Elisa Sciorio

Stool consistency, but not frequency, correlates with total gastrointestinal transit time in children.

OBJECTIVES To evaluate the correlation between stool characteristics (consistency and frequency) and gut transit time in children and to determine whether the Bristol Stool Form Scale is a reliable method of assessing intestinal transit rate in children. STUDY DESIGN From March 2011 to March 2012, 44 children (25 boys and 19 girls, mean age 7.8 years) with a diagnosis of functional constipation and 36 healthy, nonconstipated children (17 boys and 19 girls, mean age 7.6 years) were enrolled. All participants maintained a 1-week stool diary, recording the time and date of every bowel movement and stool form, and then completed a validated questionnaire on functional constipation according to Rome III criteria. Whole gut transit time (WGTT) was then assessed using the radiopaque markers test. RESULTS There was a significant correlation between stool form and WGTT in both constipated and nonconstipated children (correlation coefficient -0.84, P<.001). By contrast, there was no correlation between either stool frequency and WGTT or stool frequency and stool form. Multivariate logistic regression analysis, using WGTT as a dependent variable, showed that the sole variable significantly associated with WGTT was stool form (regression coefficient 2.9, OR 18.4, 95% CI 5.4-62.5, P<.001). CONCLUSION In this prospective, observational, case-control study, we show that stool form, as measured by the Bristol Stool Form Scale, rather than stool frequency, correlates with WGTT in both constipated and nonconstipated children.

Effect of magnesium alginate plus simethicone on gastroesophageal reflux in infants.

Objectives: Gastroesophageal reflux (GER) is a frequently occurring condition in infants capable of causing distressing symptoms. The aim of our study is to evaluate the efficacy of Mg alginate plus simethicone (Gastrotuss Baby, DMG Italia SRL, Pomezia, Italy), compared with rice-starch–thickened formula or with reassurance alone, in the treatment of GER in infants. Methods: The present randomized controlled trial was conducted in full-term infants affected by symptoms suggestive of GER, evaluated through a validated questionnaire (Infant Gastroesophageal Reflux Questionnaire Revised). The patients were randomized into 3 groups according to treatment (group A: Mg alginate plus simethicone; group B: thickened formula; group C: reassurance with lifestyle changes). Evaluation of symptom scores was performed after 1 month (T1) and 2 months (T2). Results: A total of 64 (85.3%) of 75 enrolled infants (median age 5 months; range 1–10) concluded the study. After 1 month of treatment (T1), infants treated with Mg alginate plus simethicone showed a statistically significant improvement in symptoms compared with the thickened formula and reassurance (P < 0.03, <0.0001, respectively). At the end of the study, all 3 groups of patients showed a significant reduction in symptom scores (P < 0.002, <0.038, <0.03, respectively). Median symptom score values were more significantly reduced in group A than in group B and in group C (group A vs group B P < 0.002; group A vs group C P < 0.0001; group B vs group C P < 0.001). Conclusions: Mg alginate plus simethicone seems to be more efficacious on GER symptom scores than thickened formula and reassurance with lifestyle changes alone.

Does cow's milk protein elimination diet have a role on induction and maintenance of remission in children with ulcerative colitis?

Aims of this study were to evaluate the efficacy of a cows milk protein (CMP) elimination diet on induction and maintenance of remission and to define association with atopy in children with ulcerative colitis (UC).

Do Children Just Grow Out of Irritable Bowel Syndrome

Objective Few data exist on natural history of irritable bowel syndrome (IBS) in children; therefore we investigated symptoms evolution over time in a cohort of children with IBS. Study design In this observational, single‐center study, we prospectively enrolled newly diagnosed children with IBS and reassessed them after 24 months. At both time points, patients completed a symptoms questionnaire, and a score of stool consistency was obtained. The therapeutic strategy adopted was also recorded. Results Eighty‐three children (age 11 years, range, 4‐16.6 years; 53 males) completed the study. Forty‐seven (56.6%) patients received no medical treatment, whereas polyethylene glycol, probiotics, and trimebutine were prescribed to 9 (10.8%), 24 (28.9%), and 3 (3.6%) subjects, respectively. Twenty‐four months after diagnosis, 48 children (57.8%) reported resolution of symptoms (P < .001), without differences between sexes (P = .35) or among IBS subtypes (P = .49). Of these, 30 (62.5%) had been only reassured and 18 (37.5%) had been prescribed medical treatment (P = .26). Despite not being statistically significant, symptoms resolution was more common in patients receiving no medical treatment than in those receiving probiotics (63.8% vs 41.6%, P = .08). Among patients with constipation‐IBS, no difference was found in symptoms resolution between patients receiving polyethylene glycol and those receiving no medical treatment (67% and 40%, respectively, P = 1). Conclusions Children with IBS are likely to show spontaneous symptoms resolution over a 24‐month follow‐up, regardless of sex, age, impact of symptoms on daily activities, and IBS subtypes.