• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.2
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• pp.128-133
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• 2015

We present a case of an 8-year-old boy with visceral autonomic neuropathy complicated by Guillain-Barre syndrome. In this pediatric patient, gastroparesis was the major symptom among the autonomic symptoms. Due to the gastroparesis, there was no progress with the oral diet, and nutrition was therefore supplied through a nasojejunal tube and gastrojejunal tube via Percutaneous endoscopic gastrostomy (PEG). After tube feeding for 9 months, the patient's gastrointestinal symptoms improved and his oral ingestion increased. The pediatric patient was maintained well without gastrointestinal symptoms for 3 months after removal of the PEG, had repeated vomiting episodes which lead to the suspicion of cyclic vomiting syndrome. Then he started treatment with low-dose amitriptyline, which resulted in improvement. Currently, the patient has been maintained well for 6 months without recurrence, and his present growth status is normal.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.137-246
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• 2023

Background: To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine. Methods: The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively. Results: The CA severity was only associated with TKS (r = 0.515; P < 0.001), GSRS-total (r = 0.336; P < 0.001), GSRS-abdominal pain (r = 0.323; P < 0.001), GSRS-indigestion (r = 0.257; P = 0.002), GSRS-constipation (r = 0.371; P < 0.001), and MIDAS scores (r = 0.178; P = 0.033). Attack frequency (P = 0.015), attack duration (P = 0.035) and presence of CA (P < 0.001) were risk factors for kinesiophobia. Attack frequency (P = 0.027) and presence of CA (P = 0.004) were risk factors for GIS symptoms. Conclusions: There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.4
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• pp.227-235
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• 2017

Purpose: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. Methods: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. Results: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was $14.1{\pm}2.1$ years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. Conclusion: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.572-575
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• 2003

Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.

• Clinical and Experimental Pediatrics
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• v.53 no.9
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• pp.824-829
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• 2010

The safety and effectiveness of colonoscopy in the investigation of lower gastrointestinal tract pathology in children has been established for more than 2 decades in Korea. The skill and experience have since advanced to the point that both diagnostic and therapeutic colonoscopy are now routinely performed by most pediatric gastroenterologists. Pediatric colonoscopy differs significantly from its adult parallels in nearly every aspect including patient and parent management and preparation, selection criteria for sedation and general anesthetic, bowel preparation, expected diagnoses, instrument selection, imperative for terminal ileal intubation, and requirement for biopsies from macroscopically normal mucosa. Investigation of inflammatory bowel disease, whether for diagnosis or follow-up evaluation, and suspected colonic polyps are the most common indication for pediatric colonoscopy. The child who presents with signs and symptoms of lower gastrointestinal disorder should undergo colonoscopy with biopsy to make the diagnosis, as well as to help determine the appropriate therapy. This review introduces practical information on pediatric colonoscopy, the author's experiences, and the role of colonoscopic examination in the diagnosis and treatment of pediatric lower gastrointestinal disorders.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.120-124
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• 2008

Objectives : The current study aimed at assessing clinical symptoms and personality characteristics on MMPI of patients in Hwa-Byung clinic. Methods : Thirty-one female patients($45.4{\pm}8.4$ years old) who visited to the Hwa-Byung Clinic in Ewha womans Dongdaemoon hospital were recruited. Semistructured interviews and laboratory tests for symptoms were performed for the patients group. Patients group and control group($42.9{\pm}8.0$ years old) completed MMPI. Results : All patients had symptoms of chest tightness or chest pain. 19(61.3%) out of 31 patients had gastrointestinal complaints. There were respiratory symptoms in 13(41.9%) patients. 12 patients(38.7%) suffered from difficulties in their sleep. 12 patients(38.7%) had psychiatric symptoms including anxiety or depressed mood. 8 patients(27.6%) were diagnosed as gastrointestinal diseases by the laboratory test. After controlling age and education, scores of Hs, D, Hy, Pt on MMPI in patients group were significantly higher than control group (p=0.001, p=0.049, p=0.000, and p=0.029, ANCOVA, respectively). Conclusion : In the current study, patients who have visited Hwa-Byung clinic showed various somatic symptoms including chest tightness, gastrointestinal symptoms, complaints in respiratory system and psychiatric symptoms. Based on laboratory tests, considerable proportion of patients was diagnosed as physical illnesses. Additionally, patients in Hwa-Byung clinic have a tendency to be more hypochondriatic, depressed, hysteric and anxious.

• Journal of Oriental Neuropsychiatry
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• v.20 no.2
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• pp.187-196
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• 2009

Objectives : This study was performed to report the effect of oriental treatments for panic disorder with functional gastrointestinal disturbance. Methods : In this case, a 30 year-old female patient has been suffered by panic disorder with functional gastrointestinal disturbance for 10 years. This case can be caused by KanKiUlKyul(肝氣鬱結), KanKiBeomYi(肝氣犯胃) and KanKiSeungBi(肝氣乘脾). We treated the patient with Herbal medication, Cognitive-behavioral therapy and Relaxation therapy. The effects of treatment were measured by GSRS(Gastrointestinal Symptom Rating Scale), BPI(Brief Pain Inventory) and VAS(Visual Analog Scale) Results : As a result of oriental treatments, the symptoms of Panic Disorder with Functional Gastrointestinal Disturbance was improved. Conclusions : These results suggest that oriental treatments have an effect on Panic Disorder with Functional Gastrointestinal Disturbance.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8613-8618
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• 2016

Background: The symptoms of small bowel malignancies are mild and frequently nonspecific, thus patients are often not diagnosed until the disease is at an advanced stage. Moreover, the lack of sufficient studies and available data on small bowel cancer makes diagnosis difficult, further delaying proper treatment for these patients. In fact, only a small number of published studies exist, and there are no studies specific to Thailand. Radiologic and endoscopic studies and findings may allow physicians to better understand the disease, leading to earlier diagnosis and improved patient outcomes. Objective: To retrospectively analyze the clinical, radiologic, and endoscopic characteristics of small bowel cancer patients in Thailand's Siriraj Hospital. Materials and Methods: This retrospective analysis included 185 adult patients (97 men, 88 women; mean age = $57.6{\pm}14.9$) with pathologically confirmed small bowel cancer diagnosed between January 2006 and December 2013. Clinical, radiologic, and endoscopic findings were collected and compared between each subtype of small bowel cancer. Results: Of the 185 patients analyzed, gastrointestinal stromal tumor (GIST) was the most common diagnosis (39.5%, n=73). Adenocarcinoma was the second most common (25.9%, n = 48), while lymphoma and all other types were identified in 24.3% (n = 45) and 10.3% (n = 19) of cases, respectively. The most common symptoms were weight loss (43.2%), abdominal pain (38.4%), and upper gastrointestinal bleeding (23.8%). Conclusions: Based on radiology and endoscopy, this study revealed upper gastrointestinal bleeding, an intra-abdominal mass, and a sub-epithelial mass as common symptoms of GIST. Obstruction and ulcerating/circumferential masses were findicative of adenocarcinoma, as revealed by radiology and endoscopy, respectively. Finally, no specific symptoms were related to lymphoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.297-303
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• 2020

The musculoskeletal system can be involved as an extra-intestinal manifestation of inflammatory bowel disease. Among these, myositis in ulcerative colitis (UC) is very rare. A 14-year-old girl was admitted due to severe shoulder tenderness. She had complained of left jaw pain and swelling for the past 10 days. Inflammatory markers were elevated with no evidence of infectious etiology. Myositis was suspected by shoulder magnetic resonance imaging. Three days after admission, she developed hematochezia. Muscle biopsy and colonoscopy was performed due to worsening left mandibular area pain and persistent hematochezia. Colonoscopy showed consistent findings with UC. She was finally diagnosed with UC with myositis as an extra-intestinal manifestation. She showed a dramatic response to UC treatment. Gastrointestinal symptoms were well-controlled. After 14 months, UC symptoms and muscle pain were aggravated, which were relieved after steroid and cyclosporin treatment. We report a unique case of UC initially presented with myositis, preceding gastrointestinal symptoms.

• The Journal of Pediatrics of Korean Medicine
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• v.37 no.1
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• pp.15-44
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• 2023

Objectives The purpose of this study is to analyze the types of childhood simple obesity and suggest clinical symptoms, treatment principles, and traditional Chinese medicine (TCM) treatments for each type. Methods All kinds of literature published by the China National Knowledge Infrastructure (CNKI) up to August 20, 2022 were analyzed. We extracted information about types of childhood simple obesity, relevant clinical symptoms, treatment principles and TCM treatments. Results 25 studies were included. Spleen deficiency with dampness obstruction, gastrointestinal dampness-heat, internal excess of phlegm-dampness were the most reported. Spleen deficiency with dampness obstruction has symptoms of powerless, heavy limbs, pale tongue, teeth-marked tongue, sunken and slippery pulse. As a treatment, herbal medicine (HM) like modified Banggihwanggitang and acupoint like Joksamri were mainly reported. Gastrointestinal dampness-heat has symptoms of thirst, constipation, edacity, rapid hungering, heavy limbs, red tongue, slippery and rapid pulse. HM like Modified Xiehuangsan to clear heat was mainly reported. Internal excess of phlegm-dampness has symptoms of heavy limbs, lack of strength, tongue with white slimy fur, slippery pulse. Modified Ijintang to dry dampness to resolve phlegm was mainly reported. Conclusions This study analyzed types of pattern, clinical symptoms, treatment principles, and TCM treatments of childhood simple obesity. Based on this study, it is necessary to derive a standardized dialectical information that reflects the domestic situation.