Background: Recurrent Abdominal Pains (RAP) is one of the frequent complaints in general practice, particularly in pediatrics and is among the common cause of referral to gastroenterology clinics. Purpose: This study is designed to investigate the effects of probiotics for the treatment of RAP and desired therapeutic outcomes. Methods: 125 children with the diagnosis of RAP according to Rome III criteria for IBS, Functional Abdominal Pain (FAP), Functional Dyspepsia (FD) and Abdominal Migraine (AM), were enrolled in this double-blind randomized controlled trial. Results: 65 subjects received probiotics, and others received placebo treatment for 4 weeks. Lactobacillus Reuteri was therapeutically effective in 32 patients compared to 8 patients, responding to the placebo treatment. Compared to baseline, all pain-related variables showed a significant reduction for the IBS and FD at the end of the 4th week. However, it did not respond well in FAP and AM groups. Pain-related outcomes such as, frequency of the pain, severity and duration of the pain were decreased following the probiotic treatment. No therapeutic response was seen in AM group after the administration of probiotics. Lactobacillus Reuteri significantly led to pain relief in the overall population, and also in FAP, FD and IBS subgroups. Conclusion: Lactobacillus Reuteri probiotics are likely to lead to RAP relief and can be recommended for the treatment of functional gastrointestinal disorders.

Background The diagnosis of esophageal varices (EV) is based on the findings of esophagogastroduodenoscopy (EGD), biopsy, and serum markers. Thus, noninvasive cost-effective tests through which high-risk EV children can be diagnosed are needed. Purpose This cross-sectional study aimed to identify the noninvasive markers for EV in children with liver cirrhosis. Methods A total of 98 children with liver cirrhosis were evaluated in this study. The spleen size, platelet count, serum albumin, liver function test results, and risk scores were evaluated prior to endoscopy. The endoscopic investigations aimed to identify the presence of EV and red signs, and determine varices sizes. Results Endoscopy revealed varices in 43 subjects (43.9%). The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index (APRI), platelet count to spleen size ratio, and risk score differed significantly between patients with and without EV on univariate analysis; however, the logistic regression analysis showed no differences, indicating that none of these parameters were independently associated with the presence of EV. Conclusion Platelet count, risk score, platelet count to spleen size, and APRI can be useful tools for the identification of high-risk patients with EV and might reduce the need for invasive methods like EGD.

Background: The prevalence of infant colic is high and it has a significant impact on the live of the infants and their families, given that effective treatment has not been found. Objective: The aim of this study to evaluate the effects of pedilact probiotic drops for the treatment of infants colic in children. Methods: This study was carried out on 72 infants, presented with infantile colic who were admitted to the Tehran children Medical Center. These children were assigned randomly (using 2 blindedrandomized trial) into two equal groups named PRR (Probiotic receiving) and PCR (Placebo receiving) groups. The demographic information of the infants such as age and sex, maternal age, patient admission time and confounding factors such as passive smoker, family history of atopy, antibiotic use, and delivery type was recorded in both groups based on the statements provided by the mothers. The weight of the infants was also recorded. Results: There was no significant difference in the distribution of infant's sex, mother's age, type of labor, type of nutrition, quality of life and exposure to smoke between the two groups. The weight of the newborns increased in each of the two groups and there was a significant increase in the PRR group (p value < 0.0001), while in the PCR group no significant growth was observed (p value ¼ 0.437). The frequency of crying in both groups decreased over the time, which was significant in PRR group only (p value < 0.001). There were no significant difference between PRR and PCR groups in fecal consistency and pattern of sleep on each day of 0, 7, 14, 21, and 28 (28 days p value ¼ 0.475 and 0.086, respectively).

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PurposeJaundice accounts for most hospital admissions in the neonatal period. Nowadays, in addition to phototherapy, other auxiliary methods are used to reduce jaundice and the length of hospitalization. This study aimed to investigate the effect of probiotics on the treatment of hyper-bilirubinemia in full-term neonates.MethodsIn this randomized clinical trial, 83 full-term neonates, who were admitted to the hospital to receive phototherapy in the first 6 months of 2015, were randomly divided into two groups: synbiotic (SG, n=40) and control (CG, n=43). Both groups received phototherapy but the SG also received 5 drops/day of synbiotics. Serum bilirubin, urine, stool, feeding frequency, and weight were measured daily until hospital discharge. A p-value<0.05 was considered statistically significant.ResultsThe mean total serum bilirubin in the SG was lower than that in the CG (9.38±2.37 and 11.17±2.60 mg/dL, respectively). The urine and stool frequency in the SG was significantly higher than that in the CG (p<0.05). The duration of hospitalization in the SG was shorter than that in the CG.ConclusionUse of synbiotics as an adjuvant therapy had a significant treatment effect on jaundice in full-term neonates. Further studies including larger samples with long follow-up periods are essential to confirm the benefits of routine use of synbiotics in neonatal patients with jaundice.

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Functional dyspepsia is a common gastric disease that can be associated with Helicobacter pylori infection. The aim of this study is to evaluate antral endoscopy of individuals who presented with functional dyspepsia, H. pylori infection status and the effects of eradication therapy on the symptoms. Following the diagnosis of dyspepsia as per Rome III criteria, 260 individuals who were eligible for the study underwent upper gastrointestinal endoscopy and were divided into four groups of 65 according to the endoscopic view, grades I, II, III and IV (negative). Stool antigen test was also performed for all patients to identify H. pylori infection. The early signs of dyspepsia were assessed by a standard questionnaire. In all groups, omeprazole, amoxicillin, clarithromycin and metronidazole were used for eradication treatment, and 1 month after the treatment, a faecal antigen test was repeated to evaluate the eradication of H. pylori . There was no statistically significant difference between the groups in terms of clinical symptoms before treatment. The highest response to eradication treatment was seen in individuals with antral gastropathy grade III (66.2%) and the lowest response was in patients without antral gastropathy Grade IV (32.3%). This difference was statistically significant. There was no statistically significant relationship between the participants in terms of family history, age, gender and response to treatment. Eradicating H. pylori reduces the symptoms of dyspepsia. The response of eradication therapy was greatest among the patients with grade III antral gastropathy.