Rumination Syndrome in Children and Adolescents: A Mini Review

Introduction: Rumination syndrome involves recurrent regurgitation of food and is believed to be underdiagnosed with patients experiencing long delays in diagnosis. It can be associated with significant social consequences, high rates of school absenteeism, and medical complications such as weight loss. The primary aims of the current review are to assess the literature regarding prevalence, pathophysiology, and treatment outcomes with a focus on neurotypical children and adolescents.Results: Population studies in children/adolescents, 5 years of age or older, range from 0 to 5.1%. There are fewer studies in clinical settings, but the prevalence appears to be higher in patients with other gastrointestinal symptoms, particularly chronic vomiting. While physiologic changes that occur during a rumination episode are well-described, the underlying cause is less well-defined. In general, rumination appears to have similarities to other functional gastrointestinal disorders including dysmotility, possibly inflammation, and an interaction with psychologic function. While diaphragmatic breathing is considered the mainstay of treatment, pediatric data demonstrating efficacy is lacking, especially as an isolated treatment.Conclusion: Pediatric rumination syndrome remains greatly understudied, particularly regarding treatment. There is a need to better define prevalence in both the primary care and subspecialty clinical settings, especially in patients presenting with vomiting or apparent gastroesophageal reflux. There is a need to determine whether treatment of co-morbid conditions results in improvement of rumination. Diaphragmatic breathing needs to be studied and compared to other competing responses.

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Development and Preliminary Validation of the Questionnaire on Pediatric Gastrointestinal Symptoms to Assess Functional Gastrointestinal Disorders in Children and Adolescents

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/01.mpg.0000172748.64103.33 ◽

2005 ◽

Vol 41 (3) ◽

pp. 296-304 ◽

Cited By ~ 78

Author(s):

Arlene Caplan ◽

Lynn Walker ◽

Andr??e Rasquin

Keyword(s):

Children And Adolescents ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Gastrointestinal Disorders ◽

Preliminary Validation

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Prevalence of functional gastrointestinal disorders in infants and young children in China

BMC Pediatrics ◽

10.1186/s12887-021-02610-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ying Huang ◽

Serene Yaling Tan ◽

Panam Parikh ◽

Vanitha Buthmanaban ◽

Shaman Rajindrajith ◽

...

Keyword(s):

Young Children ◽

Maternal Education ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Gastrointestinal Disorders ◽

Cross Sectional ◽

Validated Questionnaire ◽

Rome Iv ◽

Infants And Young Children

Abstract Background The prevalence of functional gastrointestinal disorders (FGIDs) in children, particularly from Asia, is largely unknown. There are not many studies done in Asia especially using the Rome IV criteria. The aim of this study is to assess the prevalence of FGIDs in infants and young children in a representative sample in China. Methods A prospective, cross-sectional, community-based survey was conducted among healthy infants and young children between the ages of 0–4 years in Jinhua and Shanghai, China. A total of 2604 subjects (1300 subjects from Jinhua and 1304 subjects from Shanghai) completed a validated questionnaire on pediatric gastrointestinal symptoms. FGIDs in infants and young children were diagnosed using the Rome IV criteria. Results According to the Rome IV criteria, the prevalence of having a FGID in Chinese infants and young children is 27.3%. Infant regurgitation (33.9%) was the most common FGID among the 0–6 months old while functional constipation (7.0%) was the most common among the 1–4 years old. Risk factor analysis revealed that prevalence of infantile colic was higher with better maternal education and low birth weight. Prevalence of infantile regurgitation was significantly greater in males, living in a rural area, being exclusively breast fed at least up to 4 months and starting formula feeds within the first month. The risk of functional constipation was lower for infants who were delivered vaginally. Conclusions Infantile regurgitation was the most common FGID in Chinese infants while functional constipation was most prevalent among young Chinese children. Trial registration Netherlands Trial Registry Identifier: NL6973/NTR7161.

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The Digestive Health among Participants of the Woodstock Rock Festival in Poland—A Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102256 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2256 ◽

Cited By ~ 1

Author(s):

Karolina Skonieczna-Żydecka ◽

Ewa Stachowska ◽

Dominika Maciejewska ◽

Karina Ryterska ◽

Joanna Palma ◽

...

Keyword(s):

Digestive Tract ◽

Electronic Device ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Intestinal Barrier ◽

Study Participant ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Paper Version ◽

Gastrointestinal Complaints

Alterations of gut microbiota, intestinal barrier and the gut-brain axis may be involved in pathophysiology of functional gastrointestinal disorders. Our aim was to assess the prevalence of digestive tract symptoms and identify common variables potentially disrupting the gut-brain axis among participants of the Woodstock Festival Poland, 2017. In total 428 people filled in a questionnaire assessing health of their digestive tract. The investigator collected answers on an electronic device, while the study participant responded using a paper version of the same questionnaire. Liver and gallbladder related symptoms were the most prevalent among our study group (n = 266, 62%), however symptoms related to altered intestinal permeability were found to be the most intensive complaints. In females the intensity of gastrointestinal complaints was higher compared to men (p < 0.05), as well as the incidence of factors with the potential to alter gut-brain axis (p < 0.0001). Chronic psychological distress, intake of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics, were the most common associations with gastrointestinal symptoms, which were the most prevalent in females. Further attention should be focused on stress as one of the main factors negatively influencing public health.

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Gluten and Functional Abdominal Pain Disorders in Children

Nutrients ◽

10.3390/nu10101491 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1491 ◽

Cited By ~ 2

Author(s):

Alejandro Llanos-Chea ◽

Alessio Fasano

Keyword(s):

Abdominal Pain ◽

Pediatric Patients ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Gluten Sensitivity ◽

Gluten Free ◽

Functional Abdominal Pain ◽

Adults And Children ◽

Small Intestinal ◽

Irritable Bowel

In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders.

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3D Bio-Printing: an Introduction to a New Approach for Cancer Patients at the Interface of Art and Medicine

Leonardo ◽

10.1162/leon_a_01418 ◽

2017 ◽

Vol 50 (2) ◽

pp. 195-196

Author(s):

Eugen Bogdan Petcu

Keyword(s):

Cancer Patients ◽

Social Consequences ◽

Clinical Settings ◽

3D Bioprinting ◽

Multidisciplinary Therapy ◽

Significant Development ◽

New Approach ◽

Organ Regeneration ◽

Art And Medicine ◽

Actual Field

Cancer patients require a complex multidisciplinary therapy. In this context the 3D additive biological manufacturing could represent a significant development with potential significant medical and social consequences. This article reviews the 3D bioprinting methods and clinical settings in which this new revolutionary method could be applied. Apart from the actual field of post-cancer therapy prosthetics and medical education, this method could be applied in the actual molecular cancer research and organ regeneration/fabrication. Considering all of these, it is possible that in the future, 3D biological printing could be used on a regular basis in clinical oncology.

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Burden of drug use for gastrointestinal symptoms and functional gastrointestinal disorders in France: a national study using reimbursement data for 57 million inhabitants

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284819853790 ◽

2019 ◽

Vol 12 ◽

pp. 175628481985379 ◽

Cited By ~ 2

Author(s):

Philippe Tuppin ◽

Sébastien Rivière ◽

David Deutsch ◽

Christelle Gastaldi-Menager ◽

Jean-Marc Sabaté

Keyword(s):

Anatomical Therapeutic Chemical ◽

Large Population ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Individual Characteristics ◽

National Study ◽

Gastrointestinal Disorders ◽

Anti Inflammatory ◽

Stage Renal Disease ◽

End Stage

Background: Gastrointestinal therapeutic drugs (GTDs) are extensively prescribed. The aim of this study was to investigate the characteristics of GTD use in a large population: the French general health scheme beneficiaries (87% of the 66 million inhabitants) in 2016. Methods: The national health data system was used to identify individual characteristics, diseases and GTD classes reimbursed, together with the costs, using anatomical therapeutic chemical class. Results: Among the 57.5 million individuals included, 45% received at least one reimbursement among the 130 million prescriptions reimbursed (90% prescribed by a general practitioner): proton-pump inhibitors (PPI; A02BC: 24%), drugs for functional gastrointestinal disorders (A03: 20%), drugs for constipation (A06: 10%), antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07: 10%), antiemetics and antinauseants (A04: 7%), other drugs for acid-related disorders (A02X: 6%), other drugs for peptic ulcer and gastro-oesophageal reflux disease (A02BX: 4.5%), antacids (A02A: 1.5%). The overall cost of reimbursed GTDs was €707 million and the mean cost per user was €28. Marked variations were observed according to age, sex, and disease. The rates of at least one reimbursement among infants were A07: 28%, A03: 17%, A02BX: 9%, A02X: 7%, A02BC: 6% and A06: 5%. Women more frequently received a reimbursement than men for each GTD class. Reimbursement rates also varied according to health status (end-stage renal disease A02BC: 66%, pregnancy A03: 53%, A04: 11%), treatments (people with at least six reimbursements for nonsteroidal anti-inflammatory drugs in 2016 A02BC: 62%). Chronic GTD use (>10 reimbursements/year) was observed in 19% of people with at least one A02BC reimbursement, A02BX: 11%, A03: 7%, A04: 2%, A06: 17% and A07: 3%. Conclusions: This study demonstrates extensive and chronic use of GTD in France, raising the question of their relevance according to current guidelines. They must be disseminated to general practitioners, who are the main prescribers of these drugs.

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