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All Journal Paediatrica Indonesiana The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Yvan Vandenplas
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Health Professions Medicine & Pharmacology

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Evaluation and Management of the Pediatric Patients with Suspected Gastroesophageal Reflux Diseases Badriul Hegar; Yvan Vandenplas
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (277.402 KB) | DOI: 10.24871/1232011171-178

Abstract

Gastroesophageal reflux is a normal physiologic process occurring in healthy infants. Symptoms due to gastro-esophageal reflux diseases (GERD) are troublesome when they have adverse effects on the well- being of the patient. A thorough history and physical examination is generally sufficient to establish a clinical diagnosis of uncomplicated infant with gastroesophageal reflux. Poor weight gain is a warning sign. Irritability and regurgitation are associated with a wide range of physiologic and pathologic conditions. Heartburn or substernal burning is a reliable indicator for GERD in adolescents. Barrett esophagus does occur in children with severe chronic reflux. GERD is commonly cited as a cause of dysphagia; however, there are no strong pediatric data demonstrating this relationship. An etiologic role for reflux in reactive airways disease, such as asthma, has not been established. No test can determine whether reflux is causing recurrent pneumonia. Data showing the correlation between reflux and upper airway disease is weak, consisting mainly of case descriptions. Sandifer syndrome is an uncommon, but specific manifestation of GERD. Children with cerebral palsy are at particularly high risk of GERD. Similarly, children with certain genetic syndromes such as Cornelia de Lange and Down syndrome are prone to GERD. A higher prevalence of GERD and its complications has been reported in patients with a variety of chronic respiratory disorders including bronchopulmonary dysplasia and cystic fibrosis. GERD treatment is frequently administered to premature infants. However, the true prevalence of GERD is unknown. Keywords: gastroesophageal reflux diseases, infants, children
Esophagus and Its Function Related to Gastro-esophageal Reflux Badriul Hegar; Aldo Reynaldo; Yvan Vandenplas
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (320.109 KB) | DOI: 10.24871/1332012166-173

Abstract

ABSTRACTThe main function of the esophagus is to transport food from the mouth into stomach. Anatomical structures, innervations and blood supplies are needed in order to transport the food into stomach. Mastication stimulates the parasympathetic nerves that regulate salivary, gastric and pancreatic secretion. Saliva secretion stimulates swallowing and increases primary esophageal peristalsis, helps in clearing the esophagus from refluxed material. Swallowing induces peristaltic of esophagus that propulses a solid bolus down the esophagus into the stomach.      Innervations are important for esophagus to do its function. One of the most important is coordination between the various reflexes. Delayed clearance of acid from the esophageal and decreased pressure of the lower sphincter esophagus (LES) are the major mechanisms involved in the development of esophagitis. The resistance of the mucosa to the noxious effect of the refluxed material (acid, pepsin, chymotrypsin and trypsin, bile, etc.) is different from person to person. The LES pressure is a defense mechanisms to prevent gastro-esophageal reflux disease (GERD). The LES pressure decreases postprandially. The frequency of postprandinal GER is related to the meal size. Gastric bolus feeding is related to greater intragastric pressure causes more of transient LES relaxations. Osmolality and volume of the feeding slow gastric emptying and incrase postprandial GER. The occurrence of GERD is associated with whether or not the preventive factors are functioning. Other preventive factors for GERD are esophageal peristalsis, secretion and mucosal resistance, gravity and position, the LES tone and angle of his. Patient with GERD should be searched for any disturbances on those factors. Keywords: gastroesophageal reflux diseases, lower esophageal sphincter, esophagitis, peristaltic 
Helicobacter pylori infection in children Yvan Vandenplas
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 1, NUMBER 1, December 2000
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112000%p

Abstract

Helicobacter pylori colonizes the stomach of man, especially during childhood. However, H. pylori strains are not created equal, with major differences in virulence factors such as the vacuolating cytotoxin A and the cytotoxic-associated gene A, probably accounting for different clinical symptoms. The majority of infected subjects remain asymptomatic. Symptoms are aspecific. Helicobacter pylori infection is correlated with socioeconomic conditions and hygienic circumstances, resulting in an extremely high prevalence in children in developing countries. The golden standard technique to diagnose Helicobacter infection is culture of gastric biopsies; specificity and sensitivity of serology are low during childhood. Carbon-13 urea breath tests are a useful in the diagnosis but especially during follow-up. Recommended treatment consists of proton pump inhibitors in combination with two antibiotics out of amoxycillin, clarithromycin and metronidazole. The importance or clinical relevance of Helicobacter infection in asymptomatic individuals remains to be determined.Key words: Helicobacter pylori, gastritis
Superior mesenteric artery blood flow in infants of very preterm and very low birthweight and its related factors Evita Karianni Bermanshah Ifran; Wresti Indriatmi; Tetty Yuniarti; Nadjib Advani; Saleha Sungkar; Dewi Irawati Soeria Santoso; Rinawati Rohsiswatmo; Yvan Vandenplas; Badriul Hegar
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.80-7

Abstract

Abstract Background Significant hemodynamic changes in preterm infants during early life could have consequences, especially on the intestinal blood flow. Alteration of superior mesenteric artery (SMA) blood flow may lead to impairment in gut function and feeding intolerance. Objectives To assess SMA blood flow velocity in very preterm and/or very low birth weight (VLBW) infants in early life and to elucidate the factors influencing them. Methods This is a cross-sectional study conducted in NICU at Cipto Mangunkusumo Hospital, Jakarta. Superior mesenteric artery (SMA) blood flow was evaluated by peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) measurement using Color Doppler US at < 48 hours after birth. Maternal and neonatal data that could be potentially associated with SMA blood flow were obtained. Bivariate analyses were conducted with a P value of < 0.05 considered significant. Results We examined 156 infants eligible for the study. PSV, EDV, and RI of SMA blood flow were not related to both gestational age and birth weight. Infant with small for gestational age (SGA) showed significantly lower EDV median [15.5 (range 0.0-32.8) vs 19.4 (range 0.0-113.0)] and higher RI [0.80 (range 0.58-1.00) vs 0.78 (range 0.50-1.00)] compared to appropriate for gestational age (AGA). Infants born from mother with preeclampsia showed lower PSV median [(78.2 (range 32.0-163.0) vs 89.7 (range 29.2-357.0)]) and EDV [16.2 (range 0.0-48.5) vs 19.4 (range 0.0-113.0)] compared to without PE, while absent/reverse end-diastolic velocity (AREDV) revealed a lower EDV median [16.9 (range 0.0 – 32.4) vs 19.4 (range 0.0 – 113.0)] compared to no AREDV. Furthermore, infants with hs-PDA showed lower EDV median [16.2 (range 0.0-113.0) vs 19.4 (range 0.0-71.1)] but higher RI median [0.80 (range 0.50-1.00) vs 0.78 (range 0.55-1.00)] compared to non hs-PDA. No difference in SMA blood flow across other factors was observed.
Functional gastrointestinal disorders in adolescents during online learning Simanjuntak, Sumardi F.; Prawitasari, Titis; Kadim, Muzal; Sari, Teny Tjitra; Gunardi, Hartono; Vandenplas, Yvan; Hegar, Badriul
Paediatrica Indonesiana Vol 63 No 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.353-60

Abstract

Background The COVID-19 pandemic necessitated the use of online schooling in order to comply with national and local lockdown guidelines. Online learning required students and teachers to adapt to a new method of schooling. The inability of adolescents to adapt to their environment can interfere with their psychosocial condition and become a risk factor for functional gastrointestinal disorders (FGID). Objective To determine the prevalence of FGID in adolescents and evaluate possible risk factors that existed during online learning. Methods This cross-sectional study was done in children aged 12-18 years who participated in online learning during the COVID-19 pandemic. The diagnosis of FGID was based on Rome IV criteria. Psychosocial problems were assessed using the Pediatric Symptom Checklist Questionnaire–17 (PSC-17) which includes internalization, externalization, and attention subscales. Subjects with a PSC-17 mixed subscale total score of >15 were considered as having an increased likelihood of having a behavioral health disorder. Data were collected by online questionnaires via Google Forms. Results Of 1,413 participants, 23% experienced FGID; of these, 32.6% had >2 FGID diagnostic criteria. Upon multivariate analysis, internalization psychosocial problems were the most common risk factors for FGID, followed by mixed subscale psychosocial problems, unstable internet connection, and not understanding of the material. ConclusionThe prevalence of FGID in adolescents in this study is 23%. Environmental and psychosocial conditions are interrelated as risk factors for FGID in adolescents during online learning in the COVID-19 pandemic.
Intestinal microbiota and health in infants and children Hendricx, Fabian; Vandenplas, Yvan
Paediatrica Indonesiana Vol 63 No 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.325-7

Abstract

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Co-Authors Aldo Reynaldo Aldo Reynaldo Badriul Hegar Badriul Hegar Badriul Hegar Evita Karianni Bermanshah Hartono Gunardi Hendricx, Fabian Muzal Kadim Nadjib Advani Rinawati Rohsiswatmo Saleha Sungkar Santoso, Dewi Irawati Soeria Simanjuntak, Sumardi F. Teny Tjitra Sari, Teny Tjitra Tetty Yuniarti Titis Prawitasari, Titis Wresti Indriatmi