Mizu Jiang

Background: Children referred for assessment of suspected gastroesophageal reflux disease (GERD) may present predominantly with gastrointestinal, respiratory, or chest symptoms. This study compared multichannel intraluminal impedance-pH (MII-pH) reflux characteristics across these presenting-symptom groups. Methods: This single-center retrospective cross-sectional study included 202 children monitored between September 2024 and June 2026. The principal comparison included 157 children aged ≥1 year: 32 with gastrointestinal, 86 with respiratory, and 39 with chest symptoms. Forty-one infants were analyzed separately. Group comparisons used nonparametric tests, with age- and sex-adjusted median and logistic regression for continuous outcomes and abnormal monitoring classifications, respectively. Results: In the principal comparison of children aged ≥1 year, the weakly acidic reflux proportion and proximal reflux ratio did not differ between the respiratory or chest symptoms group and the gastrointestinal group. However, the proportion of abnormal classifications recorded in the original clinical reports was higher in the gastrointestinal group (84.4% vs. 32.6% vs. 38.5%, p < 0.001; adjusted odds ratios 0.064 and 0.093 for the respiratory or chest symptoms groups, respectively). In an exploratory analysis of the infant cohort, which included only seven children with gastrointestinal symptoms, the non-gastrointestinal-symptom group had a higher weakly acidic reflux proportion (83.6% vs. 62.9%, p = 0.008), whereas the absolute number of weakly acidic reflux events did not differ significantly (36.0 vs. 61.0, p = 0.093). Conclusions: Children presenting predominantly with respiratory or chest symptoms did not exhibit higher weakly acidic or proximal reflux proportions than those with gastrointestinal symptoms. Differences in abnormal report-based MII-pH classifications should be interpreted cautiously because of potential interpretation bias and should not be considered evidence of independently confirmed differences in GERD prevalence.

Background: Oral rehydration salts (ORS) are essential for pediatric diarrhea management. However, not all children with diarrhea receive standardized ORS therapy. This study aimed to assess ORS utilization in the management of pediatric diarrhea among pediatricians in China and to identify factors associated with their ORS prescribing practices. Methods: A nationwide cross-sectional survey was conducted among 1,788 pediatricians participating in diarrhea training programs across China between August 2021 and April 2023. Data on demographics, professional characteristics, and ORS practices were collected. Chi-squared tests and logistic regression were used. Results: The overall ORS recommendation rate was 85.96%, with significant regional variation (highest: Central South China, 90.22%; lowest: Northeast China, 77.55%). Only 60.57% of pediatricians preferred reduced osmolarity ORS, with the lowest usage in Northwest China (41.73%). Furthermore, 36.81% used ORS only when the child was already dehydrated, 18.12% mistakenly believed that ORS was restricted to oral administration (rising to 25.52% in North China), and 42.51% incorrectly believed that ORS was exclusively for treating diarrhea (reaching 55.65% in North China). Although 98.61% provided guidance to parents, 21.87% incorrectly supported adding fruit juice or milk to ORS. Multiple logistic regression identified higher professional titles and specialization in pediatric gastroenterology as significant predictors of appropriate ORS prescribing practices. Conclusions: Deficits exist in the knowledge and practice of ORS in China, especially in specific regions and among certain pediatricians. Future targeted and specific pediatric diarrhea training programs may contribute to more standardized treatment of pediatric diarrhea.

Background: Global prevalence estimates of paediatric disorders of gut–brain interaction (DGBI) are largely unknown and published studies are hindered by heterogeneous methodology. Objective: To determine the multinational prevalence and burden of paediatric DGBI as defined by Rome V. Design: Caregivers of 8000 children aged 0–17 years from China, Italy, Mexico and the USA completed an online Rome V survey assessing gastrointestinal symptoms, illness burden and comorbid health conditions. Prevalence was calculated by DGBI category, country, sex and age. Results: Paediatric DGBI were highly prevalent, affecting 28.0% (95% CI 27.0% to 29.0%) of children. Upper DGBI were present in 8.7% (95% CI 8.2% to 9.5%) and lower DGBI in 23.7% (95% CI 22.8% to 24.7%). The most common lower DGBI were defecation and anorectal disorders (20.2%) followed by abdominal pain disorders (4.4%) and discomfort disorders (1.8%). The most common upper DGBI were gastroduodenal disorders (6.6%), followed by functional feeding disorders (3.4%) and oesophageal disorders (0.6%). Significant geographic differences were observed with the highest prevalence in Mexico and the lowest in China. There was a female predominance in gastroduodenal and discomfort disorders. Overall prevalence declined with age, from approximately 41% in children aged 0–3 years to 22% in adolescents. DGBI were associated with significant anxiety, depression, functional disability and healthcare utilisation, as well as parental time spent in care and coordination particularly when upper and lower DGBI overlapped. Conclusions: This global Rome V study demonstrates the high multi-national prevalence, burden and heterogeneity of paediatric DGBI, supporting improved recognition, classification, research and clinical care

Immunological workup revealed normal serum immunoglobulins, T lymphocyte subsets and complement levels (C3, C4). Comprehensive gastroscopy and colonoscopy were performed. Gastroscopy showed normal gastric mucosa. Colonoscopy revealed mucosal hyperaemia with scattered patchy erosions in the ileocecal region, ascending, transverse and descending colon. The sigmoid and …

Background Helicobacter pylori (H. pylori) is a Gram-negative obligate pathogen that colonizes the human gastric environment. Its identification fundamentally altered the historical perception of the stomach as sterile, marking a pivotal shift in gastric microbial research. For 30 years, the dynamic interplay between this bacterium and the gastric lining has been a key research focus. Data sources The development of next-generation sequencing and advanced bioinformatics has provided powerful, culture-independent tools for probing the intricate diversity of the gastric microbiome. Current investigations extensively cover microbe–microbe interactions within the stomach, the relationship between the resident microbiota and H. pylori, and the dialogue between the microbiome and the host. Results This article reviews current evidence detailing how H. pylori infection reshapes the microbial community on the human gastric mucosa. Conclusion Future research employing integrated multi-omics strategies is essential to unravel the long-term consequences of H. pylori on the mucosal ecosystem and host physiology. Graphic abstract The alternative text for this image may have been generated using AI.

Background: Irritable bowel syndrome (IBS) is a common disorder of gut‑brain interaction (DGBI) in children, but data on its clinical heterogeneity and nutritional profiles across different IBS subtypes remain limited. This study aimed to characterize the clinical features of IBS subtypes and assess variations in nutritional status across subtypes and sexes in hospitalized children. Methods: Children hospitalized with an initial diagnosis of IBS at the Children’s Hospital, Zhejiang University School of Medicine (January 2020 to October 2025) were enrolled. Demographic and clinical data regarding nutritional status were obtained. Results: Among 478 children with IBS (mean age, 12.29±2.19 years; 57.3% boys), diarrhea-predominant IBS (IBS-D) was the most common subtype (n=296, 61.9%), with a higher proportion of boys (66.6%). Sleep disturbances and symptom aggravation by cold/irritant foods varied by subtypes, with constipation-predominant IBS (IBS-C) being more likely to have sleep issues (P vs. 8.6% in normal-weight children) and decreased appetite (64.3%). Children with malnutrition and obesity had more psychiatric comorbidities (P=0.02). Boys with IBS-D had a higher BAZ (P=0.006) and obesity prevalence than girls (24.4% vs. 11.1% in girls, P=0.007). Conclusions: IBS-D predominated in hospitalized children, particularly in boys, and nutritional status differed across IBS subtypes and between sexes. These findings highlight the importance of comprehensive evaluation of nutritional status, psychological health, and lifestyle factors and support the need for individualized and multidisciplinary management strategies for children with IBS.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain, altered motility, and visceral hypersensitivity. Emerging evidence implicates G protein-coupled receptors (GPCRs) as key integrators of microbial, immune, endocrine, and neural signals in IBS pathophysiology. This review summarizes recent advances in understanding how GPCRs mediate gut immune regulation, microbiota–host crosstalk, metabolic signaling, and pain processing in IBS. Recent studies show that microbial metabolites (e.g., short-chain fatty acids, biogenic amines, and lipid mediators) signal through GPCRs on immune cells, epithelia, and neurons to influence intestinal homeostasis. On immune cells and neurons, GPCRs also mediate signals from external substances (such as fats, sugars, histamine, etc.) to regulate immune and neural functions. And there are challenges and future directions in targeting GPCRs for IBS, including patient heterogeneity and the complexity of host–microbiome interactions. This review provides a mechanistic framework for GPCR-based therapies in IBS.