This year I had the opportunity to give a lecture to our group that reviewed much of the important advances that happened in 2024. Here are some of the slides (if you have any trouble reading the slides, you can search for the original blog post using author name).
This blog entry has abbreviated/summarized the presentations. Though not intentional, some important material is likely to have been omitted; in addition, transcription errors are possible as well. All of the speakers had terrific presentations. The course syllabus is attached:
The 3rd Module had a “potpourri” of GI problems.
Extraesophageal Manifestations of Gastroesophageal Reflux –Ben Gold, MD (GI Care For Kids, Atlanta) (pg 86)
“Is reflux really the scurge of the earth and the cause of every malady known to human-kind in the head, neck, and lungs…?“
Key points:
Airway protection: “Aerodigestive disease reflexes are intact by 38 weeks gestation.”
Central deglutition apnea: a normal protective mechanism to prevent aspiration during swallowing. (Hasenstab KA, Jadcherla, S. J Pediatr 2014; 165:250-255). No proof at present that central apnea is caused by reflux though there is a biologic plausibility.
“Although reflux causes physiologic apnea, it causes pathologic apneic episodes in only a very small number of newborns and infants.” “When reflux causes pathological apnea, the infant is more likely to be awake and the apnea is more likely to be obstructive in nature.”
Laryngeal Reflux:
Asthma:
“Chronic cough, chronic laryngitis, hoarseness and asthma are multifactorial disease processes and acid reflux can be an aggravating cofactor.” GER is an unlikely contributor to asthma if reflux testing is negative.
“Two NIH-funded blinded, randomized placebo-controlled trials (RCT), one in adults (using esomeprazole), one in children (using lansoprazole) showed NO difference in asthma outcomes comparing placebo and acid suppression therapy”
Multi-Channel Intraluminal Impedance/pH probe studies: Pediatric studies are critically needed to determine if knowing the amount of nonacid reflux changes treatment or outcome
Proton Pump Inhibitors can cause gastric bacterial overgrowth (Rosen R et al JAMA Pediatr 2014; JAMA Pediatr. doi:10.1001/jamapediatrics.2014.696)
Ben Gold (speaker) and Jay Hochman prior to 5K Run
Related blog posts:
EoE: PPI, PPI-REE, TCS, OVB, SFED, 4FED….…Alphabet Distress — Sandeep K Gupta, MD (Indiana University) pg 105 in Syllabus
Treatment endpoints discussed -histologic, symptomatic, fibrosis, etc.
Related blog posts:
“Gotta keep on movin”: New tricks and treatments for motility disorders –Carlo DiLorenzo (Nationwide Children’s Hospital) pg 116 in Syllabus
Key points:
Treatments reviewed -“try everything”
Related blog posts:
What’s New in the Diagnosis and Management of Constipation –Manu Sood (Children’s Hospital of Wisconsin) -page 130 in Syllabus
Reviewed recent guidelines from NASPGHAN
“Miralax is considered a 1st line agent”
Outcomes in children with constipation:
Pointers:
Related blog posts:
Later this week, our national pediatric GI meeting (North American Society for Pediatric Gastroenterology Hepatology and Nutrition) is starting in Atlanta. Many in my group are involved and presenting.
The following link (with permission from NASPGHAN) is to the website with links to all of these lectures:
For those interested only in the Syllabus for the Postgraduate Course: NASPGHAN 2014 Postgraduate Course.
Topics include in this 200 page (online) book: primary sclerosing cholangitis, jaundiced infant, acute liver failure, “dreaded” endoscopy wake up calls, endoscopy for biliary tract disease, extraesophageal manifestations of gastroesophageal reflux, constipation, eosinophilic esophagitis, motility disorders, FODMAPs diet, nutrition for neurologically impaired, early onset inflammatory bowel disease, “luminitis” due to non-IBD causes, new IBD treatments, and diet-microbiome.
Should be great!
Also, to plan your meeting -go to NASPGHAN home page and use mobile guidebook: NASPGHAN 2014 has gone mobile using Guidebook!
gutsandgrowth 