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Article ; Online: Use of Lumen-Apposing Metal Stents for Inflammatory Bowel Disease-Related Strictures at a Pediatric Center: A Case Series.

Sharlin, Colby / Patel, Ashish / Fernando, Shahan / Carroll, Joshua / Procopio, Brianna / McOmber, Mark / McMahon, Lisa / Pasternak, Brad

JPGN reports

2021 Volume 2, Issue 2, Page(s) e055

Language	English
Publishing date	2021-03-08
Publishing country	United States
Document type	Case Reports
ISSN	2691-171X
ISSN (online)	2691-171X
DOI	10.1097/PG9.0000000000000055
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Increased Gut Permeability in First-degree Relatives of Children with Irritable Bowel Syndrome or Functional Abdominal Pain

McOmber, Mark / Rafati, Danny / Cain, Kevin / Devaraj, Sridevi / Weidler, Erica M. / Heitkemper, Margaret / Shulman, Robert J.

Clinical Gastroenterology and Hepatology. 2020 Feb. 01, v. 18, no. 2

2020

Abstract: Background & Aims: Increased gut permeability might contribute to the pathogenesis of irritable bowel syndrome or functional abdominal pain (IBS or FAP). We investigated whether siblings and parents of children with IBS or FAP have increased gut ... ...

Abstract	Background & Aims: Increased gut permeability might contribute to the pathogenesis of irritable bowel syndrome or functional abdominal pain (IBS or FAP). We investigated whether siblings and parents of children with IBS or FAP have increased gut permeability. Methods: We performed permeability tests (using sucrose, lactulose, mannitol, and sucralose) on 29 siblings and 43 parents of children with IBS or FAP, and 43 children (controls) and 42 parents of controls, from primary and secondary care. Permeability studies were repeated in 7 siblings and 37 parents of children with IBS or FAP and 23 controls and 36 parents of controls following ingestion of 400 mg of ibuprofen. Percent recovery of sucrose was calculated based on analyses of urine collected overnight; the lactulose/mannitol ratio and percent recovery of sucralose were based on analyses of urine samples collected over a 24-hour period. Results: When we controlled for age, sex, and family membership, siblings of children with IBS or FAP had increased small bowel permeability (urinary lactulose/mannitol ratio) vs controls (P = .004). There was no difference in gastroduodenal (percent sucrose recovery) or colonic (percent sucralose recovery) permeability between groups. Similarly, parents of children with IBS or FAP also had increased small bowel permeability, compared with parents of controls (P = .015), with no differences in gastric or colonic permeability. After administration of ibuprofen, gastroduodenal and small bowel permeability tended to be greater in IBS or FAP siblings (P = .08) and gastroduodenal permeability tended to be greater in IBS or FAP parents (P = .086). Conclusions: Siblings and parents of children with IBS or FAP have increased baseline small intestinal permeability compared with control children and their parents. These results indicate that there are familial influences on gastrointestinal permeability in patients with IBS or FAP.
Keywords	ibuprofen ; ingestion ; irritable bowel syndrome ; lactulose ; mannitol ; pain ; pathogenesis ; permeability ; sucralose ; sucrose
Language	English
Dates of publication	2020-0201
Size	p. 375-384.e1.
Publishing place	Elsevier BV
Document type	Article
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2019.05.011
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Technological imbalance: seeking a small-caliber duodenoscope.

Lin, Tom K / Barth, Bradley / Fishman, Douglas S / Fox, Victor L / Giefer, Matthew J / Gugig, Roberto / Kramer, Robert E / Liu, Quin Y / Mamula, Petar / McOmber, Mark E / Vitale, David S / Wilsey, Michael J / Troendle, David M

Gastrointestinal endoscopy

2022 Volume 96, Issue 6, Page(s) 1055–1057

MeSH term(s)	Humans ; Duodenoscopes
Language	English
Publishing date	2022-08-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2022.08.025
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Article ; Online: Quality indicators for pediatric colonoscopy: results from a multicenter consortium.

Thakkar, Kalpesh / Holub, Jennifer L / Gilger, Mark A / Shub, Mitchell D / McOmber, Mark / Tsou, Marc / Fishman, Douglas S

Gastrointestinal endoscopy

2016 Volume 83, Issue 3, Page(s) 533–541

Abstract: Background and aims: Currently, there are no quality measures specific to children undergoing GI endoscopy. We aimed to determine the baseline quality of pediatric colonoscopy by using the Pediatric Endoscopy Database System-Clinical Outcomes Research ... ...

Abstract	Background and aims: Currently, there are no quality measures specific to children undergoing GI endoscopy. We aimed to determine the baseline quality of pediatric colonoscopy by using the Pediatric Endoscopy Database System-Clinical Outcomes Research Initiative (PEDS-CORI), a central registry. Methods: We conducted prospective data collection by using a standard computerized report generator and central registry (PEDS-CORI) to examine key quality indicators from 14 pediatric centers between January 2000 and December 2011. Specific quality indicators, including bowel preparation, ileal intubation rate, documentation of American Society of Anesthesiologists Physical Status Classification System (ASA) class, and procedure time, were compared during the study period. Results: We analyzed 21,807 colonoscopy procedures performed in patients with a mean age of 11.5 ± 4.8 years. Of the 21,807 reports received during the study period, 56% did not include bowel preparation quality, and 12.7% did not include ASA classification. When bowel preparation was reported, the quality was described as excellent, good, or fair in 90.3%. The overall ileal intubation rate was 69.4%, and 15.6% reported cecal intubation only, calculated to be 85% cecum or ileum intubation. Thus, 15% of colonoscopy procedures did not report reaching the cecum or ileum. When excluding the proportion of procedures not intended to reach the ileum (31.5%), the overall ileal intubation rate increased to 84.0%. The rate of ileum examination varied from 85% to 95%, depending on procedure indication. Conclusions: Colonoscopy reports from our central registry revealed significant variations and inconsistent documentation in pediatric colonoscopy. Our study identifies areas for quality improvement and highlights the need for developing accepted quality measures specific to pediatric endoscopy.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Colonoscopy/standards ; Documentation/standards ; Female ; Humans ; Infant ; Infant, Newborn ; Intubation, Gastrointestinal ; Male ; Prospective Studies ; Quality Indicators, Health Care ; Registries ; Young Adult
Language	English
Publishing date	2016-03
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2015.06.028
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Article ; Online: Increased Gut Permeability in First-degree Relatives of Children with Irritable Bowel Syndrome or Functional Abdominal Pain.

McOmber, Mark / Rafati, Danny / Cain, Kevin / Devaraj, Sridevi / Weidler, Erica M / Heitkemper, Margaret / Shulman, Robert J

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

2019 Volume 18, Issue 2, Page(s) 375–384.e1

Abstract: Background & aims: Increased gut permeability might contribute to the pathogenesis of irritable bowel syndrome or functional abdominal pain (IBS or FAP). We investigated whether siblings and parents of children with IBS or FAP have increased gut ... ...

Abstract	Background & aims: Increased gut permeability might contribute to the pathogenesis of irritable bowel syndrome or functional abdominal pain (IBS or FAP). We investigated whether siblings and parents of children with IBS or FAP have increased gut permeability. Methods: We performed permeability tests (using sucrose, lactulose, mannitol, and sucralose) on 29 siblings and 43 parents of children with IBS or FAP, and 43 children (controls) and 42 parents of controls, from primary and secondary care. Permeability studies were repeated in 7 siblings and 37 parents of children with IBS or FAP and 23 controls and 36 parents of controls following ingestion of 400 mg of ibuprofen. Percent recovery of sucrose was calculated based on analyses of urine collected overnight; the lactulose/mannitol ratio and percent recovery of sucralose were based on analyses of urine samples collected over a 24-hour period. Results: When we controlled for age, sex, and family membership, siblings of children with IBS or FAP had increased small bowel permeability (urinary lactulose/mannitol ratio) vs controls (P = .004). There was no difference in gastroduodenal (percent sucrose recovery) or colonic (percent sucralose recovery) permeability between groups. Similarly, parents of children with IBS or FAP also had increased small bowel permeability, compared with parents of controls (P = .015), with no differences in gastric or colonic permeability. After administration of ibuprofen, gastroduodenal and small bowel permeability tended to be greater in IBS or FAP siblings (P = .08) and gastroduodenal permeability tended to be greater in IBS or FAP parents (P = .086). Conclusions: Siblings and parents of children with IBS or FAP have increased baseline small intestinal permeability compared with control children and their parents. These results indicate that there are familial influences on gastrointestinal permeability in patients with IBS or FAP.
MeSH term(s)	Abdominal Pain ; Child ; Humans ; Irritable Bowel Syndrome ; Lactulose ; Permeability
Chemical Substances	Lactulose (4618-18-2)
Language	English
Publishing date	2019-05-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2019.05.011
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Article: Pediatric functional gastrointestinal disorders.

McOmber, Mark A / Shulman, Robert J

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

2008 Volume 23, Issue 3, Page(s) 268–274

Abstract: Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. In this review, the authors highlight some of the common functional disorders seen in ... ...

Abstract	Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. In this review, the authors highlight some of the common functional disorders seen in pediatric patients (functional dyspepsia, irritable bowel syndrome, functional abdominal pain) as well as one of the more intriguing (cyclic vomiting). The most recent Pediatric Rome Working Group has modified the definitions of functional gastrointestinal disorders. Current studies have used these categorizations to understand better the epidemiology, etiology, and treatment options for these disorders. As more data are available, children and their families will be offered a better understanding of the conditions and more effective treatments to overcome them. The importance of making an accurate diagnosis of a functional gastrointestinal disorder cannot be overemphasized.
MeSH term(s)	Abdominal Pain/diagnosis ; Abdominal Pain/etiology ; Child ; Dyspepsia/diagnosis ; Dyspepsia/epidemiology ; Dyspepsia/pathology ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/epidemiology ; Gastrointestinal Diseases/pathology ; Humans ; Irritable Bowel Syndrome/diagnosis ; Irritable Bowel Syndrome/epidemiology ; Irritable Bowel Syndrome/pathology ; Recurrence ; Severity of Illness Index ; Vomiting/diagnosis ; Vomiting/epidemiology ; Vomiting/pathology
Language	English
Publishing date	2008-05-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
ZDB-ID	645074-x
ISSN	1941-2452 ; 0884-5336
ISSN (online)	1941-2452
ISSN	0884-5336
DOI	10.1177/0884533608318671
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Article: Pediatric Functional Gastrointestinal Disorders

McOmber, Mark A / Shulman, Robert J

Nutrition in clinical practice. 2008 June, v. 23, no. 3

2008

Abstract	Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. In this review, the authors highlight some of the common functional disorders seen in pediatric patients (functional dyspepsia, irritable bowel syndrome, functional abdominal pain) as well as one of the more intriguing (cyclic vomiting). The most recent Pediatric Rome Working Group has modified the definitions of functional gastrointestinal disorders. Current studies have used these categorizations to understand better the epidemiology, etiology, and treatment options for these disorders. As more data are available, children and their families will be offered a better understanding of the conditions and more effective treatments to overcome them. The importance of making an accurate diagnosis of a functional gastrointestinal disorder cannot be overemphasized.
Keywords	children ; economic impact ; epidemiology ; etiology ; health care workers ; indigestion ; irritable bowel syndrome ; pain ; patients ; vomiting
Language	English
Dates of publication	2008-06
Size	p. 268-274.
Publishing place	SAGE Publications
Document type	Article
ZDB-ID	645074-x
ISSN	1941-2452 ; 0884-5336
ISSN (online)	1941-2452
ISSN	0884-5336
DOI	10.1177/0884533608318671
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Role of ERCP in pediatric blunt abdominal trauma: a case series at a level one pediatric trauma center.

Garvey, Erin M / Haakinson, Danielle J / McOmber, Mark / Notrica, David M

Journal of pediatric surgery

2015 Volume 50, Issue 2, Page(s) 335–338

Abstract: Background: There is no consensus regarding the appropriate use of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric trauma. We report our experience with ERCP for management of pediatric pancreatic and biliary injury following blunt ... ...

Abstract	Background: There is no consensus regarding the appropriate use of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric trauma. We report our experience with ERCP for management of pediatric pancreatic and biliary injury following blunt abdominal trauma. Methods: A retrospective chart review was performed for pediatric patients with blunt abdominal trauma from July 2008 through December 2012 at our pediatric trauma center. For patients who underwent ERCP, demographics, injury characteristics, diagnostic details, procedures performed, length of stay, total parenteral nutrition use, and complications were reviewed. Results: There were 532 patients identified: 115 hepatic injuries, 25 pancreatic injuries and one gall bladder injury. Nine patients (mean age 7.8 years) underwent ERCP. Seven (78%) had pancreatic injuries, while two (22%) had bilateral hepatic duct injuries. The median time to diagnosis was one day (range, 0-12). Diagnostic ERCP only was performed in three patients, two of which proceeded to distal pancreatectomy. Five patients had stents placed (two biliary and three pancreatic) and four sphincterotomies were performed. Despite pancreatic stenting, one patient required distal pancreatectomy for persistent leak. Median length of stay was 11 days. Conclusions: Pediatric pancreatic and biliary ductal injuries following blunt abdominal trauma are uncommon. ERCP can safely provide definitive treatment for some patients.
MeSH term(s)	Abdominal Injuries/diagnosis ; Abdominal Injuries/surgery ; Adolescent ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Female ; Humans ; Infant ; Liver/injuries ; Liver/surgery ; Male ; Pancreas/injuries ; Pancreas/surgery ; Pancreatectomy/methods ; Retrospective Studies ; Stents ; Trauma Centers ; Wounds, Nonpenetrating/diagnosis ; Wounds, Nonpenetrating/surgery
Language	English
Publishing date	2015-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2014.08.017
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Article ; Online: Effects of timing, sex, and age on site-specific gastrointestinal permeability testing in children and adults.

McOmber, Mark E / Ou, Ching-Nan / Shulman, Robert J

Journal of pediatric gastroenterology and nutrition

2010 Volume 50, Issue 3, Page(s) 269–275

Abstract: Objectives: Measurement of gastrointestinal (GI) permeability is commonly used in research and often used clinically. Despite its utility, little is known about sugar excretion timeframes or the potential effects of age and sex on GI permeability ... ...

Abstract	Objectives: Measurement of gastrointestinal (GI) permeability is commonly used in research and often used clinically. Despite its utility, little is known about sugar excretion timeframes or the potential effects of age and sex on GI permeability testing. We seek to determine the timeframes of sugar excretion and the potential effects of age and sex on urinary recovery of the sugars. Subjects and methods: Healthy adults (n = 17) and children (n = 15) fasted 4 hours after the evening meal and then ingested a solution of sucrose, lactulose, mannitol, and sucralose. Urine was collected at 30, 60, and 90 minutes after ingestion and then each time the subjects voided during the next 24 hours. Each urine void was collected separately. Results: Median age for the adults was 47.5 years (range 21-57 years) and for children 10 years (range 5-17 years). There were no differences between children and adults in mean percent dose of sugar recovered. The time of peak urinary recovery of the sugars was generally similar between children and adults. Sucrose urinary recovery declined with age (P = 0.008; r2 = 0.19) unrelated to sex. Lactulose and sucralose urinary recovery declined with age in females (P = 0.05, r2 = 0.24 and P = 0.011, r2 = 0.41; respectively) but not in males. Conclusions: Overall, sugar urinary recovery is comparable in children and adults. Specific sugar urinary recovery may change as a function of age and/or sex. These results need to be taken into account when planning and interpreting gastrointestinal permeability studies.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Biomedical Research/methods ; Cell Membrane Permeability ; Child ; Child, Preschool ; Dietary Sucrose/pharmacokinetics ; Dietary Sucrose/urine ; Female ; Humans ; Intestinal Absorption ; Intestinal Mucosa/metabolism ; Lactulose/pharmacokinetics ; Lactulose/urine ; Male ; Middle Aged ; Sex Factors ; Sucrose/analogs & derivatives ; Sucrose/pharmacokinetics ; Sucrose/urine ; Time Factors ; Young Adult
Chemical Substances	Dietary Sucrose ; Lactulose (4618-18-2) ; Sucrose (57-50-1) ; trichlorosucrose (96K6UQ3ZD4)
Language	English
Publishing date	2010-01-08
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	603201-1
ISSN	1536-4801 ; 0277-2116
ISSN (online)	1536-4801
ISSN	0277-2116
DOI	10.1097/MPG.0b013e3181aa3aa9
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Article: Recurrent abdominal pain and irritable bowel syndrome in children.

McOmber, Mark E / Shulman, Robert J

Current opinion in pediatrics

2007 Volume 19, Issue 5, Page(s) 581–585

Abstract: Purpose of review: Recurrent abdominal pain continues to be one of the most ubiquitous conditions faced by the healthcare team, and has a significant emotional and economic impact. We have moved from considering it a psychological condition to ... ...

Abstract	Purpose of review: Recurrent abdominal pain continues to be one of the most ubiquitous conditions faced by the healthcare team, and has a significant emotional and economic impact. We have moved from considering it a psychological condition to recognizing the physiological and environmental contributions, and considering the condition in the framework of a biopsychosocial model where biology, psychology and social environment interact. Here, we review current studies addressing etiologies, diagnostic techniques and treatment options for recurrent abdominal pain in children. Recent findings: Studies continue to highlight the role of visceral hypersensitivity in recurrent abdominal pain. The psychological state of the child and the parent (most often the mother) in terms of their anxiety, somatization and coping skills can, however, modulate the expression of symptoms. Diagnosis still is made by history and physical examination. Newer treatment options include relaxation and distraction therapies as well as medications. The role of probiotics in children remains to be defined. Summary: The approach to the child with recurrent abdominal pain must include the recognition of the physiological contributions, and this information must be relayed to the child and parents. Acknowledgement also must be paid to the role of psychological state in the parent as well as in the child in modulating the severity of symptoms.
MeSH term(s)	Abdominal Pain/diagnosis ; Abdominal Pain/psychology ; Abdominal Pain/therapy ; Child ; Humans ; Irritable Bowel Syndrome/diagnosis ; Irritable Bowel Syndrome/psychology ; Irritable Bowel Syndrome/therapy ; Mothers/psychology ; Recurrence
Language	English
Publishing date	2007-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0b013e3282bf6ddc
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