Factors Associated With Chronic Intestinal Inflammation Resembling Inflammatory Bowel Disease in Pediatric Intestinal Failure: A Matched Case-Control Study

Culbreath, Katherine; Keefe, Gregory P.; Nes, Emily; Staffa, Steven J.; Carey, Alexandra; Jaksic, Tom; Goldsmith, Jeffrey D.; Modi, Biren P.; Ouahed, Jodie; Jiménez, Lissette

doi:10.1097/mpg.0000000000003718

Cited by 4 publications

(4 citation statements)

References 32 publications

(49 reference statements)

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“…Management of anastomotic ulceration is challenging, and the diagnostic workup may require capsule endoscopy and enteroscopy in addition to routine upper and lower endoscopic examinations 65 . Although culture-proven SIBO often responds to oral antibiotics, it is associated with the presence of chronic intestinal inflammation resembling inflammatory bowel disease 63 , 64 . Medical therapy for both intestinal inflammation and anastomotic ulceration may be escalated from antibiotics, anti-inflammatory medications, corticosteroids to biologics based on severity of inflammation and the treatment response 63 , 65 , 69 .…”

Section: Upper Gastrointestinal Tractmentioning

confidence: 99%

“…Although culture-proven SIBO often responds to oral antibiotics, it is associated with the presence of chronic intestinal inflammation resembling inflammatory bowel disease 63 , 64 . Medical therapy for both intestinal inflammation and anastomotic ulceration may be escalated from antibiotics, anti-inflammatory medications, corticosteroids to biologics based on severity of inflammation and the treatment response 63 , 65 , 69 . Other treatment options for anastomotic ulceration include endoscopic procedures, such as argon plasma coagulation and surgery, while recurrences are common after all treatment modalities and may later occur several years after initially successful therapy 65 , 69 .…”

Section: Upper Gastrointestinal Tractmentioning

confidence: 99%

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Major surgical conditions of childhood and their lifelong implications: comprehensive review

Cullis,

Fouad,

Goldstein

et al. 2024

BJS Open

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Background In recent decades, the survival of children with congenital anomalies and paediatric cancer has improved dramatically such that there has been a steady shift towards understanding their lifelong health outcomes. Paediatric surgeons will actively manage such conditions in childhood and adolescence, however, adult surgeons must later care for these ‘grown-ups’ in adulthood. This article aims to highlight some of those rare disorders encountered by paediatric surgeons requiring long-term follow-up, their management in childhood and their survivorship impact, in order that the adult specialist may be better equipped with skills and knowledge to manage these patients into adulthood. Methods A comprehensive literature review was performed to identify relevant publications. Research studies, review articles and guidelines were sought, focusing on the paediatric management and long-term outcomes of surgical conditions of childhood. The article has been written for adult surgeon readership. Results This article describes the aforementioned conditions, their management in childhood and their lifelong implications, including: oesophageal atresia, tracheo-oesophageal fistula, malrotation, short bowel syndrome, duodenal atresia, gastroschisis, exomphalos, choledochal malformations, biliary atresia, Hirschsprung disease, anorectal malformations, congenital diaphragmatic hernia, congenital lung lesions and paediatric cancer. Conclusion The increasing survivorship of children affected by surgical conditions will translate into a growing population of adults with lifelong conditions and specialist healthcare needs. The importance of transition from childhood to adulthood is becoming realized. It is hoped that this timely review will enthuse the readership to offer care for such vulnerable patients, and to collaborate with paediatric surgeons in providing successful and seamless transitional care.

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Section: Upper Gastrointestinal Tractmentioning

confidence: 99%

Section: Upper Gastrointestinal Tractmentioning

confidence: 99%

Major surgical conditions of childhood and their lifelong implications: comprehensive review

Cullis,

Fouad,

Goldstein

et al. 2024

BJS Open

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“…Judicious use of antibiotics has important implications in the long-term care of SBS patients. Culbreath et al [50 ▪▪ ], and Moran-Lev et al have both described the incidence of chronic intestinal inflammation in SBS patients resembling inflammatory bowel disease (IBD) [51 ▪▪ ]. Multiple associations have been described between antibiotic use, dysbiosis and IBD incidence [52,53].…”

Section: Microbiome-based Approaches To Short Bowel Syndrome Managementmentioning

confidence: 99%

“…Multiple associations have been described between antibiotic use, dysbiosis and IBD incidence[52,53]. Higher abundance of Proteobacteria following antibiotic use in SBBO management[22], longer PN duration [50 && ], and more frequent episodes of bacterial overgrowth [were associated with increased intestinal inflammation and may be associated with features of chronic colitis in this population[50…”

mentioning

confidence: 99%

Intestinal microbiome in short bowel syndrome: diagnostic and therapeutic opportunities

Chowdhury,

Hill,

Shah

et al. 2023

Current Opinion in Gastroenterology

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Purpose of review The intestinal microbiome plays a strong, complementary role in the development and integrity of the intestinal epithelium. This biology is crucial for intestinal adaptation, particularly after the mucosal insults that lead to short bowel syndrome (SBS). The purpose of this review is to discuss relationships between the intestinal microbiota and the physiology of intestinal adaptation. Recent findings We will address interactions between the intestinal microbiome and nutritional metabolism, factors leading to dysbiosis in SBS, and common compositional differences of the gut microbiome in SBS patients as compared to healthy controls. We will also discuss novel opportunities to expand diagnostic and therapeutic interventions in this population, by using our knowledge of the microbiome to manipulate luminal bacteria and study their resultant metabolites. As microbial therapeutics advance across so many fields of medicine, this review is timely in its advocacy for ongoing research that focuses on the SBS population. Our review will discuss 4 key areas: 1) physiology of the intestinal microbiome in SBS, 2) clinical and therapeutic insults that lead to a state of dysbiosis, 3) currently available evidence on microbiome-based approaches to SBS management, and 4) opportunities and innovations to inspire future research. Summary The clinical implications of this review are both current, and potential. Understanding how the microbiome impacts intestinal adaptation and host physiology may enhance our understanding of why we experience such clinical variability in SBS patients’ outcomes. This review may also expand clinicians’ understanding of what ‘personalized medicine’ can mean for this patient population, and how we may someday consider our nutritional, therapeutic, and prognostic recommendations based on our patients’ host, and microbial physiology.

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Performance of pan‐enteroscopy in children with intestinal failure due to short bowel syndrome: A single‐center retrospective study

Salazar,

Chan,

Liu

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesIn pediatric patients with intestinal failure (IF) due to short bowel syndrome, we hypothesized that young children, those with shorter residual small bowel and those with congenital malrotation of the bowel would be more likely to undergo pan‐enteroscopy. We aimed to determine the feasibility and diagnostic yield of pan‐enteroscopy in this cohort.MethodsWe performed a single‐center, retrospective study of pediatric patients with IF due to short bowel syndrome (SBS) who had undergone at least one GI endoscopic evaluation between January 1, 2018 and January 1, 2023.ResultsA pan‐enteroscopy might have been possible in 381 of the 431 procedures (206 patients) reviewed. 44 (21%) patients underwent 54 pan‐enteroscopies. Children with a residual bowel length <35 cm had higher odds of undergoing pan‐enteroscopy (odds ratio [OR] 3.72, 95% confidence interval [CI] [1.32, 10.48], p = 0.01), as did patients with periprocedural glucagon‐like peptide 2 (GLP‐2) analog use (OR 4.30, 95% CI [1.24, 14.95], p = 0.02). Patients with diagnoses other than necrotizing enterocolitis (NEC) tended to be more likely to achieve a pan‐enteroscopy (OR 2.73, 95% CI [0.95,7.88], p = 0.06). Evidence of gross and histopathologic abnormalities were found in 77.8% and 78% of the procedures, respectively. No complications were identified.ConclusionIn a large cohort of children with SBS, pan‐enteroscopy was successfully performed in 14.2% of the procedures and microscopic abnormalities were common. Shorter residual bowel length, underlying diagnoses of non‐NEC, and GLP‐2 analog use were generally associated with successful pan‐enteroscopy, independent of age and several other factors. These data suggest that pan‐enteroscopy is feasible and of high‐yield in a subset of patients with SBS.

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Factors Associated With Chronic Intestinal Inflammation Resembling Inflammatory Bowel Disease in Pediatric Intestinal Failure: A Matched Case-Control Study

Cited by 4 publications

References 32 publications

Major surgical conditions of childhood and their lifelong implications: comprehensive review

Major surgical conditions of childhood and their lifelong implications: comprehensive review

Intestinal microbiome in short bowel syndrome: diagnostic and therapeutic opportunities

Performance of pan‐enteroscopy in children with intestinal failure due to short bowel syndrome: A single‐center retrospective study

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