Evaluation of Gastrointestinal and Hepatological Problems in Obese Patients Evaluated in the Pediatric Gastroenterology Clinic with the Diagnosis of Hepatosteatosis
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Research Article
P: 130-134
August 2020

Evaluation of Gastrointestinal and Hepatological Problems in Obese Patients Evaluated in the Pediatric Gastroenterology Clinic with the Diagnosis of Hepatosteatosis

J Ankara Univ Fac Med 2020;73(2):130-134
1. Sağlık Bilimleri Üniversitesi, Keçiören Eğitim ve Araştırma Hastanesi, Çocuk Gastroenteroloji Kliniği, Ankara, Türkiye
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Received Date: 23.02.2020
Accepted Date: 13.04.2020
Publish Date: 21.07.2020
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ABSTRACT

Objectives:

There are many gastrointestinal (GI) and hepatic diseases for which obesity is the direct cause (eg, nonalcoholic fatty liver disease) or is a significant risk factor, such as reflux esophagitis and gallstones. In our study; we aimed to investigate the incidence of GI diseases in pediatric patients with obesity and hepatosteatosis and to evaluate the efficacy of diagnostic investigations for etiology in patients with hepatosteatosis and/or elevated transaminases.

Materials and Methods:

This study was retrospectively conducted in 201 pediatric patients who were diagnosed with obesity [body mass index (BMI) ≥95%] and hepatosteatosis between January and December 2018.

Results:

A total of 201 [55.2% (n=111) male] patients with a mean age of 12.9±3.4 years were included in the study. The mean BMI of the patients was 29.8 and the BMI standard deviation score was 2.69. Twenty-three (11.4%) of the patients had gastro esophageal reflux disease, 23 (11.4%) had constipation and 13 (6.5%) had functional abdominal pain and/or irritable bowel syndrome and 13 (6.5%) had symptoms compatible with gastritis. One of the patients with hepatosteatosis and elevated transaminases was diagnosed with autoimmune hepatitis and the other was diagnosed with alpha-1 antitrypsin deficiency.

Conclusion:

Consequently, obesity and obesity-related morbidities, which are increasing in the world and in our country, are an important health problem since childhood. GI diseases are quite common in obese patients. Other treatable causes of liver diseases should be evaluated in the follow-up of obese patients. In these patients, pediatric gastroenterology follow-up is absolutely necessary for multidisciplinary obesity management.

Keywords: Obesity, Fatty Liver Disease, Childhood

References

1
https://www.who.int/dietphysicalactivity/childhood_what/en/ (Erişim tarihi: 05/12/2019).
2
Styne DM, Arslanian SA, Connor EL, et al. Pediatric Obesity Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017;102:709-757.
3
Ogden CL, Carroll MD, Fryar CD, et al. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief. 2015;219:1-8.
4
Hedley AA, Ogden CL, Johnson CL, et al. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA. 2004;291:2847-2850.
5
Ogden CL, Carroll MD, Kit BK, et al. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311:806-814.
6
Ogden CL, Flegal KM, Carroll MD, et al. Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA. 2002;288:1728-1732.
7
Nam SY. Obesity-Related Digestive Diseases and Their Pathophysiology. Gut Liver. 2017;11:323-434.
8
Zachariah JP, Johnson PK. Pediatric lipid management: an earlier approach. Endocrinol Metab Clin North Am. 2014;43:981-992.
9
Marshall WA, Tanner JM. Variations in thepattern of pubertalchanges in boys. ArchDis Child. 1970;45:13-23.
10
Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44:291-303.
11
Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric Gastroesophageal Reflux Clinical Practic Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2018;66:516-554.
12
Jeffrey S, Hyams, Carlo DiLorenzo, et al. Childhood Functional Gastrointestinal Disorders: Child / Adolescent. Gastroenterology 2016;150:1456-1468.
13
Okimoto E, Ishimura N, Morito Y, et al. Prevalence of gastroesophageal reflux disease in children, adults, and elderly in the same community. J Gastroenterol Hepatol. 2015;30:1140-1146.
14
Anand G, Katz PO. Gastroesophageal reflux disease and obesity. Gastroenterol Clin North Am. 2010;39:39-46.
15
Leung AK, Hon KL. Gastroesophageal reflux in children: an updated review. Drugs Context. 2019;8:21-25.
16
Martigne L, Delaage PH, Thomas-Delecourt F, et al. Prevalence and management of gastroesophageal reflux disease in children and adolescents: a nation wide cross-sectional observational study. Eur J Pediatr. 2012;171:1767-1773.
17
Nelson SP, Chen EH, Syniar GM, et al. Prevalence of symptoms of gastroesophageal reflux during childhood: a pediatric practice-based survey. Pediatric Practice Research Group. Arch. Pediatr. Adolesc. Med. 2000;154:150-154.
18
Koebnick C, Getahun D, Smith N, et al. Extreme childhood obesity is associated with increased risk for gastroesophageal reflux disease in a large population-based study. Int J Pediatr Obes. 2011;6:257-263.
19
Pashankar DS, Corbin Z, Shah SK, et al. Increased prevalence of gastroesophageal reflux symptoms in obese children evaluated in an academic medical center. J Clin Gastroenterol. 2009;43:410-413.
20
Ho W, Spiegel BM. The relationship between obesity and functional gastrointestinal disorders: causation, association, or neither? Gastroenterol Hepatol. 2008;4:572-578.
21
Phatak UP, Pashankar DS. Obesity and gastrointestinal disorders in children. J Pediatr Gastroenterol Nutr. 2015;60:441-445.
22
Rasquin A, DiLorenzo C, Forbes D, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130:1527-1537.
23
Phatak UP, Pashankar DS. Prevalence of functional gastrointestinal disorders in obese and overweight children. Int J Obes. 2014;38:1324-1327.
24
Tambucci R, Quitadamo P, Ambrosi M, et al. Association Between Obesity/Overweight and Functional Gastrointestinal Disorders in Children. J Pediatr Gastroenterol Nutr. 2019;68:517-520.
25
Fishman L, Lenders C, Fortunato C, et al. Increased prevalence of constipation and fecal soiling in a population of obese children. J Pediatr. 2004;145:253-254.
26
Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN clinical practice guide line for the diagnosis and treatment of non alcoholic fatty liver disease in children: recommendations from the expert committee on NAFLD (ECON) and the North American society of pediatric gastroenterology, hepatology and nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr. 2017;64:319-334.
27
Welsh JA, Karpen S, Vos MB. Increasing prevalence of non-alcoholic fatty liver disease among United States adolescents, 1988-1994 to 2007-2010. J Pediatr. 2013;162:496.
28
Wong RJ, Aguilar M, Cheung R, et al. Non alcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology. 2015;148:547-555.
29
Rudolph B, Rivas Y, Kulak S, et al. Yield of diagnostic tests in obese children with an elevated alanine aminotransferase. Acta Paediatr. 2015;104:557-563.
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