Topical Collection "Controversies in Pediatric Digestive Diseases"

Quicklinks

A topical collection in Children (ISSN 2227-9067).

Editor

Collection Editor
Dr. Sari A. Acra

D. Brent Polk Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt Children’s Hospital, 2200 Children’s Way, 9214 Doctors’ Office Tower, Nashville, TN 37232-9175, USA
Phone: +1 615 343 9034
Interests: diarrheal disorders; functional dyspepsia; GERD; aerodigestive disorders; inflammatory bowel diseases; nutritional disorder

Topical Collection Information

Dear Colleagues,

Pediatric gastroenterology, hepatology, and nutrition are rapidly-evolving and diverse/complex disciplines. Our knowledge in several key areas has expanded exponentially over the last decade, including greater insight into the etiology and management of eosinophilic esophagitis and Inflammatory Bowel Disease, deciphering the role of the intestinal microbiome in health and disease, and insight into the epidemiology and management of the obesity epidemic engulfing us. While several challenges in these disciplines have been overcome, others remain open for debate and investigation. This collection in Children will act as a forum to discuss and promulgate knowledge about incompletely understood or controversial areas in the field of pediatric gastroenterology, hepatology, and nutrition. Both reviews and original research contributions will be considered for publication. Examples could include manuscripts that address the pathogenicity of C. difficile in infants, the role of patch testing in evaluating food allergens in eosinophilic esophagitis, among other timely but controversial topics.

I look forward to receiving your contributions!

Sari Acra, M.D., M.P.H.
Collection Editor

Submission

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Papers will be published continuously (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed Open Access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. For the first couple of issues the Article Processing Charge (APC) will be waived for well-prepared manuscripts. English correction and/or formatting fees of 250 CHF (Swiss Francs) will be charged in certain cases for those articles accepted for publication that require extensive additional formatting and/or English corrections.

Keywords

  • eosinophilic esophagitis
  • GERD
  • inflammatory bowel disease/ IBD
  • obesity
  • abdominal pain
  • constipation
  • diarrhea
  • c. difficile
  • microbiome
  • nutrition
  • malnutrition
  • hepatology
  • hepatitis
  • fatty liver disease

Published Papers (6 papers)

2016

Jump to: 2015, 2014

Open AccessReview Functional Nausea in Children: A Review of the Literature and Need for Diagnostic Criteria
Children 2016, 3(1), 5; doi:10.3390/children3010005
Received: 21 December 2015 / Revised: 3 March 2016 / Accepted: 8 March 2016 / Published: 10 March 2016
PDF Full-text (193 KB) | HTML Full-text | XML Full-text
Abstract
Nausea is common amongst children with functional gastrointestinal disorders and is associated with a high burden of somatic and psychosocial comorbidities in both the short and long-term. Current treatments including medications, phytotherapy, stress-reduction techniques, and gastric electrical stimulation for recalcitrant cases, are [...] Read more.
Nausea is common amongst children with functional gastrointestinal disorders and is associated with a high burden of somatic and psychosocial comorbidities in both the short and long-term. Current treatments including medications, phytotherapy, stress-reduction techniques, and gastric electrical stimulation for recalcitrant cases, are reviewed. Functional nausea merits its own diagnostic criteria as a pediatric functional gastrointestinal disorder. Full article

2015

Jump to: 2016, 2014

Open AccessArticle Young Age at Diagnosis of Type 1 Diabetes Is Associated with the Development of Celiac Disease—Associated Antibodies in Children Living in Newfoundland and Labrador, Canada
Children 2015, 2(4), 403-411; doi:10.3390/children2040403
Received: 26 June 2015 / Revised: 31 August 2015 / Accepted: 23 September 2015 / Published: 14 October 2015
PDF Full-text (159 KB) | HTML Full-text | XML Full-text
Abstract
Objectives: The objectives of this study were to establish the prevalence of positive antibodies to endomysium (EMA) and tissue transglutaminase (tTG) in children with type 1 diabetes living in Newfoundland and Labrador (NL), and to examine clinical features associated with positive antibodies. [...] Read more.
Objectives: The objectives of this study were to establish the prevalence of positive antibodies to endomysium (EMA) and tissue transglutaminase (tTG) in children with type 1 diabetes living in Newfoundland and Labrador (NL), and to examine clinical features associated with positive antibodies. Methods: Patients were recruited from the pediatric diabetes clinic. One hundred sixty-seven children with type 1 diabetes from the 280 children followed at the clinic were prospectively screened for celiac disease using EMA and tTG. The variables of Irish descent, age at onset of diabetes, duration of diabetes, sex, family history of celiac disease, hemoglobin A1C (A1C), ferritin, gastrointestinal symptoms, and body mass index were compiled for all patients. The group of patients with positive antibodies to EMA and/or tTG was compared to the group with negative antibodies. Results: The prevalence of patients with positive antibodies to EMA and/or tTG was 16.8% (n = 28). One patient had also been previously diagnosed with symptomatic celiac disease. The two statistically significant variables with positive antibodies were an earlier age at onset of diabetes (Mann-Whitney U two-tailed test: mean difference 3.2 years, 95% CI 1.7–4.8 years, p < 0.0001) and longer duration of diabetes (Mann-Whitney U two-tailed test: mean difference 2.9 years, 95% CI 1.3–4.4 years, p < 0.0001). Irish descent was associated with positive antibodies but did not reach statistical significance. On logistic regression analysis performed with these three variables together, only age at onset of diabetes remained significant. Conclusions: There is a high prevalence of celiac disease-associated antibodies in children living in NL with type 1 diabetes. Unlike other clinical features, an earlier age at onset of diabetes was predictive for positive antibodies. As the majority of children with positive antibodies did not have signs or symptoms of celiac disease, routine screening for celiac disease in type 1 diabetes is recommended. Full article
Open AccessReview Controversies in the Mechanism of Total Parenteral Nutrition Induced Pathology
Children 2015, 2(3), 358-370; doi:10.3390/children2030358
Received: 3 June 2015 / Revised: 11 July 2015 / Accepted: 14 July 2015 / Published: 31 July 2015
PDF Full-text (207 KB) | HTML Full-text | XML Full-text
Abstract
Over 30,000 patients are permanently dependent on Total Parenteral Nutrition (TPN) for survival with several folds higher requiring TPN for a prolonged duration. Unfortunately, it can cause potentially fatal complications. TPN infusion results in impairment of gut mucosal integrity, enhanced inflammation, increased [...] Read more.
Over 30,000 patients are permanently dependent on Total Parenteral Nutrition (TPN) for survival with several folds higher requiring TPN for a prolonged duration. Unfortunately, it can cause potentially fatal complications. TPN infusion results in impairment of gut mucosal integrity, enhanced inflammation, increased cytokine expression and trans-mucosal bacterial permeation. It also causes endotoxin associated down regulation of bile acid transporters and Parenteral Nutrition Associated Liver Disease (PNALD), which includes steatosis, disrupted glucose metabolism, disrupted lipid metabolism, cholestasis and liver failure. Despite multiple theories, its etiology and pathophysiology remains elusive and is likely multifactorial. An important cause for TPN related pathologies appears to be a disruption in the normal enterohepatic circulation due to a lack of feeding during such therapy. This is further validated by the fact that in clinical settings, once cholestasis sets in, its reversal occurs when a patient is receiving a major portion of calories enterally. There are several other postulated mechanisms including gut bacterial permeation predisposing to endotoxin associated down regulation of bile acid transporters. An additional potential mechanism includes toxicity of the TPN solution itself, such as lipid mediated hepatic toxicity. Prematurity, leading to a poor development of bile acid regulating nuclear receptors and transporters has also been implicated as a causative factor. This review presents the current controversies and research into mechanisms of TPN associated injury. Full article
Open AccessArticle Impact of Pre-Procedure Interventions on No-Show Rate in Pediatric Endoscopy
Children 2015, 2(1), 89-97; doi:10.3390/children2010089
Received: 30 January 2015 / Revised: 10 March 2015 / Accepted: 11 March 2015 / Published: 17 March 2015
Cited by 1 | PDF Full-text (253 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Pediatric endoscopy has evolved into an indispensable tool in the diagnosis and management of gastrointestinal diseases in children. However, there is limited literature focusing on quality improvement initiatives in pediatric endoscopy. The primary goal of this project was to reduce the no-show [...] Read more.
Pediatric endoscopy has evolved into an indispensable tool in the diagnosis and management of gastrointestinal diseases in children. However, there is limited literature focusing on quality improvement initiatives in pediatric endoscopy. The primary goal of this project was to reduce the no-show rate in the pediatric endoscopy unit. Also, we aimed to improve patient and family satisfaction with the procedure by identifying opportunities for improvement. A checklist was designed based on the potential causes of no-show. The endoscopy nurse coordinator reviewed the checklist when scheduling the procedure to identify patients at high risk for non-compliance. Once a risk factor was identified, appropriate actions were taken. She also made a pre-procedure phone call as a reminder and to address any of these risks for non-compliance if present. A patient satisfaction survey was used to identify potential areas for improvement. The no-show rate decreased from an average of 7% in the pre-intervention phase to 2% in the post-intervention phase (p = 0.009). 91% of the patients/family recorded an overall satisfaction of 4 or 5 on a scale of 1–5 5 being best). Quality improvement strategies decreased the no-show rate in the pediatric endoscopy unit. A patient satisfaction survey helped in identifying areas for improvement. Full article

2014

Jump to: 2016, 2015

Open AccessReview Controversies Surrounding Clostridium difficile Infection in Infants and Young Children
Children 2014, 1(1), 40-47; doi:10.3390/children1010040
Received: 14 April 2014 / Accepted: 26 May 2014 / Published: 13 June 2014
Cited by 1 | PDF Full-text (179 KB) | HTML Full-text | XML Full-text
Abstract
Clostridium difficile is a frequent cause of antibiotic-associated diarrhea in adults and older children. However, as many as 80% of infants can be asymptomatically colonized. The reasons for this have not been well established but are believed to be due to differences [...] Read more.
Clostridium difficile is a frequent cause of antibiotic-associated diarrhea in adults and older children. However, as many as 80% of infants can be asymptomatically colonized. The reasons for this have not been well established but are believed to be due to differences in toxin receptors or toxin internalization. Determining which children who test positive for C. difficile warrant treatment is exceedingly difficult, especially in the setting of increased rates of detection and the rising risk of disease in children lacking classic risk factors for C. difficile. Full article
Open AccessReview Artificial Sweetened Beverages and Pediatric Obesity: The Controversy Continues
Children 2014, 1(1), 31-39; doi:10.3390/children1010031
Received: 4 February 2014 / Revised: 2 April 2014 / Accepted: 15 May 2014 / Published: 28 May 2014
PDF Full-text (256 KB) | HTML Full-text | XML Full-text
Abstract
The pediatric obesity epidemic has gathered public and political interest recently. People often choose “diet” or artificial sweetened beverages (ASB) to combat this epidemic, but the obesity incidence continues to rise. First, I review the pediatric studies on the effect of ASB [...] Read more.
The pediatric obesity epidemic has gathered public and political interest recently. People often choose “diet” or artificial sweetened beverages (ASB) to combat this epidemic, but the obesity incidence continues to rise. First, I review the pediatric studies on the effect of ASB consumption with subsequent food intake. Next, I present pediatric studies of chronic ASB consumption and weight change. Some epidemiologic pediatric studies have supported an association between artificial sweetener use and increased BMI but cannot prove causation. Randomized control trials have provided some evidence of weight loss with ASB ingestion among children, but study limitations may minimize these conclusions. Finally, I summarize the possible mechanisms that may drive potential effects of artificial sweeteners. Full article

Journal Contact

MDPI AG
Children Editorial Office
St. Alban-Anlage 66, 4052 Basel, Switzerland
children@mdpi.com
Tel. +41 61 683 77 34
Fax: +41 61 302 89 18
Editorial Board
Contact Details Submit to Children
Back to Top