Background. In the last decade a 10-day schema of sequential therapy of Helicobacter pylori infection based on proton pomp inhibitor (PPI), amoxicillin (AMO), clarithromycin (CLA) and metronidazole (MET) has been introduced. Many studies have emphasized greater efficacy of this therapy in comparison to the efficacy of the standard 7-day triple therapy (PPI + AMO + CLA or MET). Objectives. The aim of the study was to assess the sequential and standard triple therapy. Material and Methods. Sixty-nine children, aged 5 to 17 years, with symptoms of dyspepsia and gastric or duodenal ulcer were included in the study. The children were randomly divided into three groups. Group I -23 children treated with PPI + AMO + CLA, group II -23 children treated with PPI + AMO + MET, and group III -23 children treated with sequential therapy. The diagnosis of Helicobacter pylori infection was based on histopathological evaluation of gastric mucosa sample and on culture. The sensitivity of bacterial strains to antibiotics was assessed based on E-tests. The efficacy of Helicobacter pylori eradication was assessed 6-8 weeks after the completion of the treatment. Results. In children infected with Helicobacter pylori strains, which were sensitive to clarithromycin, the highest rate of eradication was obtained in the group treated with PPI + AMO + CLA (100%) and in the group treated with sequential therapy (90.48%), the lowest was in the group treated with PPI + AMO + MET. Conclusions. Efficiency of treatment of Helicobacter pylori infection in children depended on sensitivity of the strains to clarithromycin. Sensitivity to metronidazole did not influence significantly the eradication rate (Adv Clin Exp Med 2016, 25, 4, 701-708).

Background: Butyric acid’s effectiveness has not yet been assessed in the pediatric inflammatory bowel disease (IBD) population. This study aimed to evaluate the effectiveness of oral sodium butyrate as an add-on to standard therapy in children and adolescents with newly diagnosed IBD. Methods: This was a prospective, randomized, placebo-controlled multicenter study. Patients aged 6–18 years with colonic Crohn’s disease or ulcerative colitis, who received standard therapy depending on the disease’s severity, were randomized to receive 150 mg sodium butyrate twice a day (group A) or placebo (group B). The primary outcome was the difference in disease activity and fecal calprotectin concentration between the two study groups measured at 12 weeks of the study. Results: In total, 72 patients with initially active disease completed the study, 29 patients in group A and 43 in group B. At week 12 of the study, the majority of patients achieved remission. No difference in remission rate or median disease activity was found between the two groups (p = 0.37 and 0.31, respectively). None of the patients reported adverse events. Conclusions: A 12-week supplementation with sodium butyrate, as adjunctive therapy, did not show efficacy in newly diagnosed children and adolescents with IBD.

Introduction: Lower gastrointestinal bleeding (LGIB) is not a rare clinical problem in children. The aetiology of LGIB varies according to age. Likewise, experiences in different countries reflect the disparities in the frequency of various causes of LGIB in children. Although some cases can be diagnosed clinically, choosing the appropriate diagnostic methods in children is challenging. The aim of the study was to determine the aetiology of LGIB in children and analyse the diagnostic procedures needed to make a diagnosis. Material and methods:The medical records of children with chronic LGIB admitted to the Paediatric Gastroenterology Department were reviewed. The diagnoses and diagnostic procedures were analysed according to age groups (< 5 with subgroups < 2 and 2-5, 5-10, and > 10 years old). Results: 227 patients were enrolled in the study. The most important causes of LGIB among all patients were constipation associated with anal fissures (36.6%) and inflammatory bowel disease (IBD) (33.5%). According to age groups, the main causes of LGIB were: up to 5 years old -constipation (39.62%) and food allergy (28.3%), in the youngest age subgroup up to 2 years old -food allergy (52.38%), between 5 and 10 years old -constipation (44%) and ulcerative colitis (14%), over 10 years old -IBD ulcerative colitis (36.29%), Crohn's disease (13.71%), and constipation (32.26%). Patients with IBD were more likely to have anaemia and weight loss. The level of faecal calprotectin was significantly elevated in children with IBD and colorectal polyps. Conclusions: Constipation is a common cause of LGIB in all age groups of children. Food allergy should be considered in infants and young children, but it is rarely seen in children over 5 years old. In children older than 5 years old, diagnostics for IBD should be carried out, especially in patients with weight loss, high levels of faecal calprotectin, and anaemia. Colorectal polyps and Meckel's diverticulum are less common causes of LGIB.

No abstract

No abstract