Journal of Pediatric Gastroenterology and Nutrition

06/19/2026

🧬🧒 New JPGN pilot study: Can the microbiome guide treatment decisions in pediatric Crohn disease?

This PAZAZ study tested a personalized approach using microbiome signatures to guide add‑on antibiotic therapy (azithromycin + metronidazole) alongside dietary therapy.

Key findings:

📌 Feasibility:
• Microbiome sequencing + prediction completed within 4 weeks in 92% of patients
• Real‑time microbiome-informed treatment allocation is achievable

📌 Clinical insight:
• Patients predicted to relapse often did NOT respond to initial dietary therapy
• This limited the planned treatment stratification strategy

📌 Outcomes:
• High dropout and need for therapy escalation
• Study not powered for efficacy—but highlights key challenges

📌 Why it matters:
• Moves microbiome-guided care from theory → real-world feasibility
• Suggests microbiome profiles may help identify **who responds to diet alone vs needs escalation early**

✨ Takeaway: Microbiome‑based precision medicine in pediatric Crohn disease is **feasible—but complex**, and may be most useful for **early treatment stratification rather than add‑on therapy**.

Full article: https://doi.org/10.1002/jpn3.70357?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer

06/19/2026

🧒🔪 New JPGN study: What predicts early complications after surgery in pediatric ulcerative colitis?

This single-center experience evaluates outcomes of minimally invasive colectomy and IPAA in children with UC.

Key findings:

📌 Safety & outcomes:
• Minimally invasive surgery (laparoscopic/robotic) is safe
• Comparable complication rates vs open surgery

📌 Recovery advantages:
• Faster return to feeding, bowel function, and discharge with laparoscopic approach
• Robotic surgery may further accelerate recovery

📌 Complication risk:
• ~26% experienced early postoperative complications
• Diagnosis before age 6 (VEO-IBD) significantly increased risk

📌 Clinical implications:
• Younger patients may require closer perioperative management
• Nutritional status may also influence outcomes

✨ Takeaway: Minimally invasive surgery improves recovery in pediatric UC—but **very early-onset disease carries higher complication risk**, highlighting the need for tailored perioperative care.

Full article: https://doi.org/10.1002/jpn3.70364?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer

Objective To report a single-center experience with a multidisciplinary minimally invasive surgical approach for pediatric ulcerative colitis (UC) and identify risk factors for early postoperative c...

06/18/2026

🧒🧠 New JPGN study: Symptoms in pediatric IBD don’t occur in isolation—they cluster.

Using ImproveCareNow data, this study identified distinct symptom profiles in adolescents with IBD.

Key findings:

📌 Three symptom clusters:
• Low Symptom Burden
• High Symptom Burden (pain, anxiety, depression, fatigue, sleep disturbance)
• Impaired Energy (sleep disturbance + fatigue)

📌 Who is at higher risk?
• Older adolescents
• More comorbidities
• Lower self-efficacy

📌 Key insight:
• Even with mild or quiescent disease, many adolescents report significant symptom burden

📌 Why it matters:
• Symptom clusters reflect **multidimensional disease impact**
• Highlight need for integrated biopsychosocial care—not just inflammation control

✨ Takeaway: Managing pediatric IBD requires more than disease activity scores—**fatigue, sleep, and mental health matter too.**

Full article: https://doi.org/10.1002/jpn3.70365?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer

06/18/2026

🚨🧒 New JPGN study: Which pediatric IBD patients are most likely to return to the ED?

This real-world cohort study (n=531) examined predictors of emergency department (ED) use in children with IBD.

Key findings:

📌 Strongest predictor:
• Prior ED visits → significantly increased risk of future ED use
• Applies to both all-cause and IBD-related visits

📌 High-risk period:
• ED use highest in the first month after diagnosis
• Risk declines but remains elevated over the first year

📌 Additional risk factors (all-cause ED use):
• Public insurance
• Recent IBD diagnosis (

06/17/2026

📊🧒 New JPGN study: Are we truly achieving treat‑to‑target goals in pediatric IBD?

This real‑world analysis evaluated how well children with Crohn’s disease and ulcerative colitis meet STRIDE‑II targets.

Key findings:

📌 Early success:
• Clinical remission + CRP normalization achieved within 5–10 weeks

📌 Delayed biomarker response:
• F***l calprotectin normalization lagged (12–19 weeks)

📌 Target achievement at 6 months:
• 54% (Crohn’s disease)
• 43% (ulcerative colitis)

📌 Relapse:
• More frequent in UC vs CD (67% vs 43%)

📌 Endoscopic healing:
• ~39% (CD) and 59% (UC) by ~1 year

✨ Takeaway: Even when early targets are met, **durability is a challenge**—especially in UC—highlighting the need for ongoing monitoring and treatment adjustment.

Full article: https://doi.org/10.1002/jpn3.70345?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer

06/17/2026

📊 The 3 most downloaded abstracts in Journal of Pediatric Gastroenterology and Nutrition (JPGN) in 23-25:

✔️ Cyclic vomiting syndrome
✔️ Helicobacter pylori
✔️ Pediatric feeding disorders

Interesting mix, right?

💭 From functional disorders
➡️ to infections
➡️ to complex feeding issues

This reflects the breadth — and complexity — of pediatric GI practice today.

👉 Which of these do you find most challenging in your practice?

06/16/2026

🧒📊 New JPGN study: Which children with ulcerative colitis won’t be in remission at 2 years?

Using data from the ImproveCareNow registry (n=1,290), this study identifies early predictors of poor long‑term outcomes in pediatric UC.

Key findings:

📌 2-year outcomes:
• ~30% of children were not in remission at 2 years

📌 Early predictors (within ~30 days):
• Higher disease severity (PUCAI) → higher risk of nonremission
• Higher BMI z-score → increased risk
• No early immunomodulator use → worse outcomes

📌 Important nuance:
• These predictors showed only modest discrimination (AUC ~0.60)

📌 Clinical implications:
• Early disease control matters
• Initial severity remains the strongest signal
• Treatment decisions soon after diagnosis may influence trajectory

✨ Takeaway: **Early disease activity predicts long-term control.** Prompt, effective management after diagnosis may help improve outcomes in pediatric UC.

Full article: https://doi.org/10.1002/jpn3.70370?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer

06/16/2026

📣📣📣 Liver topic of the month📣📣📣

Feeding strategy matters in biliary atresia.

In a retrospective cohort from Denmark and the Netherlands, breastmilk intake after Kasai was associated with preserved growth, lower bilirubin levels, and reduced cholangitis, whereas insufficient MCT intake was associated with poorer growth outcomes.

Further prospective studies are needed—but these findings reinforce the clinical importance of post-operative nutrition.

🔗 Read the paper: https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpn3.70384?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer

06/15/2026

🧒🫀 New JPGN study: Could H. pylori affect vascular health in children?

This study evaluated endothelial function in children with H. pylori infection and assessed changes after eradication therapy.

Key findings:

📌 Baseline differences:
• H. pylori-positive children had:
– Higher hs‑CRP (systemic inflammation)
– Higher cholesterol, triglycerides, and LDL
– Lower HDL and hemoglobin
– Reduced endothelial function (lower FMD)

📌 After eradication therapy:
• Significant improvement in:
– Endothelial function (FMD)
– Hemoglobin and HDL
• Reduction in:
– Inflammatory markers
– Adverse lipid profiles

📌 Correlations:
• Worse endothelial function associated with:
– Longer symptom duration
– Higher inflammation and cholesterol
• Better function associated with higher HDL

✨ Takeaway: Pediatric H. pylori infection may extend beyond the gut—affecting **vascular function and cardiometabolic markers**, with improvement after eradication.

Full article: https://doi.org/10.1002/jpn3.70351?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer

Objectives This study evaluated enothelial function in children with Helicobacter pylori (H. pylori) using flow-mediated dilatation (FMD) and assessed the effect of eradication therapy. Methods Si...

06/15/2026

🧠📊 New JPGN study: How reliable is pediatric anorectal manometry interpretation?

This multicenter study evaluated interrater reliability among 10 pediatric motility experts reviewing HR-ARM studies.

Key findings:

📌 Strong agreement for objective metrics:
• Resting pressure (ICC 0.97)
• Squeeze pressure (ICC 0.97)
• Squeeze duration (ICC 0.93)

📌 Weaker agreement for interpretation:
• Rectoanal inhibitory reflex (RAIR): fair agreement (κ=0.35)
• Bear down maneuver: moderate agreement (κ=0.50)
• Overall study interpretation: moderate agreement (κ=0.43)

📌 What this means:
• Quantitative measures are highly reproducible
• Interpretation of functional components is more variable

✨ Takeaway: Pediatric HR-ARM shows excellent reliability for measured parameters—but **standardization is urgently needed** for interpreting key clinical features like RAIR and defecation maneuvers.

Full article: https://doi.org/10.1002/jpn3.70346?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer