediatric Gastrointestinal Symptoms scoring criteria, whereas the physician's Rome II diagnosis was based on clinical impression from history and physical examination completed at this visit. Statistical comparisons involved Pearson χ2 tests and Fisher exact tests. Kappa and weighted kappa measured agreement rates. Results: Most children met the criteria for a functional gastrointestinal disorder based on the Rome II criteria. Functional dyspepsia was the most common diagnosis made by all three sources. The percentage of children classified as “no diagnosis” was small and was often a function of symptom duration (especially when diagnosis rested on the child self-report). Diagnostic agreement was fair to moderate. Diagnoses based on parent and child questionnaires agreed more often on functional dyspepsia than irritable bowel syndrome. Diagnostic disagreement was most likely to result from parent and child disagreement on defecation symptoms. Conclusions: The Rome II classification system shows promise for improving diagnosis, study and treatment of children with recurrent abdominal pain. However, further refinement and clarification of the Rome II criteria for symptom duration and frequency may be needed to improve diagnostic agreement.

Diagnosing functional abdominal pain with the Rome II criteria: parent, child, and clinician agreement.

Crohn's-associated chronic recurrent multifocal osteomyelitis responsive to infliximab

Thirty-five cases of cholelithiasis diagnosed at a children's hospital over a 7.5-year period are reviewed and compared to 693 cases of pediatric gallstones reported in the literature. Symptomatology and associated medical history are more important in diagnosing cholelithiasis than are laboratory tests. Hemolytic disease is the most common associated condition in our series (46%) as well as in the literature (30%), but the frequency of the various associated conditions varies with age. Isolated gallstone disease does occur, particularly in the young infant. Jaundice is the most common symptom in children less than 1 year of age, being present in greater than 90 percent of symptomatic patients previously reported. Overall, the most common symptom in our series is vomiting (60%). Right upper quadrant pain in the absence of vomiting does not appear to be significant, as this occurred in only one patient (3%) in our series.

Craig A. Friesen

Papers

Treatment of eosinophilic gastroenteritis with montelukast.

Clinical efficacy and pharmacokinetics of montelukast in dyspeptic children with duodenal eosinophilia.

Diagnosing functional abdominal pain with the Rome II criteria: parent, child, and clinician agreement.

Crohn's-associated chronic recurrent multifocal osteomyelitis responsive to infliximab

Cholelithiasis. Clinical characteristics in children. Case analysis and literature review.