Effect of Octreotide on the Colonic Motility in Pediatric Patients with Chronic Recalcitrant Constipation

Objective: The aim of the present study was to study the effect of octreotide on colonic motility in pediatric patients with recalcitrant chronic constipation/encopresis and other suspected colonic motility disorders. Methods: This was a nonrandomized, single-center, open-label, prospective study evaluating the effect of a single subcutaneous dose of octreotide on colonic motility. Results: Thirteen patients (5 boys) were enrolled in the study. The age range was 4.6 to 16.2 years. Eleven patients (84%) had normal colonic manometry and 2 patients (16%) had colonic neuropathy. Motility Index (MI) (mmHg) for the 15 minutes before and after octreotide infusion was 6.03 ± 1.26 (95% confidence interval [CI] 5.35–6.72) and 5.32 ± 1.66 (95% CI 4.42–6.23), respectively, with P value of 0.08. MI for the 30 minutes before and after octreotide infusion was 6.89 ± 1.37 (95% CI 6.14–7.64) and 6.71 ± 1.47 (95% CI 5.91–7.52), respectively, with P value of 0.55. MI for the 45 minutes before and after octreotide infusion was 7.73 ± 1.32 (95% CI 7.01–8.45) and 7.53 ± 1.38 (95% CI 6.78–8.28), respectively, with P value of 0.8. Conclusion: Our study showed that the administration of octreotide resulted in no significant changes in colonic MI in pediatric patients with chronic recalcitrant constipation

All tTG positive patient do not have celiac disease

Tissue transglutaminase antibody IgA level (tTG) is an excellent screening test for celiac disease in the presence of adequate IgA levels. Most labs while screening for Celiac disease (CD) will do the IgA levels automatically. However the serological test is not a diagnostic test

Parent Satisfaction with Outpatient Pediatric Endoscopy Procedures at University of New Mexico Children\u27s Hospital

As a part of endoscopy quality improvement (EQI) project, we decided to measure parent satisfaction about pediatric endoscopy service at University of New Mexico Children\u27s Hospital

Infliximab therapy in pediatric Crohn’s disease: a review

Kalyan Ray Parashette1, Raghavendra Charan Makam2, Carmen Cuffari31Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA; 2Department of Internal Medicine, Berkshire Medical Center, Pittsfield, MA, USA; 3Division of Pediatric Gastroenterology, The Johns Hopkins Children’s Center, Baltimore, MD, USAAbstract: Anti-tumor necrosis factor alpha (TNF-α) therapy has re-defined our treatment paradigms in managing patients with Crohn’s disease (CD) and ulcerative colitis. Although the ACCENT studies showed proven efficacy in the induction and maintenance of disease remission in adult patients with moderate to severe CD, the pediatric experience was instrumental in bringing forth the notion of “top-down” therapy to improve overall clinical response while reducing the risk of complications resulting from long-standing active disease. Infliximab has proven efficacy in the induction and maintenance of disease remission in children and adolescents with CD. In an open-labeled study of 112 pediatric patients with moderate to severe CD, 58% achieved clinical remission on induction of infliximab (5 mg/kg) therapy. Among those patients who achieved disease remission, 56% maintained disease remission on maintenance (5 mg/kg every 8 weeks) therapy. Longitudinal follow-up studies have also shown that responsiveness to infliximab therapy also correlates well with reduced rates of hospitalization, and surgery for complication of long-standing active disease, including stricture and fistulae formation. Moreover, these children have also been shown to improve overall growth while maintaining an effective disease remission. The pediatric experience has been instructive in suggesting that the early introduction of anti-TNF-α therapy may perhaps alter the natural history of CD in children, an observation that has stimulated a great deal of interest among gastroenterologists who care for adult patients with CD.Keywords: Crohn’s disease, infliximab, pediatri

Effect of Octreotide on the Colonic Motility in Pediatric Patients with Chronic Recalcitrant Constipation

Objective: The aim of the present study was to study the effect of octreotide on colonic motility in pediatric patients with recalcitrant chronic constipation/encopresis and other suspected colonic motility disorders. Methods: This was a nonrandomized, single-center, open-label, prospective study evaluating the effect of a single subcutaneous dose of octreotide on colonic motility. Results: Thirteen patients (5 boys) were enrolled in the study. The age range was 4.6 to 16.2 years. Eleven patients (84%) had normal colonic manometry and 2 patients (16%) had colonic neuropathy. Motility Index (MI) (mmHg) for the 15 minutes before and after octreotide infusion was 6.03 ± 1.26 (95% confidence interval [CI] 5.35–6.72) and 5.32 ± 1.66 (95% CI 4.42–6.23), respectively, with P value of 0.08. MI for the 30 minutes before and after octreotide infusion was 6.89 ± 1.37 (95% CI 6.14–7.64) and 6.71 ± 1.47 (95% CI 5.91–7.52), respectively, with P value of 0.55. MI for the 45 minutes before and after octreotide infusion was 7.73 ± 1.32 (95% CI 7.01–8.45) and 7.53 ± 1.38 (95% CI 6.78–8.28), respectively, with P value of 0.8. Conclusion: Our study showed that the administration of octreotide resulted in no significant changes in colonic MI in pediatric patients with chronic recalcitrant constipation