Background: Chronic abdominal pain occurs frequently in pediatric patients with inflammatory bowel disease (IBD) in remission. Aims: To assess the prevalence and factors associated with Functional Abdominal Pain Disorders among IBD children in remission (IBD-FAPD). Methods: Patients with IBD for symbolscript 1 year, in clinical remission for symbolscript 3 months were recruited from a National IBD network. IBD-FAPDs were assessed using the Rome III questionnaire criteria. Patient-or parent-reported outcomes were assessed. Results: Among 102 included patients, 57 (56%) were boys, mean age (DS) was 15.0 symbolscript 2.0) years and 75 (74%) had Crohn's disease. Twenty-two patients (22%) had at least one Functional Gastrointestinal Disorder among which 17 had at least one IBD-FAPD. Past severity of disease or treatments received and level of remission were not significantly associated with IBD-FAPD. Patients with IBD-FAPD reported more fatigue (peds-FACIT-F: 35.9 symbolscript 9.8 vs. 43.0 symbolscript 6.9, p symbolscript 0.01) and a lower HR-QoL (IMPACT III: 76.5 symbolscript 9.6 vs. 81.6 symbolscript 9.2, p symbolscript 0.04) than patients without FAPD, and their parents had higher levels of State and Trait anxiety than the other parents. Conclusions: Prevalence of IBD-FAPD was 17%. IBD-FAPD was not associated with past severity of disease, but with fatigue and lower HR-QoL. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.

ABSTRACTObjectives:Crohn disease (CD) can affect patient's quality of life (QOL) with physical, social, and psychological impacts. This study aimed to investigate the QOL of children with CD and its relationship with patient and disease characteristics.Methods:Children ages from 10 to 17 years with diagnosed CD for more than 6 months were eligible to this cross‐sectional study conducted in 35 French pediatric centers. QOL was assessed by the IMPACT‐III questionnaire. Patient and disease characteristics were collected.Results:A total of 218 children (42% of girls) were included at a median age of 14 years (interquartile range [IQR]: 13‐‐16). Median duration of CD was 3.2 years (IQR: 1.7–5.1) and 63% of children were in clinical remission assessed by wPCDAI. Total IMPACT‐III score was 62.8 (±11.0). The lowest score was in “emotional functioning” subdomain (mean: 42.8 ± 11.2). Clinical remission was the main independent factor associated with QOL of children with CD (5.74 points higher compared with those “with active disease”, 95% confidence interval [CI] 2.77‐‐8.70, P < 0.001). Age of patient at the evaluation was found negatively correlated with QOL (−0.76 per year, 95% CI: −1.47 to −0.06, P = 0.009). Presence of psychological disorders was associated with a lower QOL (−9.6 points lower to those without, 95% CI: −13.34 to −5.86, P < 0.0001). Total IMPACT‐III and its subdomains scores were not related to sex, disease duration, or treatments.Conclusions:These results not only confirm that clinical remission is a major issue for the QOL of patients, but also highlights the importance of psychological care.

Introduction With advances in surgical and neonatal care, the survival of patients with oesophageal atresia (OA) has improved over time. Whereas a number of OA-related conditions (delayed primary anastomosis, anastomotic stricture and oesophageal dysmotility) may have an impact on feeding development and although children with OA experience several oral aversive events, paediatric feeding disorders (PFD) remain poorly described in this population. The primary aim of our study was to describe PFD in children born with OA, using a standardised scale. The secondary aim was to determine conditions associated with PFD. Methods The Feeding Disorders in Children with Oesophageal Atresia Study is a national cohort study based on the OA registry from the French National Network. Parents of children born with OA between 2013 and 2016 in one of the 22 participating centres were asked to complete the French version of the Montreal Children's Hospital Feeding Scale. Results Of the 248 eligible children, 145 children, with a median age of 2.3 years (Q1-Q3 1.8-2.9, min-max 1.1-4.0 years), were included. Sixty-one children (42%) developed PFD; 13% were tube-fed (n=19). Almost 40% of children with PFD failed to thrive (n=23). The presence of chronic respiratory symptoms was associated with the development of PFD. Ten children with PFD (16%) had no other condition or OA-related complication. Conclusion PFD are common in children with OA, and there is no typical profile of patients at risk of PFD. Therefore, all children with OA require a systematic screening for PFD that could improve the care and outcomes of patients, especially in terms of growth. This study of patients from the French national network oesophageal atresia (OA) registry used a standardised questionnaire to investigate the frequency of feeding disorders. These were diagnosed in 42%, of whom over a third had failed to thrive. The authors advocate systematic feeding assessment in follow up of children operated on for OA.

ABSTRACT Objectives: Dumping syndrome (DS) is mostly described as a complication of antireflux surgery in oesophageal atresia (OA) but we previously reported 2 cases of DS before any other surgery in infants operated at birth for OA. The objectives of the present study were to assess the prevalence of abnormal oral glucose tolerance test (OGTT) at 3 months of age in infants operated at birth with type C OA, to describe symptoms and clinical features, and to assess risk factors in infants presenting with abnormal OGTT suggestive of DS. Methods: A prospective case series study including infants with type C OA without fundoplication, born between 2013 and 2016 in 8 centres was conducted. An OGTT was performed between 2.5 and 3.5 months. Abnormal OGTT was defined as early hyperglycaemia (>1.8 g/L until 30 minutes; >1.7 g/L between 30 minutes and 2 hours; and >1.4 g/L between 2 and 3 hours) and/or late hypoglycaemia (<0.6 g/L after 2 hours). Results: Eleven of the 38 OGTT (29%) showed abnormalities. None of the patients’ demographics (birth weight, sex, prematurity, associated malformation, use of enteral nutrition) or conditions of the surgery tested was associated with abnormal OGTT. No clinical sign was specific for it. Conclusions: DS should be considered in every infant operated at birth for OA presenting with digestive symptoms. No risk factor was predictive for abnormal OGTT. An OGTT to screen for potential DS around 3 months of age should be considered in infants born with EA. Clinical Trial name and registration number: DUMPING NCT02525705

Esophageal covered self-expandable metallic stents (CSEMS) are rarely used in young children to treat esophagotracheal fistulas. We present a series of 3 children managed with CSEMS.