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Lawrence R Schiller, Darrell S Pardi, Joseph H Sellin
Chronic diarrhea is a common problem affecting up to 5% of the population at a given time. Patients vary in their definition of diarrhea, citing loose stool consistency, increased frequency, urgency of bowel movements, or incontinence as key symptoms. Physicians have used increased frequency of defecation or increased stool weight as major criteria and distinguish acute diarrhea, often due to self-limited, acute infections, from chronic diarrhea, which has a broader differential diagnosis, by duration of symptoms; 4 weeks is a frequently used cutoff...
August 2, 2016: Clinical Gastroenterology and Hepatology
Andrea Lo Vecchio, Jorge Amil Dias, James A Berkley, Chris Boey, Mitchell B Cohen, Sylvia Cruchet, Ilaria Liguoro, Eduardo Salazar Lindo, Bhupinder Sandhu, Philip Sherman, Toshiaki Shimizu, Alfredo Guarino
OBJECTIVE: Acute gastroenteritis (AGE) is a major cause of child mortality and morbidity. This study aimed at systematically reviewing clinical practice guidelines (CPGs) on AGE to compare recommendations and provide the basis for developing single universal guidelines. METHODS: CPGs were identified by searching MEDLINE, Cochrane-Library, National Guideline Clearinghouse and Web sites of relevant societies/organizations producing and/or endorsing CPGs. RESULTS: The definition of AGE varies among the 15 CPGs identified...
August 2016: Journal of Pediatric Gastroenterology and Nutrition
Rima Fawaz, Ulrich Baumann, Udeme Ekong, Björn Fischler, Nedim Hadzic, Cara L Mack, Valérie A McLin, Jean P Molleston, Ezequiel Neimark, Vicky Lee Ng, Saul J Karpen
Cholestatic jaundice in infancy affects approximately 1 in every 2500 term infants and is infrequently recognized by primary providers in the setting of physiologic jaundice. Cholestatic jaundice is always pathologic and indicates hepatobiliary dysfunction. Early detection by the primary care physician and timely referrals to the pediatric gastroenterologist/hepatologist are important contributors to optimal treatment and prognosis. The most common causes of cholestatic jaundice in the first months of life are biliary atresia (BA, 25-40%) followed by an expanding list of monogenic disorders (25%), plus many unknown or multifactorial (e...
July 16, 2016: Journal of Pediatric Gastroenterology and Nutrition
Joanna M Peloquin, Gautam Goel, Eduardo J Villablanca, Ramnik J Xavier
Inflammatory bowel disease (IBD), including Crohn disease and ulcerative colitis, is characterized by chronic intestinal inflammation due to a complex interaction of genetic determinants, disruption of mucosal barriers, aberrant inflammatory signals, loss of tolerance, and environmental triggers. Importantly, the incidence of pediatric IBD is rising, particularly in children younger than 10 years. In this review, we discuss the clinical presentation of these patients and highlight environmental exposures that may affect disease risk, particularly among people with a background genetic risk...
May 20, 2016: Annual Review of Immunology
Vivian Tang, Clarissa Valim, Rajat Moman, Ashley Richman, Jing Zhou, Veena Ramgopal, Rachel Albert, James H Boone, Paul A Rufo
OBJECTIVES: A simple and reliable biomarker for Crohn disease (CD) would be a valuable clinical tool. We hypothesized that anti-Saccharomyces cerevisiae antibody (ASCA) might be present in the stool of patients with CD. Accordingly, we measured ASCA in the stool and serum of children and adolescents with known or suspected inflammatory bowel disease (IBD). METHODS: We included 114 patients aged ≤ 19 years (73 male) with IBD, including 83 patients with Crohn disease (CD) and 31 subjects without CD (28 with UC, and 3 patients with suspected IBD but without evidence of chronic inflammation at the time of their endoscopy and colonoscopy)...
April 21, 2016: Journal of Pediatric Gastroenterology and Nutrition
Rohit Kohli, Shikha Sunduram, Marialena Mouzaki, Sabina Ali, Pushpa Sathya, Stephanie Abrams, Stavra A Xanthakos, Miriam Vos, Jeffrey B Schwimmer
No abstract text is available yet for this article.
May 2016: Journal of Pediatrics
Lena E Gottesman, Michael T Del Vecchio, Stephen C Aronoff
BACKGROUND: The etiologies of conjugated hyperbilirubinemia in infancy are diverse. OBJECTIVE: Determine the prevalence rates of the specific etiologies of conjugated hyperbilirubinemia in infancy. DATA SOURCES: EMBASE and Pubmed were searched electronically and the bibliographies of selected studies were search manually. The search was conducted independently by two authors. STUDY SELECTION: (1) prospective or retrospective case series or cohort study with 10 or more subjects; (2) consecutive infants who presented with conjugated hyperbilirubinemia; (3) subjects underwent appropriate diagnostic work-up for conjugated hyperbilirubinemia; (4) no specific diagnoses were excluded in the studied cohort...
2015: BMC Pediatrics
Anne Rowan-Legg
Constipation is a common childhood problem, with both somatic and psychological effects. The etiology of paediatric constipation is likely multifactorial, and seldom due to organic pathology. Children benefit from prompt and thorough management of this disorder. The goal of treatment is to produce soft, painless stools and to prevent reaccumulation of feces. Education, behavioural modification, daily maintenance stool softeners and dietary modification are all important components of therapy. Fecal disimpaction may be necessary at the outset of treatment...
December 2011: Paediatrics & Child Health
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