Assessing the correlation between fecal calprotectin, blood markers and disease activity in pediatric inflammatory bowel disease.

Background: Crohn's disease (CD) and ulcerative colitis (UC) are the 2 main types of inflammatory bowel disease (IBD), a chronic inflammatory condition of the gastrointestinal tract. Management of IBD necessitates frequent clinical monitoring, including blood tests and occasionally endoscopy. Fecal calprotectin (FC) is a non-invasive measurement of luminal inflammatory activity, and can therefore be used as a useful monitoring tool.

Use of endolumenal functional lumen imaging probe in investigating paediatric gastrointestinal motility disorders.

Investigating gastrointestinal (GI) motility disorders relies on diagnostic tools to assess muscular contractions, peristalsis propagation and the integrity and coordination of various sphincters. Manometries are the gold standard to study the GI motor function but it is increasingly acknowledged that manometries do not provide a complete picture in relation to sphincters competencies and muscle fibrosis. Endolumenal functional lumen imaging probe (EndoFLIP) an emerging technology, uses impedance planimetry to measure hollow organs cross sectional area, distensibility and compliance.

Rate of paediatric gastrostomy insertion in England and relationship to epidemiology of cerebral palsy.

Background And Objectives: Gastrostomy tubes are commonly used to provide an alternative route for enteral nutrition. Most of the gastrostomies are inserted in children with cerebral palsy. Previous studies have shown an increase in insertion rate, however, epidemiological studies reveal a stasis in prevalence of cerebral palsy.

EndoFLIP assessment of pyloric sphincter in children: a single-center experience.

Background: Gastrointestinal complaints are common in children with neurodisabilities, vomiting, retching and poor feed tolerance are frequently reported. Endolumenal functional lumen imaging probe (EndoFLIP) is used to assess compliance and distensibility of the pylorus and can predict response to Botulinum Toxin in adult with gastroparesis. We aimed to review pyloric muscle measurements using EndoFLIP in children with neuromuscular disabilities and significant foregut symptoms and to assess the clinical response to intrapyloric Botulinum Toxin.

Gastroesophageal reflux disease in children: What's new right now?

Gastroesophageal reflux (GER) in children is very common and refers to the involuntary passage of gastric contents into the esophagus. This is often physiological and managed conservatively. In contrast, GER disease (GERD) is a less common pathologic process causing troublesome symptoms, which may need medical management.

Parenteral Nutrition in Pediatric Patients with Neurodisability: Current Perspectives.

Pediatric neurodisability describes functional limitations in children with varied severity and complexity often attributed to brain or neuromuscular abnormalities. The life expectancy of children with neurodisability is improving, but many will require significant medical support. The gastrointestinal tract is usually affected in children with neurodisability and can lead to a wide range of symptoms.

Burden of Pediatric Functional Gastrointestinal Disorder in an Emergency Department-A Single-Center Experience.

Objectives: Functional gastrointestinal disorders (FGIDs) are recurrent or chronic gastrointestinal signs and symptoms in the absence of anatomical or biochemical alterations. They are commonly treated in outpatient setting but often present to emergency departments. We aimed to estimate the burden of pediatric FGID on a busy accident and emergency (A&E) department.

Ultrasonic-Assisted Extraction of Toxic Acidic Components from Acidic Oil Using 1,8-Diazobicyclo[5.4.0]undec-7-ene-Based Ionic Liquids.

Ionic liquids (ILs) show remarkable performance in enhancing the naphthenic acid extraction efficiency and decreasing the extraction time. However, the ultrasonic-assisted IL-based extraction of naphthenic acid is merely addressed previously. Therefore, this study investigated the impact of essential ultrasonic parameters, including amplitude and time, on naphthenic acid extraction using different ILs, and the system was optimized for maximum extraction.

Bowel transit studies in children: evidence base, role and practicalities.

Constipation is common in children and adults with varied worldwide prevalence. The majority of children have functional constipation as defined by Rome clinical criteria and respond favourably to standard medical therapy; up to one-third can develop difficult-to-treat constipation requiring investigation and specialist treatment. Colon function tests aim to assess the neuromuscular integrity, the movement of faeces across the colon and evaluate/predict response to the therapy.

Review of a paediatric inflammatory bowel disease service during the pandemic and the impact of the CNS role.

Background: Inflammatory bowel disease (IBD) is a chronic relapsing and remitting condition. The COVID-19 pandemic has severely disrupted provision of medical care across the world. IBD clinical nurse specialists (CNSs) played a pivotal role in the care of children with IBD during the pandemic national lockdown and in the recovery phase.

Nurse-led service for children with gastrostomies: a 2-year review.

Background: Percutaneous endoscopic gastrostomy (PEG) feeding can provide long-term nutritional support for patients with a functional gastrointestinal system but insufficient oral intake. Some patients, however, may require jejunal feeding, which can be achieved using a PEG tube with jejunal extension (PEG-J). A previous review at a tertiary paediatric hospital revealed poor documentation and a high incidence of buried bumper syndrome (BBS) in children with gastrostomies.

Ultrasonic-Assisted Technique as a Novel Method for Removal of Naphthenic Acid from Model Oil Using Piperidinium-Based Ionic Liquids.

In this study, piperidinium-based ionic liquids (IL) containing trifluoromethanesulfonate, phenolate, and dicyanamide anions were synthesized. Using the ILs, extraction of naphthenic acid from highly acidic oil with a total acid number (TAN) of 1.44 was studied.

Nutrition Evaluation Screening Tool: An Easy to Use Screening Tool for Hospitalised Children.

Purpose: Nutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children.

Development, formulation and optimization of a novel biocompatible ionic liquids dispersant for the effective oil spill remediation.

The application of chemical dispersants in marine oil spill remediation is comprehensively reported across the globe. But, the augmented toxicity and poor biodegradability of reported chemical dispersants have created necessity for their replacement with the bio-based green dispersants. Therefore, in the present study, we have synthesized five ionic liquids (ILs) namely 1-butyl-3-methylimidazolium lauroylsarcosinate, 1,1'-(1,4-butanediyl)bis(1-H-pyrrolidinium) dodecylbenzenesulfonate, tetrabutylammonium citrate, tetrabutylammonium polyphosphate and tetrabutylammonium ethoxylate oleyl ether glycolate, and formulated a water based ILs dispersant combining the synthesized ILs at specified compositions.

Anorectal manometry in children with defecation disorders BSPGHAN Motility Working Group consensus statement.

Defecatory disorders in children, including chronic constipation (CC) and fecal incontinence (FI), are common conditions worldwide and have a significant impact on children, their families, and the healthcare system. Anorectal manometry (ARM) and high-resolution anorectal manometry (HRAM) are relatively novel tools for the assessment of anal sphincter function and rectal sensation and have contributed significantly to improving the understanding of the anorectum as a functional unit. ARM has been recognized as the investigation of choice for adults with symptoms of defecation disorders, including fecal incontinence (FI), evacuation difficulties, and constipation.

Distal oesophageal spasm secondary to eosinophilic oesophagitis in a child: response to diet therapy.

We report a case of a school-age child with symptomatic distal oesophageal spasm (DES), clinical dysphagia and typical feature in high-resolution oesophageal manometry secondary to eosinophilic oesophagitis (EoE). His symptoms resolved with normalisation of oesophageal manometry after standard treatment of EoE. DES is mainly an adult disorder and rarely affect children; to the best of our knowledge, this is the first reported case in a child that document full recovery after treating the underlying EoE.

Renal involvement in paediatric inflammatory bowel disease.

Inflammatory bowel disease (IBD), which includes Crohn's disease, ulcerative colitis and inflammatory bowel disease unclassified, is a chronic inflammatory disorder that predominantly affects the gastrointestinal (GI) tract and has a rising incidence in both children and adults. Symptoms are caused by inappropriate inflammatory response triggered by interaction between the environment, gut microbiome and host immune system in a genetically susceptible individual. Extranintestinal manifestations of IBD are common and can affect any body system outside the gut; they can precede or run parallel to GI inflammation.

Pediatric Esophageal Dilatations: A Cross-Specialty Experience.

Esophageal dilatations are commonly performed in pediatric patients who have undergone an esophageal atresia/tracheoesophageal fistula (EA/TEF) repair or following caustic injury. We sought to compare the practice of esophageal dilatation across different specialties. We analyzed all patients who had an esophageal dilatation at our center between April 2014 and December 2018.

Azathioprine dosing and metabolite measurement in pediatric inflammatory bowel disease: does one size fit all?

Background: Azathioprine is widely used for the maintenance of remission in children with inflammatory bowel disease (IBD). Measuring thiopurine metabolites 6-thioguanine (6-TGN) and 6-methyl-mercaptopurine (6-MMP) can aid in optimizing treatment and preventing toxicity. We report a proactive approach combining early metabolite measurements with IBD activity index to achieve optimal azathioprine dosing.

Synthesis, characterization, ecotoxicity and biodegradability evaluations of novel biocompatible surface active lauroyl sarcosinate ionic liquids.

Ionic liquids (ILs) based surfactants have been emerged as attractive alternatives to the conventional surfactants owing to their tailor-made and eco-friendly properties. Therefore, present study described the synthesis of nine new fatty amino acids based IL surfactants utilizing lauroyl sarcosinate anion and pyrrolidinium, imidazolium, pyridinium, piperidinium, morpholinium and cholinium cations for the first time. The synthesized surface active lauroyl sarcosinate ionic liquids (SALSILs) were characterized by H NMR, C NMR and TGA.

Preservation of the colo-anal reflex in colonic transection and post-operative Hirschsprung's disease: Potential extrinsic neural pathway.

Background: The colo-anal reflex is a distinct reflex whereby the internal anal sphincter (IAS) relaxes in association with colonic high amplitude propagating contractions (HAPCs) in contrast to the recto-anal inhibitory reflex (RAIR), which is characterized by IAS relaxation upon rectal distension. The RAIR is mediated by the myenteric plexus and therefore absent in Hirschsprung disease. We retrospectively assessed the presence and the characteristics of the colo-anal reflex in children in whom large bowel continuity had been surgically disrupted to assess the role of the extrinsic nervous system in the reflex.

The Use of Pyridostigmine in a Child With Chronic Intestinal Pseudo-Obstruction.

Chronic intestinal pseudo-obstruction is a rare disorder that affects the motility of the gastrointestinal tract. It results in acute or subacute intestinal obstruction symptoms in the absence of mechanical lesion. It can lead to intestinal failure in children with significant strain on nutrition, growth, and development.

Management of pneumatosis intestinalis in children over the age of 6 months: a conservative approach.

Background: Pneumatosis intestinalis (PI) is an uncommon and poorly understood condition. Although it can be an incidental finding in asymptomatic individuals, it can also be secondary to life-threatening bowel ischaemia and sepsis. In premature infants, it is a pathognomonic sign of necrotising enterocolitis.

BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance monitoring-indications, methods and interpretation.

Background: Combined pH-impedance monitoring has been suggested as the investigation of choice for diagnosing gastro-oesophageal reflux in children. Although it is superior to oesophageal pH monitoring in detecting all types of reflux episodes (acid, weakly acidic and alkaline) with the ability to evaluate symptom association with reflux events, it is still limited by the lack of true paediatric normal value and the high cost involved (equipment and personnel).

Objective: To produce a position statement on behalf of the Motility Working Group of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition on the indications and practical application of combined oesophageal pH-impedance monitoring in children.