AimThe practical value of using fibre‐enriched enteral feeding regimens to rehabilitate malnourished children remains inconclusive. This study determined the usage patterns, gastrointestinal tolerance, anthropometrics and safety of high‐fibre enteral feeding in malnourished children with growth failure.MethodsThis Turkish observational study between February 2013 and June 2015 comprised 345 paediatric patients from 17 centres with malnutrition‐related growth failure, with a weight and height of <2 SD percentiles for their age. Changes in anthropometrics, gastrointestinal symptoms, defecation habits and safety data relating to adverse events were analysed during the six‐month follow‐up period.ResultsMost subjects (99.7%) were supplemented with enteral feeding. The absolute difference and 95% confidence interval values for the Z scores of height for age, weight for age, weight for height and body mass index for height increased significantly in four months to six months to 0.21 (0.09–0.32), 0.61 (0.51–0.70), 0.81 (0.56–1.06) and 0.70 (0.53–0.86), respectively (p < 0.001 for each). The percentage of patients with normal defecation frequency significantly increased from 70.3% to 92.8% at the four months to six months visit (p = 0.004). Adverse events occurred in 15 (4.3%) of patients.ConclusionUsing a six‐month high‐fibre enteral feeding was associated with favourable outcomes in anthropometrics, appetite, gastrointestinal tolerance and safety in malnourished children.

IntroductionExcessive crying is a common semptom in the first three months of life. This situation named as infantile colic (first three months colic) is seen 10%–40% of the babies. Some theories were asserted in order to explain infantile colic, however they could not explain the aetiology in a certain way. In recent years, it is claimed that the changes in intestinal microbiota can result the colic. Measurement of faecal calprotectin showing the intestinal inflammation could be helpful for the diagnosis of infantile colic.AimThe purpose of our study was measuring the levels of faecal calprotectin among babies with and without infantile colic to highlight the aetiology of the problem and to develop appropriate diagnostic criteria for the diagnosis.Cases-methodThe study was performed at the General Paediatrics Clinic in Medipol Mega University Hospital, levels of faecal calprotectin were measured in 70 babies aged 1–3 months. Of all these infants 35 had infantile colic. Stool samples were examined with Elisa Method by using Philcalpro kit in Istanbul University Paediatric Gastroenterology Laboratory. All babies were followed at least one year.FindingsSocio-demographic and feeding characteristics of the infants with or without infantile colic were similar. The faecal calprotectin levels in the study group were significantly higher than those in the whole group. Median calprotectin values of study and control groups were 651 and 354 µgr/g respectively. There was no significant difference between the children with high calprotectin levels (>350 µgr/g) in terms of birth weight, gender, type of delivery, dietary patterns and probiotic usage. During the follow-up period, 4 children in the study group and 3 in the control had the diagnosis of food allergy. In conclusion, the high levels of calprotectin in stool may indicate the presence of intestinal inflammation may play a role in the aetiology of infantile colic.

Summary Background: Crohn’s disease (CD) and ulcerative colitis (UC) are the two major relapsing conditions of inflammatory bowel diseases. Case Report: A case of Crohn’s disease with orofacial manifestations in a 10 year old girl is described. She had suffered from fever, dysphagia, arthralgia, painful recurrent ulcers of the oral mucosa and swelling of the lower lip lasting over 6 weeks. Clinical examination and the punch biopsy from the buccal mucosa revealed major recurrent aphthous ulcerations. A partial regression and significant relief of lesions were achieved two weeks after the treatment, but the patient suffered from abdominal pain, irregular bowel movements, arthritis, multiple hyperplastic and swollen mucosal folds, after 3 months. The patient was referred to a pediatric gastroenterologist. Esophagogastroduodenoscopy showed pyloric ulcer formation. Abdominal ultrasound showed increased thickening of the ileal wall with multiple enlarged lympadenopathies in the periileal region. Colonoscopy images showed deep ulcers with surrounding erythema. The histopathological examination of biopsies from the terminal ileum and the colon showed basal plasmacytosis, minimal crypt distortions and aphthous ulcerations. The diagnosis of Orofacial Crohn’s disease was made. Exclusive enteral nutrition for 8 weeks, followed by azathiopurine treatment was started with an excellent clinical response on abdominal and oral symptoms. Conclusion: Diagnosis of the disease by dentists and other clinicians through the evaluation of oral clinical findings is very rare. Mucocutaneous and granulomatous lesions of the oral cavity should alert the clinician to pursue an underlying systemic cause. Early communication with a gastroenterologist can help early diagnosis of Crohn’s disease for better patient management and prognosis.