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Background: Liver diseases are among the most commonly diagnosed conditions, with the main risk factors being inappropriate lifestyles, including poor diet, excessive alcohol consumption, low physical activity and smoking, including electronic cigarettes. Non-communicable chronic liver diseases also often develop as a result of accompanying overweight and obesity, as well as type 2 diabetes. Methods: The literature on risk factors for non-communicable chronic liver diseases, which show a high strong influence on their occurrence, was analysed. Results: Measures to prevent non-communicable chronic liver disease include the selection of suitable food ingredients that have proven protective effects on the liver. Such ingredients include dietary fibre, probiotics, herbs, various types of polyphenols and fatty acids (omega-3). Conclusions: Because of their liver-protective effects, nutritionists recommend consuming vegetables, fruits, herbs and spices that provide valuable ingredients with anti-inflammatory and anti-cancer effects. These components should be provided with food and, in the case of probiotics, supplementation appears to be important. As a preventive measure, a diet rich in these nutrients is therefore recommended, as well as one that prevents overweight and other diseases that can result in liver disease. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). These diseases are characterized by inflammation, which may be a consequence of changes in the intestinal microbiota and lead to mineral and vitamin deficiencies. The aims of this study were to determine the level of dietary supplement intake in children with IBD and to determine the influence of factors such as sex, nutritional status, diet, and other comorbidities on supplement intake. The study was conducted from May 2022 to September 2023 and was a prospective study. The group of children with IBD that ultimately qualified for the study numbered 96, and the control group numbered 30. The children who participated in the study were aged 4–18 years. Most parents of children with IBD (81.4%) declared that they use supplementation for their children, while 75% of parents of children without IBD declared giving their children nutritional supplements. Vitamins in both groups were most often given to children as dietary supplements (p = 0.018), including vitamin D. Depending on the diet used, the intake of vitamin B6 (p = 0.018), vitamin E (p = 0.040) and iron (p = 0.006) was significantly different among children with IBD. Statistical significance (p = 0.021) was observed for supplementation use and disease stage among children with IBD. For 80.2% of parents of children with IBD, the main reason for using supplements was a doctor's recommendation. In the control group, 43.3% of parents indicated that the main reason for using supplements was to correct nutritional deficiencies. Supplementation was common in both groups, but attention should be paid to other current diseases in children with IBD and to nutritional status. In our opinion, educating parents about supplementation is important, especially among parents of children with IBD. [ABSTRACT FROM AUTHOR]

Aim: In the study, we aimed to introduce a formula for measuring the oesophageal total wall thickness area, which could be used for developing an artificial intelligence-based algorithm for the detection of patients whose total wall thickness area exceeds the norms. Material and methods: Mathematical formulas for measuring the square area of the oesophageal total wall thickness area were introduced and applied. Children were grouped according to their weight in clusters. For each cluster, the range (minimal and maximal value) were established. The measurements were done by using the formula for the area of the circular ring according to the formula A = π (B2-b2); the product of π and subtraction square b (smaller radius) and square B (bigger radius). The basic data for our calculations were derived from papers published by Dalby et al., 2010 and Loff et al., 2022. Results: The square area (in mm2) of the oesophageal wall was calculated and proposed to be introduced for further analysis. This value set could be used for creating an algorithm for computer-aided analysis of patients diagnosed with sonographic examination and isolating patients for surveillance. Our newly introduced approach could be implemented in sonographic, computer tomography, and magnetic resonance examinations in eosinophilic oesophagitis and other oesophageal diseases. Conclusions: Total wall thickness area could be used for monitoring children with eosinophilic oesophagitis and other oesophageal diseases. The method could also be applied for adults. Therefore, it can be a foundation for further progress with applying artificial intelligence algorithms. [ABSTRACT FROM AUTHOR]

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We report the case of a 3-year-old girl who was admitted to the hospital because she had been passing tarry stools for about a month. Passing black, tarry stools is a distressing symptom and usually the result of gastrointestinal (GI) bleeding. Injury due to an ingested foreign body may be one of the causes of GI bleeding. The increasing popularity of magnetic toys in recent decades has raised the incidence of magnet ingestion in the pediatric population. Injuries caused by these objects carry a significant and potentially preventable risk of morbidity and even mortality in children. The clinical picture is variable and may include non-specific symptoms such as GI bleeding. It is important for pediatricians to consider the possibility of a foreign body in the GI tract in the diagnosis of GI bleeding and spread awareness about the danger of objects containing magnets. [ABSTRACT FROM AUTHOR]

Introduction: Electrogastrography (EGG) is a noninvasive diagnostic method recording gastric electrical activity with electrodes affixed to the abdominal wall overlying the stomach. The paper presents consensus on EGG with respect to indications, methodics, interpretation of the results in different age groups, as well as advantages and possible limitations of this diagnostic method reached by a panel of experts from leading Polish gastrointestinal clinics (children and adults) and research centres frequently applying this highly sophisticated technique who met at the 1st National Symposium on the Importance of Electrogastrography in Clinical Practice in Wroctaw on 12th of December 2009. Indications: According to the experts, EGG might be of some value in diagnostics and follow-up, predominantly in a variety of functional gastrointestinal disorders like irritable bowel syndrome, functional dyspepsia, aerophagia, cyclic vomiting syndrome, functional abdominal pain, functional diarrhea, functional constipation, nonretentive encopresis and some organic disorders, e.g. gastroesophageal reflux disease, diabetic and idiopathic gastroparesis, chronic intestinal pseudo-obstruction, postoperative and drug-induced dismotility, cystic fibrosis, hyper-/hypothyreosis, Parkinson's disease, anorexia nervosa/bulimia nervosa or renal failure. Methodics: Proper recording requires a set of optimal conditions like a warm and quiet room, thorough skin preparation and comfortable but relatively motionless supine or slightly reclining position. Typical EGG, usually carried out after withdrawal of agents affecting gastric motility prior to examination, consists of a fasting recording for 30-60 minutes followed by a short break for food intake (a test meal) and then postprandial examination lasting from 60 to 120 minutes. Interpretation of the results: Raw signals obtained during the examination undergo a visual and computer evaluation. The analysis of parameters characteristic for a traditional single channel EGG like dominant frequency (DF), dominant power (DP) or power ratio (PR) enables to define the final recordings as normogastria (2.4-3.7 cycles per minute - cpm), bradygastria (<2.4 cpm), tachygastria (>3.7 cpm), non-specific rhythm pattern, lack of postprandial power increase or uninterpretable waveform due to, for example, motion artefacts or other technical problems. Normal values may differ according to age of the patient. Uncoupling of slow waves, defined as the lack of synchronization between different parts of the stomach, is what a novel method known as multi-channel EGG can show due to simultaneous recording of signals with a help of four channels. In addition, multi-channel EGG enriched the range of parameters to be interpreted and striving for its application should be advised. However, clinical significance of some of these new indices deserves further study. Advantages and disadvantages of EGG: EGG is a noninvasive, relatively easy to perform and repeatable diagnostic method and, most likely, a valuable complementary tool in diagnostics and monitoring of the treatment of motility disorders in both children and adults. Nevertheless, EGG neither diagnoses unequivocally any specific disease nor is a substitute for other diagnostic modalities like a manometric study or scintigraphy. Moreover, EGG results may not enhance the currently available choice of medical therapy. In spite of the fact that the list of its indications is growing fast, there are still a lot of questions to be answered (selection of a test meal, quality improvement in signal acquisition, positive impact of the disclosed abnormalities on the management of affected patients, characteristics of the pathophysiology of EGG dysrhythmias, clinical significance of transient dysrhythmias, etc.). [ABSTRACT FROM AUTHOR]

Chronic abdominal pain is a very common complaint in the population of children and adolescents. In most cases, the usual cause are functional gastrointestinal disorders. However, in a few percent of children, the reason for persistent chronic stomach pain are organic diseases occurring in the gastrointestinal tract, as well as parenteral diseases, including uro-genital tract abnormalities, inflammation of the lower respiratory tract and cancer processes. Among organic causes, in addition to those commonly encountered, such as: intolerances and food allergies, gastroesophageal reflux disease, chronic gastritis or duodenitis, or urinary tract infections, the diagnosis should also include very rare causes, for example, neoplastic diseases, among them tumors of the abdominal cavity. In the case described in the present article, a 6-year-old girl with chronic abdominal pain, symptoms of gastro-oesophageal reflux and constipation, and previously diagnosed food allergy and lactose intolerance, was referred for widening the diagnosics due to the occurrence of alarm symptoms. The nodule revealed in the chest X-ray, in CT scan, turned out to be a paravertebral tumor with the specific features of neuroblastoma. After a macroscopically complete tumor resection based on the result of histopathological examination, the diagnosis of ganglineuroblastoma was established. The presence of alarm symptoms in anamnesis and physical examination in children with abdominal pain suggests a higher probability of the organic origin of the disease and should always lead to extended diagnostics. Ganglioneuroblastoma is a very rare disease, in most cases is located primarily in the abdominal cavity, and the most common associated symptom is abdominal pain.

Unlabelled: The aim of the study was to analyze the occurrence of anemia in children with newly diagnosed Crohn's disease and 3 months after the initiation of treatment depending on location and activity of the disease., Materials and Methods: 36 children aged from 2 to 18 years with newly diagnosed Crohn's disease treated in the years 2005-2011. According to the classification of Paris children were divided into 2 groups: II - 9 children (0-10 years); II - 27 children (11-17 years). We analyzed RBC, Hb, HCT, MCV, Fe, PCDAI at diagnosis and 3 months after the treatment, depending on the location and phenotype of the disease. Anemia was defined according to WHO criteria. Children were treated in accordance with the standards and activity of the disease. During the observation period supplementation of iron was not used. We analyzed the potential factors that could affect on the incidence of anemia., Results: In the group I mean activity of the disease was lower than in group II in both observed periods. No statistically significant differences in hemoglobin, red blood cell count, hematocrit and volume of erythrocytes at diagnosis and after 3 months were noted. The average iron concentration increased from 6.98 microg/dl to 9.95 microg/dl (p < 0.05) after the treatment. A statistically significant higher incidence of iron deficit in group II in both analyzed periods was observed, respectively, 66.7% vs 92.59% and 55.5% vs 77.77% (p < 0.05). Anemia was more frequent in group II (p > 0.05). After 3 months of treatment the incidence of anemia reduced from 63.88% to 44.4% (p < 0.05) and iron deficit from 83.3% to 72.2% (p > 0.05). Inflammatory changes in upper gastrointestinal tract were found in 61.1% of children with Helicobacter pylori infection in 8.3% of cases. Ileal location was observed in 52.7% of children, more often in group II than I, 62.9% vs 22.22% (p < 0.05). Isolated location of inflammatory lesions in the colon more frequently observed in group I than II, respectively 55.5% vs 29.6% (p < 0.05). Thiopurine were used in 38.8% of children more often in group II than I, respectively 48.1% vs 11.1% (p < 0.05). Corticosteroids were used in 50.0% of children, often in group II than I, respectively 55.5% vs. 33.3% (p > 0.05)., Conclusions: In children with newly diagnosed Crohn's disease anemia was diagnosed in 63.88% of the children and in 47.2% of children after 3 months of treatment (p < 0.05), iron deficiencies, respectively, in 83.3% and 72.2% of children (p > 0.05). 3-month treatment period of Crohn's disease has increased the iron concentration from 6.98 microg/dl to 9.95 mg/dl although the absence of supplementation (p < 0.05). In group II more often than in group I risk factors of anemia like changes in the upper gastrointestinal tract, the location of the ileum, intestinal villous atrophy and the use of immunosuppressive drugs were observed (p < 0.05). Anemia and iron deficiency were more often observed in the ileocolonic location than when the upper gastrointestinal tract was involved (adquately 55.5% vs 30.5%; p < 0.05 and 75.0% vs 41.6%; p < 0.05).

Blue rubber bleb nevus syndrome (BRBNS or Bean's syndrome) is a rare disease characterized by the interaction of hemangiomas of rubber-like tenacity in the skin and gastrointestinal tract, rarely in other organs. Cutaneous malformations are usually asymptomatic and not require any treatment. The most common symptoms of gastrointestinal tract are iron deficiency anemia and bleeding. Hemangiomas can occur in any organ and cause a wide spectrum of symptoms. BRBNS can cause massive bleeding and even death. In this article we present a case of Bean's syndrome in a 7,5-year-old girl with bleeding from the lower gastrointestinal tract, which has been caused by hemangiomas located in the skin, large intestine, chest and armpit.

Unlabelled: Cystic fibrosis is the most common, multiorgan inherited autosomal recessive disorder. The gene associated with this disease encodes the CF transmembrane conductance regulator (CFTR). The aim of this article is a presentation of 5-years-old girl with cystic fibrosis and associated liver disease as the only manifestation of CF., Case Report: We described the case of a 5.5-years-old girl with ascites and peripheral edema without of the symptoms. Laboratory tests revealed hepatic cell damage with cholestasis, extreme lipid abnormalities and hypocholesterolemia. Based on positive sweat test (CI: 122 mEq/l) and genetic analysis (homozygote deltaF508) the diagnosis of cystic fibrosis was confirmed. Patient was successfully treated with nutritional treatment and pancreatic enzymes.

The Aim of This Study: To evaluate the frequency and type of endoscopic and histopathological changes in upper gastrointestinal tract in children with inflammatory bowel diseases., Material and Methods: The study included 97 patients aged from 3 to 18 years (mean age 12.8 years, 45 girls and 52 boys) with inflammatory bowel diseases (IBD), treated in the 2nd Chair and Department of Pediatrics, Gastroenterology and Feeding of Children from 2005 to 2007. These children were divided into 3 groups depending on the clinical diagnosis: group 1: 38 children with ulcerative colitis (UC), group 2: 26 children with Crohn's disease (CD), and group 3: 33 children with indeterminate colitis (IC). In all patients upper gastrointestinal endoscopy was performed. During endoscopy biopsies were routinely taken from the stomach (antral region), the duodenum and all mucosal changes. H. pylori infection was detected by a positive culture. The obtained results were analyzed using 2 test (p<0.05)., Results: Esophageal changes were observed in 27.8% children with IBD, most frequently in CD and IC groups, respectively in 34.6% and 36.3% of children. No endoscopic abnormalities in the esophagus were noted in 72.2% of IBD children and the figure rises to 84.3% in UC children (p<0.05). Endoscopic examination of the stomach revealed no changes in 23.7% of IBD children, in 76.3% of these patients inflammatory lesions were observed. Only in 11.5% of the CD patient were no abnormalities in the stomach observed (p<0.05). In the CD group children mild endoscopic changes were observed in 53.8%, and severe in 34.6% of these patients. Ulceration of the duodenum, often in the descending part was revealed in 23.1% of CD children. Helicobacter pylori infection was found in 10.3% of the IBD children, most frequently in the IC group (12.1%). Histopathological examination confirmed esophageal changes in 31.9% of IBD patients, in the stomach and duodenum respectively in 77.3% and 48.4% of these children. Noncaseating granulomas were noted in 3.1% of the CD patients, partial villus atrophy was noted in 1 child with CD., Conclusions: In the group of IBD children, various inflammatory changes during the upper endoscopy were observed. Endoscopic examination most frequently revealed inflammatory changes of the stomach, less frequently of the duodenum and of the esophagus. Histopathological examination of IBD patients most frequently confirmed stomach changes. Less frequently histopathological changes were observed of the duodenum and of the esophagus, particularly in CD children. In the group of IBD children H. pylori infection was noted in few of the patients. Upper endoscopy in the IBD children is an important diagnostic tool and should be a part of monitoring the activity of the disease and results of the therapy.

Unlabelled: In patients with inflammatory bowel diseases, in inflamed alimentary tract mucosa the number of phagocytic cells (macrophages, neutrophils, monocytes), which are the source of reactive oxygen forms, is increased as compared with healthy mucosa. The intensity of the inflammation correlates with the production of free oxygen radicals., The Aim of the Study: To demonstration of connection between inflammatory process activity in ulcerative colitis and Crohn's disease and carbonyl groups level., Material and Methods: The study comprised 63 children hospitalized in The 2nd Chair and Department of Pediatrics, Gastroenterology and Feeding of Children. In 50 children inflammatory bowel diseases were diagnosed, including 26 with ulcerative colitis, 17 with Crohn's disease and 7 with indeterminate colitis; 13 patients composed control group. In all patients the amount of carbonyl groups in serum proteins, erythrocytes sedimentation rate, C-reactive protein, seromucoid, cytoplasmic and perinuclear types of antinuclear antibodies against neutrophils cytoplasm, were determined., Results: Among the children with inflammatory bowel diseases 58% had an increased content of carbonyl groups in the serum as compared to 7.7% in control group. In patient with inflammatory bowel diseases an improper concentration of carbonyl groups was more frequently observed in ulcerative colitis (69.2%) and this frequency increased along with activity of the disease., Conclusions: The content of carbonyl groups in the serum in patients with inflammatory bowel diseases increases with activity of inflammatory process and other selected markers of inflammation. There is a need to answer the question whether free radical scavengers can influence the treatment course in patients with inflammatory bowel diseases and whether they should be used routinely.

Unlabelled: In the last decades an increase in morbidity of inflammatory bowel disease, particularly of Crohn disease, in children has been observed., Objective: Assessment of clinical course and activity of inflammatory bowel disease in children younger than 5 years was the goal of the study., Material and Methods: The study comprised 21 children aged 2 to 5 years (13 boys and 8 girls) who were diagnosed with: Leśniowski-Crohn disease (7 children), ulcerative colitis (7 children) and indeterminate colitis (remaining 7 children)., Results: Among studied children boys prevailed (61.9%). In 6 children the disease started in the first and second year of life; the average age of disease onset was 26.9 months and the time between the onset of the disease and the diagnosis was 16.6 months. 46% of patients came from the cities with population above 100000 when only 23% lived in the country. Autoimmune diseases were diagnosed in the families of 6 children, food or pollen allergy in the families of 11 children. Abdominal pain, diarrhea, presence of blood and mucous in the stool, fever and lack of thrive were most apparent in the clinical picture. The pathological changes were present mainly in the large intestine and only in one case in the upper part of the alimentary tract and jejunum. The observed course of the disease was severe or moderate. In two children aged 3 years colectomy was performed., Conclusions: In children younger than 5 years severe and moderate course of the Leśniowski-Crohn disease and ulcerative colitis is apparent. Fever, abdominal pain, diarrhea, presence of blood and mucous in the stool and lack of appetite were the most often seen symptoms. Pathological changes in children younger than 5 years were present mainly in the large intestine and only in single cases in the upper part of the alimentary tract and jejunum. In children with inflammatory bowel disease a frequent occurrence of allergy, bronchitis, pneumonia and urinary tract infection, which required antibiotics, was observed.

Nodular lymphoid hyperplasia (NLH) is a rare condition with unknown etiology frequently associated with common variable immunodeficiency (CVID) and selective immunoglobulin A deficiency. NLH is a common cause of gastrointestinal bleeding. The risk of malignancy has been well recognized in subjects with NLH. The present knowledge about the nodular lymphoid hyperplasia (NLH) was described.

Unlabelled: Eosinophilic esophsgitis (EE) is a chronic inflammatory disease of the esophagus which is characterized by isolated eosinophilic infiltrations within squamous esophageal epithelium and by macroscopic lesions which lead to clinical symptoms of the disease. The aim of the work is presentation of the case of EE in a boy, together with discussion of epidemiology, pathophysiology, clinical symptoms and treatment basing on current literature. A case of a 18-years old boy with a allergy and dysphagia lasting since 6 months in whom eosinophilic esophagitis was recognized is presented., Conclusions: The authors emphasize necessity of extensive diagnostic, including histopatological study of esophagus mucosa specimens in pediatric patients in whom dysphagia is observed. It seems that there is a need for prospective studies in children, which would allow for determination of esinophilic esophagitis in Polish population.

Background: Pediatric abdominal pain is one of the most common symptom of children brought to attention of primary care physicians and pediatric surgeons. In many children clinical symptoms may be uncharacteristic and may lead to diagnostic difficulties., Aim: Clinical analysis of children with right lower quadrant abdominal pain suspected of appendicitis or children with periappendicular mass., Materials and Methods: The histories of 14 children aged from 18 months to 17 years treated in Pediatric Clinic were analysed. All children were operated because of right lower quadrant abdominal pain or abdominal mass before admission to the Pediatric Clinic or during hospitalization in Pediatric Clinic. Intraoperatively in all children pathologies other than appendicitis were the cause of symptoms., Results: The most often Crohn's disease were recognized (9 children), in 2 cases with concomitant other pathologies (fecal tumor of appendix in one case and with peritoneal abscess after perforation of intestinal wall). Sporadically the inflammation of the mesenterial lymph nodes caused by Yersinia infection suggested appendicitis. In one boy with ulcerative colitis, during exacerbation of the disease appendicitis complicated by rupture and peritonitis was observed. In 18-month old child with right lower quadrant abdominal mass invagination complicated by perforation of the ileum was recognized. In the case of 14-years old boy 6 months after appendectomy we observed mechanical intestinal obstruction complicated by perforation and peritonitis. Carcinoid of the appendix was the cause of abdominal pain in one child., Conclusions: 1. Appendicitis is the most frequent surgical etiology of the right lower quadrant pediatric abdominal pain. 2. Despite new diagnostic imagines there are no definite criteria to recognize appendicitis, in most cases physical examination and very carefull evaluation of abdominal pain are the most important. 3. All children with periappendipected of Crohn's disease. 4. All children with equivocal presentations of appendicitis and with normal appendix during operation should undergo further diagnostic evaluation.

Introduction: Infectious diseases are the most common cause of fever in children. Viral and bacterial infections of respiratory, gastrointestinal, central nervous system and urinary tract dominates. In the group of children with chronic fever in some cases inflammatory bowel diseases, immunodeficiency syndromes and infections of rare pathogens are diagnosed., Aim: Authors analysed retrospectively 10 children with chronic fever treated in the II Department of Pediatric Gastroenterology & Nutrition, Medical University of Wrocław., Results: In those children we diagnosed Crohn's disease (1 case), cat scratch disease (1 case), systemic fungial infection in the child with short bowel syndrome (1 case), severe immunodeficiency syndrome (3 cases), intraperitoneal abscess in a child with Crohn's disease (1 case), severe toxic diarrhoea in the course of treatment with cyclosporin (1 case), Yersinia enterocolitica infection (2 cases)., Conclusion: In the diagnostics of the prolonged fever in children various conditions and diseases ought to be considered.