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New Updates in Pediatric Gastroenterology

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A Special Issue of Journal of Clinical Medicine (ISSN 2077-0383) belonging to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (20 May 2026) | Viewed by 4997

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Editors

Prof. Dr. Laura Trandafir

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Guest Editor

Pediatrics Clinic, Department of Mother and Child, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: pediatric gastroenterology; inflammatory bowel disease; celiac disease; gastrointestinal diseases; pediatric liver diseases; esophageal diseases; biliary tract diseases; cirrhosis; pediatric digestive endoscopy
Special Issues, Collections and Topics in MDPI journals

Dr. Alina Stanescu-Popp

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Guest Editor

First Pediatric Clinic, Alfred Rusescu INSMC Bucharest, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
Interests: pediatric gastroenterology; inflammatory bowel disease; celiac disease; gastrointestinal diseases; pediatric liver diseases; esophageal diseases; biliary tract diseases; cirrhosis; pediatric digestive endoscopy

Dr. Oana Belei

E-Mail Website
Guest Editor

1. First Pediatric Clinic, Disturbances of Growth and Development on Children Research Center, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
2. Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania
Interests: pediatric gastroenterology; inflammatory bowel disease; celiac disease; gastrointestinal diseases; pediatric liver diseases; esophageal diseases; biliary tract diseases; cirrhosis; pediatric digestive endoscopy

Special Issue Information

Dear Colleagues,

Pediatric gastroenterology has witnessed remarkable progress over the past decades, driven by advancements in diagnostic tools, therapeutic strategies, and a deeper understanding of the gut–brain axis and microbiome. These developments have significantly improved outcomes for children with gastrointestinal, hepatic, and nutritional disorders.

This Special Issue aims to highlight the latest breakthroughs and emerging trends in pediatric gastroenterology, providing a platform for researchers and clinicians to share innovative findings that address the unique challenges of diagnosing and treating gastrointestinal disorders in children.

We seek contributions that will increase the degree of understanding of the physiopathological mechanisms involved in various pediatric digestive disorders and will allow the launch of new therapeutic directions.

Prof. Dr. Laura Trandafir
Dr. Alina Stanescu-Popp
Dr. Oana Belei
Guest Editors

Manuscript Submission Information

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. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

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

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

pediatric gastroenterology and hepatology
inflammatory bowel disease
celiac disease
gastrointestinal diseases
esophageal diseases
endoscopy
gut microbiome
inflammatory bowel disease
functional GI disorders
nutritional management
precision medicine
gut–brain axis
transitional care

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Published Papers (4 papers)

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Research

12 pages, 633 KB

Open AccessArticle

Optimising QIAstat-Dx Gastrointestinal Panel Use: Development of a Clinical Score to Predict Paediatric Bacterial Infections

by Monica Ionescu, Cristina Findrihan, Sonia Cristea, Alina Voicu, Dhea-Maria Macovei, Alina Popp and Diana Czika

J. Clin. Med. 2026, 15(15), 6020; https://doi.org/10.3390/jcm15156020 - 3 Aug 2026

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Abstract

Background: The QIAstat-Dx Gastrointestinal Panel (QGP), a rapid multiplex polymerase chain reaction (PCR) test, provides high diagnostic accuracy for ruling in common gastrointestinal pathogens. Its short turnaround time supports earlier therapeutic decisions and antibiotic stewardship, but its high cost highlights the need for more selective testing. This study aimed to develop a clinical score to identify paediatric patients most likely to have a positive bacterial QGP result. To our knowledge, no such score exists. Methods: We conducted a retrospective study including 70 paediatric patients (median age 1.08 years) who underwent QGP testing between April and October 2025 in a tertiary hospital in Bucharest, Romania. Clinical and biological variables, along with sonographic indicators of bowel inflammation, were evaluated for their association with positive bacterial QGP results. Results: No pathogens were detected in 40% of cases, a single pathogen was detected in 32.9% of samples, two pathogens in 21.4%, and three or more in 5.7%. Bacterial organisms were identified in 45.7% of tests, with Salmonella being most common (17.6% of all tests; 28.6% of positive tests). Of all evaluated variables, fever, bloody stools, C-reactive protein (CRP) > 2 mg/dL, sonographic evidence of bowel inflammation, and exclusion of other infectious foci were included in our prediction score, each assigned one point (with a maximum of 5 points). Other laboratory markers showed no significant association with a positive bacterial QGP result. Receiver operating characteristic (ROC) analysis yielded an area under the curve (AUC) of 0.758 (95% CI: 0.596–0.920, p = 0.005). The optimal cut-off, determined using Youden’s index, was 2.5, with 80% sensitivity and 67.7% specificity. A score ≥ 3 indicated a markedly increased likelihood of a positive bacterial QGP result. Conclusions: The proposed QGP clinical score may support selective use of QGP testing, improving diagnostic efficiency and reducing unnecessary costs. Prospective multicentre validation is warranted. Full article

(This article belongs to the Special Issue New Updates in Pediatric Gastroenterology)

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19 pages, 2022 KB

Open AccessArticle

Presentation and Clinical Outcomes of Inflammatory Bowel Disease in Children and Adolescents at a Tertiary Care Center in Lebanon

by Tracy Daoud, Sarah Khafaja, Rima Hanna-Wakim and Nadine Yazbeck

J. Clin. Med. 2026, 15(13), 5105; https://doi.org/10.3390/jcm15135105 - 30 Jun 2026

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Abstract

Background: Pediatric-onset inflammatory bowel disease (IBD) is a chronic relapsing condition leading to substantial morbidity and variable disease course. Early recognition of factors associated with suboptimal outcomes may improve risk stratification and therapeutic strategy. This retrospective cohort study intended to analyze the association between initial presentation characteristics and early disease course in pediatric-onset IBD. Methods: Included were pediatric patients diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC) followed at the American University of Beirut Medical Center between 2013 and 2023. Demographic, anthropometric, laboratory, endoscopic, radiologic, and clinical data were gathered from medical records. Validated pediatric activity indices were used to assess severity, and early outcomes covered mainly the first remission. Results: Eighty-eight patients were evaluated for baseline characteristics, and eighty-one patients were analyzed for treatment outcomes. Among 88 subjects, 62.5% had CD and 37.5% had UC, with a mean age at diagnosis of 11.29 (±4.60) years. The most encountered presenting symptoms were abdominal pain, diarrhea, and hematochezia, with 44.9% of subjects having malnutrition. Clinical remission after initial treatment was obtained in 60.2% of subjects. A past medical history of autoimmune or inflammatory disease was linked to persistent symptoms, whereas initial use of corticosteroids was associated with early clinical remission. Conclusions: Pediatric IBD in our cohort was marked by extensive disease involvement, high inflammatory burden, nutritional impairment, and frequent flare or treatment escalation. Corticosteroid initiation at diagnosis was associated with early clinical remission in this retrospective cohort. Nevertheless, this association should be interpreted cautiously, as the retrospective design and potential confounding by indication limit any inference regarding causality or treatment superiority. The high rate of subsequent flare underscores the need for early risk stratification and individualized multidisciplinary care to improve long-term outcomes. Full article

(This article belongs to the Special Issue New Updates in Pediatric Gastroenterology)

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9 pages, 218 KB

Open AccessArticle

Clinical, Endoscopic, and Pathologic Spectrum of Pediatric Polyps: A Single-Center Study in the Current Polypectomy Era

by Sevim Çakar, Betül Aksoy, Oğuzhan Akyaz, Tuğçe Tatar Arık, Süleyman Dolu, Mesut Akarsu, Safiye Aktaş and Yeşim Öztürk

J. Clin. Med. 2026, 15(3), 1061; https://doi.org/10.3390/jcm15031061 - 29 Jan 2026

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Abstract

Background: Pediatric gastrointestinal polyps represent a heterogeneous entity with variable clinical behavior, ranging from solitary benign lesions to syndromic forms associated with significant malignant potential. This study provides contemporary data, including upper GI and small-bowel polyps, with an unusually high syndromic yield (27.6%) compared to prior pediatric cohorts. Methods: This retrospective single-center study included children aged 0–18 years who underwent esophagogastroduodenoscopy and/or colonoscopy and were diagnosed with at least one gastrointestinal polyp between January 2015 and October 2025. Demographic characteristics, presenting symptoms, endoscopic features, histopathology, management strategies, and status of polyposis syndrome were collected. Statistical analyses were performed using IBM SPSS Statistics 27.0, with a significance threshold of p < 0.05. Results: Seventy-six patients (mean age 10.6 ± 5.0 years; 47.4% female) were evaluated. Gastrointestinal bleeding was the most common presenting symptom (37.1%). Solitary (63.2%) and sessile (59.2%) polyps predominated, with a median size of 7.0 mm (IQR 3.2–20.0). Juvenile (28.9%) and inflammatory (22.4%) polyps were the most frequent histologic subtypes. Polyposis syndromes were identified in 27.6% of patients and were significantly associated with multiple polyps (p < 0.001), proximal or intestinal distribution (p < 0.001), and adenomatous or hamartomatous histology (p < 0.001). Endoscopic polypectomy was successful in 94.7% of cases, with no major complications reported. Conclusions: Given the 27.6% prevalence of polyposis syndromes observed in this cohort, pediatric gastrointestinal polyps cannot be assumed to be uniformly benign. Our findings support comprehensive endoscopic evaluation, routine histopathology, and early genetic referral, specifically in patients with multiple, proximal, or mixed-morphology polyps. Full article

(This article belongs to the Special Issue New Updates in Pediatric Gastroenterology)

18 pages, 1193 KB

Open AccessArticle

Multimodal Management of Extreme Hypertriglyceridemia in a Child with Recurrent Pancreatitis: Clinical Challenges and Solutions

by Elena-Lia Spoială, Carmen Oltean, Ioana Vasiliu, Gabriela Paduraru, Diana-Claudia Danilă, Gabriela Ghiga, Maria Țugui, Lacramioara Ionela Butnariu, Elena Cojocaru and Laura Mihaela Trandafir

J. Clin. Med. 2026, 15(2), 636; https://doi.org/10.3390/jcm15020636 - 13 Jan 2026

Viewed by 1978

Abstract

Background: Severe hypertriglyceridemia (SHTG) in children is a rare but clinically significant disorder associated with recurrent acute pancreatitis and substantial morbidity. Early identification and prompt management are essential to prevent pancreatic and systemic complications. Methods: We report the case of an 11-year-old female with a history of xanthogranulomatous pancreatitis who presented with extreme hypertriglyceridemia, with fasting triglyceride levels exceeding 4000 mg/dL. Results: The patient was treated acutely with continuous intravenous aspart insulin (0.1 U/kg/hour) and adjusted 10% glucose infusion, with hourly glucose and potassium monitoring, leading to a rapid and marked reduction in triglyceride levels—55% reduction within the first 24 h, 76% at 48 h, and 82% after 96 h of treatment. No hypoglycemia or other adverse effects were observed. Nutritional management included a low–long-chain triglyceride (LCT) diet enriched with medium-chain triglycerides (MCTs) and omega-3 fatty acids, providing essential calories while minimizing chylomicron production. Over a 12-month follow-up, the patient remained asymptomatic, with sustained lipid normalization and no recurrence of pancreatitis. Conclusions: This case underscores the therapeutic value of combining pharmacologic and dietary strategies in pediatric SHTG. Evidence from pediatric and adult studies supports the role of insulin infusion for acute triglyceride lowering and MCT-based nutritional therapy for long-term control. Our findings highlight the need for early, individualized, and multidisciplinary management and emphasize the potential future role of emerging targeted therapies in addressing refractory pediatric hypertriglyceridemia. Full article

(This article belongs to the Special Issue New Updates in Pediatric Gastroenterology)

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