In an analysis of data on children 4 to 18 years old from the Mediterranean-European Area Project, we found FGIDs to be more frequent in girls. Functional constipation, aerophagia, abdominal migraine, and IBS are the most common disorders. However, the prevalence of FGIDs varies significantly among countries.

Breast milk is the ideal food for human infants, with benefits to mothers and babies. However, working mothers are more likely to choose not to breastfeed or to interrupt breastfeeding prematurely. This study assessed breastfeeding knowledge and attitudes among working mothers in South Jordan. Four hundred cross-sectional, self-administered Arabic surveys were distributed to working mothers at their workplaces. In addition to measuring mothers' knowledge of and attitudes toward breastfeeding, barriers that prevented continuing breastfeeding beyond 6 months were also explored. Three hundred forty-four (80%) completed questionnaires were returned. The breastfeeding initiation rate was 72.4%, but only 20.9% were exclusively breastfeeding by 6 months. The participants showed satisfactory knowledge about breastfeeding and had positive attitudes toward breastfeeding. Most of the women who initiated breastfeeding reported ending breastfeeding prematurely. Approximately 30% of the mothers attributed premature cessation of breastfeeding to work. The results of this study could be useful for health care providers and policy makers when planning effective breastfeeding promotion programs and creating breastfeeding-friendly workplaces.

Introduction Helicobacter pylori ( H. pylori ) is a Gram-negative bacteria that is harbored in the stomach and linked to chronic gastritis, peptic ulcer disease, and gastric malignancy. Most Helicobacter infections are acquired during early infancy. This study aimed to establish the prevalence of H. pylori infection in Jordanian children using the 13 C-urea breath test. Materials and methods We prospectively enrolled children between the ages of 4 and 17 years from April 2019 to July 2019. Enrolled children were patients with nongastrointestinal complaints at the pediatric clinics of two hospitals and at community centers caring for healthy children in Irbid, Jordan. Questionnaires obtaining data on sociodemographics, clinical symptomatology, and hygienic risk factors were completed. Recruited children underwent a urea breath test (UBT). Results Of 340 children who were recruited, 328 (96.5%) were included in the final analysis. The mean age (±standard deviation) was 9.56 (±3.98) years (range, 4.0–17 years), and 168 (51.2%) were males. Only 48 children (14.6%) tested positive. There were no gender differences. Living in an urban area and a family history of previous H. pylori infection were risk factors for the acquisition of infection ( P = 0.007 and 0.001, respectively). Although gastrointestinal symptoms were more common in H. pylori -infected children, only hiccups and constipation were statistically significant ( P = 0.035 and 0.038, respectively). Conclusion H. pylori infects at least 15% of Jordanian children, suggesting a significant drop in infection rates in this group. Larger-scale studies combined with clinical evaluations will be important for further understanding the reasons for the observed decrease in H. pylori infections in Jordanian children.

PurposeConstipation is a common pediatric problem worldwide. This study aims to describe the clinical characteristics of pediatric constipation in south Jordan according to gender and age group.MethodsAll patients with constipation managed at our pediatric gastroenterology service between September 2009 and December 2012 were included. Hospital charts were reviewed. Demographic data, clinical characteristics, and final diagnosis were recorded. Data were analyzed according to gender and the following age groups: infants, pre-school, school age, and adolescents.ResultsDuring the study period, 126 patients were enrolled. The number (percentage) of patients according to age were the following infants: 43 (34.1%), pre-school: 55 (43.7%), school age: 25 (19.8%), and adolescents: 3 (2.4%). Males made up 54.8% of the study population. There were no statistical gender differences in any age group. The most common symptom in all age groups was dry, hard stool. Infrequent defecation was found in almost one-half of the patients. Fecal incontinence was more common in school-aged children compared to pre-school-aged children and adolescents. Abdominal pain was seen in almost 40% of the constipated children. Abdominal pain was more prevalent in girls and older children. Fecal mass in the rectum was the most common physical finding, with constipated boys exhibiting higher rates. Functional constipation was the most common etiology.ConclusionClinical characteristics of constipation in children vary according to age group and gender. Older children had less frequent bowel motions, a longer duration of symptoms, and a higher prevalence of long-standing constipation compilations (fecal incontinence and abdominal pain).

Background Upper endoscopy is an essential tool for diagnosing pediatric gastrointestinal issues. This study aimed to assess the indications, diagnostic yields, concordance between histopathological and endoscopic findings and suitability of upper endoscopies performed at a tertiary university hospital in Jordan. Methods Hospital records of children who underwent upper endoscopy were retrospectively reviewed. Demographics, endoscopic details (e.g., indications, findings and any complications), and histopathological findings were collected. The relationship between endoscopic findings and histopathological abnormalities was reported. Results The study included 778 patients (age, 92.5 ± 54.5 months; 380 girls, 48.8%). The most common age group was children younger than 60 months (273 patients, 34.3%). The most common indication for endoscopy was abdominal pain, followed by vomiting and failure to thrive or weight loss. Normal upper endoscopy was reported in 411 patients (52.8%). Age below 60 months, abdominal pain, dysphagia/odynophagia, and heartburn were predictive of abnormal endoscopy in multivariate analysis with p-value 0.000, 0.048, 0.001 and 0.01 respectively. Abnormal endoscopy showed 67.3% sensitivity and 69.9% specificity to predict histopathological abnormalities. Of those performed, 13.6% endoscopies were described as inappropriate indication. The suitability of the procedure was a sensitive predictor for abnormal endoscopic and histopathological findings. Conclusions Abdominal pain is the most common indication for upper endoscopy in our population. It is associated with a higher chance of abnormal endoscopy. Concordance between endoscopic and histopathological findings is not high. Normal endoscopic findings shouldn`t discourage the endoscopist from obtaining tissue biopsies. Considering more biopsies may improve pathological detection rates. Compliance with established endoscopy guidelines may reduce unnecessary procedures.

BackgroundRecurrent abdominal pain (RAP) is a common complaint in children. Significant portion of them are of functional origin. This study aimed to assess the prevalence of abdominal pain-predominant functional gastrointestinal disorder (FGID) and its types in Jordanian school children.MethodsThis is a school-based survey at south Jordan. Information using the self-reporting form of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII) - the official Arabic translation - was collected. Classes from academic years (grades) 6 - 8 were selected. SPSS Statistical Package Version 17 (IBM, Armonk, NY, USA) was used. Categorical data were analyzed using Fisher’s exact test, and continuous data were analyzed using t-test. P < 0.05 was considered significant.ResultsFive hundred questionnaires were distributed, and 454 returned answered (91%). Two hundred twenty-nine (50.8%) were males. The average age of participants was 12.7 years (11 - 15 years). One hundred sixteen (25.7%) had abdominal pain-predominant FGID. Seventy-nine (68%) of them were females. Forty-seven (10.6%) had irritable bowel syndrome (IBS). Thirty-six (8%), 17 (3.8%), 11 (2.4%) and five (1.1%) had abdominal migraine, functional abdominal pain, functional abdominal pain syndrome and functional dyspepsia, respectively.ConclusionAbdominal pain-predominant FGID has become a major health issue in Jordanian children. One of four children between the ages of 11 and 15 years exhibits at least one abdominal pain-predominant FGID. The most common form of abdominal pain-predominant FGID in our children was IBS. Females are affected more often than males. Intestinal and extra-intestinal symptoms are seen regularly with abdominal pain-predominant FGIDs.

The authors report a positive experience with the implementation of a multidisciplinary approach and the use of FOE in infants with SBS and severe PNALD. The earlier the FOE was initiated during the cholestatic process, the shorter the time to resolution. The present study is a hypothesis generator, raising the question of whether an earlier introduction of this particular therapy can effectively shorten the cholestasis process in these patients.

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