Journal of Pediatric Gastroenterology and Nutrition

Dyssynergic defecation is a common disorder in children with functional constipation (FC) because of relaxation disorders of the sphincter apparatus and intra-rectal pressure during defecation. Makosiej et al. showed that persistent retentive posturing and secondary disturbance of puborectalis muscle relaxation may lead to dyssynergic defecation. The identification of the precise location of the muscular disorder enables early qualification of children for targeted therapy using electrostimulation or biofeedback: https://bit.ly/33WER0I

Anemia in Children With Inflammatory Bowel Disease: A Position Paper by the IBD Committee of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition: https://bit.ly/366qNEB

A 17-year-old previously healthy girl presented with pneumonia complicated by bilateral pulmonary emboli and a deep vein thrombosis; chest imaging incidentally showed numerous pancreatic cysts, confirmed on abdominal imaging (Fig. 1). Patient had no prior trauma. Hematologic evaluation revealed antithrombin III deficiency... https://bit.ly/333MRh1

Incident paediatric inflammatory bowel disease has been misquoted in the past to be 20% to 25% of all incident inflammatory bowel disease, but is less than 10% for cases ages <17 years. Burgess et al. showed that paediatric inflammatory bowel disease patients (aged <17 years) constitute only 1.4% of all point prevalent patients within a defined region of South-East Scotland. This low proportion of paediatric inflammatory bowel disease cases is because of compounding prevalence and caused by the low mortality rate, ageing population, and lack of a cure. https://bit.ly/3ieyMSB

New, October issue of JPGN is now available! Go on-line to read about acute pancreatitis, immune response to vaccinations in IBD, vedolizumab treatment in PSC and many more: https://bit.ly/30bfUh7

Causes of early-onset refractory diarrhea include exudative diarrhea associated with very early-onset inflammatory bowel diseases, osmotic or secretory diarrhea, and protein-losing enteropathy. Some patients with very early-onset inflammatory bowel diseases are monogenic.... Uchida et al. established comprehensive targeted gene panels that covered all responsible genes for early-onset refractory diarrhea.They found that 15/108 enrolled patients (13.8%) were monogenic. The responsible genes for primary immunodeficiency diseases were frequently involved in molecular pathogenesis. Genetic analysis was useful for selecting the optimal treatment for each patient. https://bit.ly/34yCbs2

Polyethylene Glycol Dosing for Constipation in Children Younger Than 24 Months: A Systematic Review This systematic review provides promising results surrounding safety of polyethylene glycol with a lack of reported side effects for children younger than 24 months. https://journals.lww.com//Polyethylene_Glycol_Dosing_for_C

Trichobezoars are masses of ingested hair, usually the individual's own hair, that accumulate in the gastrointestinal tract, most commonly in the stomach. When extending into the small intestine, this is termed Rapunzel syndrome. This article presents a fascinating and difficult case report with the literature review: shorturl.at/gtDY8

Two new COVID-19 updates in Pediatric Gastroenterology: 1. SARS-CoV-2 shedding seems to be present in feces for a longer time than in the respiratory tract of children. Although fecal SARS-CoV-2 presence in feces do not confirm its transmissibility, the high and fast spread of the novel coronavirus disease 19 worldwide indicate other transmission routes are also plausible: https://bit.ly/2CwvcUS 2. Pediatric Crohn Disease and Inflammatory Syndrome in Children (MIS-C) and COV...ID-19: Higher levels of proinflammatory cytokines can be seen in patients with inflammatory bowel disease and cytokine storm associated with coronavirus disease 2019 infection than are reported in either inflammatory bowel disease or with coronavirus disease 2019 alone. Infliximab therapy can effectively treat both pediatric Crohn disease and multisystem inflammatory syndrome in children temporally associated with coronavirus disease 2019 infection: https://bit.ly/2Fyuhoh See more

In the new issue of JPGN - North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper: Plant-based Milks; with Rachel Rosen's comment "GOT MILK-ish? Check these articles out: https://bit.ly/3kQM0ra , https://bit.ly/2Y9ake5