Friday, 18 May 2018

Recent advances in the pediatric Gastroenterology


Pediatric gastroenterology is described as a sub-specialty of gastroenterology and Pediatrics. It is agitated with treating the gastrointestinal tract, liver and pancreas of children from infancy till age eighteen. The main diseases concerned with it are, persistent vomiting, acute diarrhea, gastritis and problems with the development of the gastric tract.

The treatments by pediatric gastroenterologists are chronic or incurable, and impact not just during the child's initial years but throughout their adult life as well. Management strategies for these conditions need to encompass broad multidisciplinary approaches, with an emphasis upon optimal care in the short-term and enhanced outcomes in the long-term. Whilst providing consistent high-quality, child and family-focused care is important, the introduction of new treatments and the promise of future cure provide on-going challenges. The inflammatory bowel diseases are examples of such conditions.

The inflammatory bowel diseases comprise Crohn disease (CD) and ulcerative colitis (UC), Increasing rates of IBD have been seen in many areas of the world. In recent years it has been increased up to 10-fold in rates of CD and UC. High rates have been seen in individuals migrating from the Indian subcontinent to industrialized countries, such as Canada.

Pathogenesis of coeliac disease, it has become clear that there are a number of potential strategies by which these pathways could be interrupted. One very promising example is the development of vaccine-based treatment currently undergoing clinical trials in several countries. This novel immune-based strategy promises to lead to a new approach to the treatment of coeliac disease. Namely, the introduction of a vaccine will mean that individuals diagnosed with coeliac disease who are then treated with the vaccine, will subsequently be able to tolerate a gluten-containing diet, without need for gluten-free diet. This promise of a cure for coeliac disease could transform the limitations of coeliac disease, and make huge differences in the lives of many children and families. However, this approach is still the “ambulance at the bottom of the cliff.” The development of effective and safe preventative strategies may be even more important and have greater impact. One example of such an approach is the timing of introduction of gluten-containing foods in infancy.

Higher rates of childhood obesity have led to increased rates of non-alcoholic fatty liver disease. These changes have significant implications during childhood and also for future adult years. This condition has become an increasingly common indication for liver transplant, which consequently leads to a further set of long-term health issues.

The development and assessment of new diagnostic tools and markers would ensure optimization of initial assessment and on-going management, Furthermore; other endeavors should focus on advancing our understanding of the pathogenesis of specific conditions, providing impetus to finding cures.



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