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Objective: In celiac disease, a gluten-free diet is required for lifelong. Difficulties experienced by children with celiac disease can also negatively affect caregivers. The aim of this study is to evaluate the anxiety and depression of mothers having a child with celiac disease, and evaluate mothers’ attitude towards their children. Method: Thirty-six children with celiac disease, their mothers, and 36 healthy controls were included in the study. The Parent Attitude Research Instrument, State–Trait Anxiety Inventory, and the Beck Depression Inventory were completed by all mothers. Results: The mothers of children with celiac disease had significantly higher scores in depression and state-trait anxiety than the mothers of the healthy children. Mothers of children with celiac disease had significantly higher scores in the attitude of overparenting, authoritarian attitude and attitude of hostility and rejection than the mothers of healthy children. Conclusion: This study revealed that having a child with celiac disease might have negative effects on mothers and their attitudes towards their children. Because of psychopathologic risks appropriate psychologic support should be provided for mothers.

Background/aims Functional constipation (FC) is a common problem in childhood. In this study, we aimed to analyze the clinical and sociodemographic findings of patients with FC, parenting behaviors, and psychosocial states of children and parents. Materials and methods According to the Roma III diagnosis criteria, 32 patients with FC and 31 healthy controls were included. Patients' clinical and sociodemographic data set associated with constipation was determined. Strengths and Difficulties Questionnaire was used to screen the emotional and behavioral problems in children. To evaluate the parents and family, Beck Depression Inventory, State-Trait Anxiety Inventory, Parental Attitude Research Instrument were used. Results Emotional and peer problems subscale scores, parental concerns as well as over-parenting attitude were found higher in patients. Significant difference was also observed between the groups in terms of mean score of authoritarian attitude dimensions. Attitude of hostility and rejection and marital discordance was found to be significantly high in patient families. Our study revealed a decrease in the constipation rate with the increasing education level of parents, higher rate of constipation in families with less income than expenses, and lower rate of working mothers in patients with constipation. Parents' depressive symptoms and anxiety level were determined to be considerably higher. Conclusion A mother's low education level, low socioeconomic level, presence of psychological symptoms, and problems of parental attitude-primarily the authoritarian attitude-increase the risk of FC occurrence. Therefore, FC patients and their families should definitely undergo a psychosocial assessment.

Congenital intrahepatic portosystemic shunts are rare in children. Portosystemic venous malformations are characterized by extreme clinical variability. We report a full-term 33-day-old male infant presenting with neonatal jaundice. On physical examination, he had generalized icterus and the liver was palpable 3.5 cm below the right costal margin. He had no other symptoms. Laboratory tests showed AST 632 U/L, ALT 198 U/L, total bilirubin 12.1 mg/dL, conjugated bilirubin 10.2 mg/dL, alkaline phosphatase 753 U/L, GGT 47 U/L and glucose 67 U/L. Colour Doppler ultrasonography showed the left portal vein was more dilated than the right portal branch and communication with dilated left hepatic vein. There was no evidence of portal hypertension, heart failure, hepatopulmonary syndrome and encephalopathy during his hospital stay, so he was discharged from the pediatric department and his parents advised to attend monthly follow-up. Congenital portosystemic shunts are rarely observed in the childhood period. 1 Depending on anatomic characteristics they may be intrahepatic or extrahepatic. 2 Intrahepatic portosystemic shunts (PSS) are observed between the portal vein and hepatic vein or vena cava inferior. 3,4 Small shunts may close themselves before the age of 2 years. 5 With the increase in use of imaging methods, diagnosing PSS has become easier, with an increase in the number of cases reported. 6 Neonatal cholestatis is a frequent complication of PSS. 1 We present a case presenting with neonatal cholestasis diagnosed with congenital intrahepatic PSS.

Introducción. El estreñimiento funcional (EF) es un problema frecuente en la niñez. El objetivo fue investigar los hallazgos alimentarios y antropométricos de los niños con EF. Población y métodos. Se clasificó a los pacientes con EF según Roma IV. El grupo de referencia incluyó a niños sin diagnóstico de EF ni ninguna otra enfermedad. Se incluyó a los niños de los consultorios de gastroenterología pediátrica entre septiembre de 2017 y marzo de 2018. Se registraron peso, estatura e índice de masa corporal. Se usaron los puntajes Z del índice de masa corporal para identificar sobrepeso y obesidad. La desnutrición se definió según Waterlow. Se evaluaron los diarios de alimentación de tres días de ambos grupos; el mismo nutricionista calculó el promedio diario de calorías, fibra, hidratos de carbono, proteínas y grasa. Resultados. Se incluyó a 40 pacientes con EF y 40 controles sanos. Veinticuatro pacientes con EF tenían estatura y peso normales. No hubo diferencias significativas en el promedio diario de calorías, hidratos de carbono, grasa y fibra entre los grupos de EF y de referencia. Si bien la proporción (%) de proteínas en la dieta fue significativamente más baja en los niños con EF, la cantidad de proteínas ingerida a diario estuvo dentro de los límites normales en ambos grupos. Conclusión. La mayoría de los niños con EF tenían estatura y peso normales. No hubo una relación significativa entre el EF y el contenido de hidratos de carbono, grasa y fibra; solo proporciones bajas de proteínas en el EF. Introduction. Functional constipation (FC) is a common problem in childhood. This study intended to investigate the dietary properties and anthropometric findings of children with FC. Population and methods. Patients with FC were defined according to the Rome IV diagnostic criteria. The control group included children who were not diagnosed with FC or any other organic disease. The children who admitted to pediatric gastroenterology outpatient clinic between September 2017-March 2018 were included. Anthropometric measurements of weight, height, and body mass index were recorded. Body mass index z-scores were used to identify for overweight and obese children. Malnutrition was defined according to Waterlow criteria. The three-day nutritional diaries of both FC patients and control subjects were assessed and the daily average of calorie, fiber, carbohydrate, protein and fat intake were calculated by the same nutritionist. Results. Fourty patients with FC and fourty healthy control were included. Twenty-four patients with FC were in the normal height and weight ranges. There was no significant difference in the average daily calorie, carbohydrate, fat and fiber intake between the FC and control groups. Although protein ratios (%) in the diet were found to be significantly lower in children with FC, the amount of protein that taken daily was found to be within normal limits in both groups. Conclusion. Most children with FC were in the normal range for height and weight. There was no significant relationship between FC and carbohydrate, fat and fiber content in the diet, only low protein ratios were found in FC.

WOS: 000462484500011, PubMed ID: 30869487, Objectives. The aim of the present study was to investigate psychiatric symptoms in adolescents diagnosed as having chronic gastritis, and to evaluate family functioning. Methods. The population consisted of adolescents who were diagnosed endoscopically and histopathologically as having chronic gastritis without additional chronic disease. The anxiety levels, depression levels, and emotional and behavioral symptoms of the adolescents were measured using the Screen for Child Anxiety Related Emotional Disorders (SCARED), Beck Depression Inventory (BDI), and Strengths and Difficulties Questionnaire (SDQ). Family functioning was evaluated using the Family Assessment Device (FAD). Results. Fifty eight adolescents were included to study. According to the SDQ subscale results, adolescents with gastritis had more problems in emotional, hyperactivity, and peer relations areas, but the results in conduct problems and prosocial behaviors were normal. Levels of all subscales of Family Assessment Device were higher than 2, showing problems in family functioning. Conclusions. This study suggests that adolescents with chronic gastritis experience more difficulties in peer relations and family functioning, and they express more emotional problems.

WOS: 000452898000012, PubMed ID: 30874249, Symptoms of infantile inflammatory bowel disease (I-IBD) can be life-threatening and associated with poor prognosis. The presence of Mediterranean fever (MEFV) gene mutations play an important role in treatment of I-IBD. In this article, we describe a case of I-IBD with a resistant fistula, in which remission occurred following colchicine therapy. The patient was a six-month-girl with complaints of bloody diarrhea and a perianal abscess of three months duration. Laboratory tests revealed elevated inflammatory parameters, hypoalbuminemia, and anemia. Results of repeated viral, bacterial and parasitic analyses were negative. Endoscopic and histopathological examinations confirmed a diagnosis of I-IBD. Although diarrhea episodes decreased following intensive conventional treatment with immunosuppressive therapy and anti-tumor necrosis factor, the perianal abscess and fistula did not resolve. Molecular genetic analysis to identify causes of infantile disease revealed the MEFV gene mutation. Thus, colchicine was added to the treatment regimen. Following treatment with colchicine, defecation returned to normal, and the fistula resolved. The MEFV gene mutation should be investigated in children with infantile colitis and resistant fistulas, particularly in Mediterranean countries. In patients with infantile colitis who have the MEFV gene mutation, colchicine treatment may be an alternative to intensive immunosuppressive therapy.

Inflammatory myfibroblastic tumor (IMT), also known as inflammatory pseudotumor is unusual, benign solid tumor. This tumor is commonly reported in the lungs but can be present in extrapulmonary sites as well. We present the case of a 7-year-old girl with IMT in an unusual location. The patient was admitted with abdominal pain, and ultrasound showed a solid mass in the abdomen. She was operated and colocolic intussusception secondary to a mass was found. Histologic evaluation of mass revealed IMT.

Objective The aim of this study was to determine the incidence of coinfection with Helicobacter pylori and intestinal parasitosis in children with chronic abdominal pain (CAP) and to investigate the common risk factors in the development of both infections. Methods Ninety patients with CAP were enrolled in this study. Blood samples of each case were screened for human preformed IgG (HpIgG) antibodies, and stool samples were tested for HpSA and also examined for intestinal parasites by direct wet-mount, formalin-ethyl-acetate concentration, and Trichrome staining procedures. Cellophane tape test was used for Enterobius vermicularis. Children tested positive for HpIgG and/or HpSA were accepted as H. pylori positive. The risk factors were compared with a questionnaire. Results The incidence of Giardia intestinalis was 14.8% in the H. pylori-positive group and was found to be statistically higher than that in the H. pylori-negative group (1.6%). The positivity rates of H. pylori were found to be statistically higher in children attending school and using drinking water from taps. The incidences of parasitosis were significantly higher in children with a low maternal education level and with a history of parasitosis treatment in the family. Conclusion The most common etiologies of CAP in children are H. pylori infection and intestinal parasitosis. Improvement of hygienic conditions would be beneficial in preventing both infections.

Crohn’s disease is an inflammatory disorder and may affect any part of gastrointestinal tract. The signs and symptoms of Crohn’s disease are similar to many other abdominal disorders. Crohn’s disease does not typically present as an acute abdomen. However, Crohn’s disease should be considered in the differential diagnosis of patients with abdominal pain, especially relevant to patients with a long history of vague abdominal complaints and those with unexplained weight loss or growth retardation. In this case report, we present such a patient of acute abdomen admitted to us after appendectomy and diagnosed Crohn’s disease finally.