Endoscopy simulation for pre-clerkship students

Implication: Here we report a simulation session carried out with pre-clerkship medical students during their gastroenterology block.  We used endoscopy simulator to cement the clinical and anatomic implications of endoscopy and to build interest in gastroenterology. Students thought the session was helpful for their interest and understanding. Endoscopy simulation provided for pre-clinical students could help to bolster high-level understanding of gastroenterology as well as understanding of clinical and procedural aspects of the specialty

A Canadian Study toward Changing Local Practice in the Diagnosis of Pediatric Celiac Disease

Background. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition endorses serological diagnosis (SD) for pediatric celiac disease (CD). The objective of this study was to pilot SD and to prospectively evaluate gastrointestinal permeability and mucosal inflammation at diagnosis and after one year on the gluten-free diet (GFD). We hypothesized that SD would be associated with similar short term outcomes as ED. Method. Children, 3-17 years of age, referred for possible CD were eligible for SD given aTTG level ≥200 U/mL, confirmed by repeat aTTG and HLA haplotypes. Gastrointestinal permeability, assessed using sugar probes, and inflammation, assessed using fecal calprotectin (FC), at baseline and after one year on a GFD were compared to patients who had ED. Results. Enrolled SD ( = 40) and ED ( = 48) patients had similar demographics. ED and SD groups were not different in baseline lactulose: mannitol ratio (L : M) (0.049 versus 0.034; = 0.07), fractional excretion of sucrose (%FES; 0.086 versus 0.092; = 0.44), or fecal calprotectin (FC; 89.6 versus 51.4; = 0.05). At follow-up, urine permeability improved and was similar between groups, L : M (0.022 versus 0.025; = 0.55) and %FES (0.040 versus 0.047; = 0.87) ( > 0.05). FC improved but remained higher in the SD group (37.1 versus 15.9; = 0.04). Conclusion. Patients on the GFD showed improved intestinal permeability and mucosal inflammation regardless of diagnostic strategy. This prospective study supports that children diagnosed by SD have resolving mucosal disease early after commencing a GFD

Exploring Anthropometric and Laboratory Differences in Children of Varying Ethnicities with Celiac Disease

BACKGROUND: Celiac disease (CD) is a common autoimmune disorder with an increasing prevalence, including in ethnic minorities

Patient and Parent Satisfaction with a Dietitian-and Nurse-Led Celiac Disease Clinic for Children at the Stollery Children’S Hospital, Edmonton, Alberta

OBJECTIVE: To assess patient and parent satisfaction with a primarily nurse- and dietitian-led celiac disease clinic in a tertiary pediatric centre

A Canadian Study toward Changing Local Practice in the Diagnosis of Pediatric Celiac Disease

Background. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition endorses serological diagnosis (SD) for pediatric celiac disease (CD). The objective of this study was to pilot SD and to prospectively evaluate gastrointestinal permeability and mucosal inflammation at diagnosis and after one year on the gluten-free diet (GFD). We hypothesized that SD would be associated with similar short term outcomes as ED. Method. Children, 3–17 years of age, referred for possible CD were eligible for SD given aTTG level ≥200 U/mL, confirmed by repeat aTTG and HLA haplotypes. Gastrointestinal permeability, assessed using sugar probes, and inflammation, assessed using fecal calprotectin (FC), at baseline and after one year on a GFD were compared to patients who had ED. Results. Enrolled SD (n=40) and ED (n=48) patients had similar demographics. ED and SD groups were not different in baseline lactulose: mannitol ratio (L : M) (0.049 versus 0.034; p=0.07), fractional excretion of sucrose (%FES; 0.086 versus 0.092; p=0.44), or fecal calprotectin (FC; 89.6 versus 51.4; p=0.05). At follow-up, urine permeability improved and was similar between groups, L : M (0.022 versus 0.025; p=0.55) and %FES (0.040 versus 0.047; p=0.87) (p>0.05). FC improved but remained higher in the SD group (37.1 versus 15.9; p=0.04). Conclusion. Patients on the GFD showed improved intestinal permeability and mucosal inflammation regardless of diagnostic strategy. This prospective study supports that children diagnosed by SD have resolving mucosal disease early after commencing a GFD