Ancuta Ignat, Marin Burlea, Valeriu V. Lupu, Nicoleta Gimiga and Gabriela Paduraru

ABSTRACT

The role of Helicobacter pylori bacteria in the pathogenesis of the digestive diseases now, is very well established and known, but recent research claims that Helicobacter pylori is involved in producing some extra-digestive diseases. The prevalence of the infection differs from one geographical area to another, registering a descending trend in developed countries and remaining at a constant level or even increasing in developing countries. Helicobacter pylori determines an immune response of the host, which involves humor and cell immunity. The infection is located in the gastric mucosa, but in recent years we have seen studies that try to explain some allergic diseases as the consequence, at least in some patients, of the chronic infection with Helicobacter pylori. The gastro-intestinal sufferings caused by the infection with H. pylori manifested by nausea, vomiting, anorexia, epigastric pains can be associated with nutritional disorders. Many recent studies prove that the infection with H. pylori is associated with anemia, and weight loss. Helicobacter pylori was identifi ed in most diabetic patients with autoimmune neuropathy, causing electric gastric disorders, the delay of the stomach evacuation, manifestations responsible of the dyspeptic symptoms in diabetic patients. The appropriate therapeutic behavior in the case of patients with extra-digestive affections and an eventual infection with H. pylori should concern both the basic disease treatment and the effi cient eradication of the infection.

Key words: Helicobacter pylori, extradigestive manifestations, child.

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Claudia Olaru, Smaranda Diaconescu, Nicoleta Gimiga, Elena Tataranu, Alexandru Lacatus and Marin Burlea

ABSTRACT

Constipation is a common health problem that affects children of all ages. The etiology is often functional, being the result of voluntary retention of the stool. A complete case history and a detailed physical examination are essential for an appropriate diagnosis. In most cases laboratory investigations are not required; they are indicated when a suspicion of an organic cause occurs (Hirschsprung disease, pseudoobstruction, hypothyroidism, diabetes insipidus, cystic fibrosis, congenital anorectal malformations) or in treatment-resistant cases. Early diagnosis is extremely important being associated with a better response to therapy. This includes performing DRE, colonoscopy, scintigraphy, colon videocapsule and anorectal manometry. The first stage of functional constipation treatment consists in desimpactation. Polyethylene glycol is effective and well tolerated. After desimpactation, a long-term maintenance program is necessary, due to increased frequency of relapses. Maintenance drugs include mineral oil, lactulose, polyethylene glycol and sorbitol. A diet rich in dietary fiber associated with family support and, when possible, child education are essential. The delay in diagnosis and treatment can lead to the progression into a chronic health problem with physical, psychological and social implications.

Key words: constipation, colonoscopy, anorectal manometry, child

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Ancuta Ignat, Gabriela Paduraru, Nicoleta Gimiga, Gabriela Ciubotariu, Valeriu V. Lupu and Marin Burlea

ABSTRACT

Inflammatory bowel disease (Crohn disease and ulcero-hemorrhagic rectocolitis) remains a chapter open to research due to its frequency (higher in the last decades), the clinical and evolutive particularities of digestive and extra digestive disorders, pathogenic enigma which represents a source of therapeutic difficulties. Specific genetic patterns and gene mutations favour the aberrant immune response to the antigens in the environment or the autoantigens causing bowel inflammations with high chronicization potential; the cytokines released and other still unknown mechanisms can be responsible for extra digestive disorders. The authors systematize recent data related to the pathogenesis of clinical evolutive types, modern diagnosis possibilities, the limits and the possibilities of modern therapeutic measures in arthropathies accompanying the inflammatory bowel disease.

Key words: inflammatory bowel disease, child, arthritis

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Nicoleta Gimiga, Smaranda Diaconescu, Claudia Olaru, Ancuta Ignat, Gabriela Paduraru, Valeriu V. Lupu and Marin Burlea

ABSTRACT

Gastrointestinal bleeding,a major and frequent urgency in pediatric gastroenterology can develop self-limited (75- 85% of cases) or severe, with hemodynamic compromised, when require clinical assessment, resuscitation and digestive endoscopy for diagnosis and possible treatment. Application of endoscopic parameters (Forrest classification) to assess recurrence and prognosis of gastrointestinal bleeding peg subsequent attitude. Therapeutic endoscopy within circumstances established by The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition choosing one of the techniques of injection, or mechanical coagulation in an individualized manner to etiopathogeny of gastrointestinal bleeding, it decreases the number of surgical intervention and frequency of deaths. Both early endoscopic diagnosis and endoscopic haemostatic therapy with endovenous administration of proton pump inhibitors, are measures that reduce bleeding and hemorrhage recurrence rate of 80-90%. Endoscopist experience will influence the readiness of surgical recommendation in serious, life-threatening cases.

Key words: gastrointestinal bleeding, endoscopic treatment, hemostasis

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