Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Care of the Child with a Gastrointestinal Disorder

  • Chapter
  • First Online:
Pediatric Diagnostic Labs for Primary Care: An Evidence-based Approach

  • 487 Accesses

Abstract

The child who presents with a possible gastrointestinal disorder needs a complete history and physical and a careful diagnostic plan when ordering diagnostic laboratory tests. The sensitivity, specificity, positive and negative likelihood ratios, and pretest probability of your working diagnosis help the clinician decide what diagnostic laboratory tests to order. Diagnostic stewardship asks the clinicians to order tests based on a careful history and physical. The child with jaundice may require specialty care, but an initial workup in primary care helps the specialist decide on the situation’s urgency. For example, a newborn with prolonged jaundice and elevated direct bilirubin needs an urgent appointment. In contrast, the well-appearing child with a negative history and physical whose mother insists on a specialist may be able to wait for an appointment. Primary care clinicians must exercise good judgment in evaluating the child with a GI complaint when ordering diagnostic lab tests to avoid false-positive results and further confuse the diagnosis.

Anna L. Rundle: Special Thanks to Dr. Steven Lobritto

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 84.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abadie V, Sollid LM, Barreiro LB, Jabri B. Integration of genetic and immunological insights into a model of CD pathogenesis. Annu Rev Immunol. 2011;29:493–525.

    Article  CAS  PubMed  Google Scholar 

  • Alharbi A, Toulah FH, Wakid MH, Azhar E, Farraj S, Mirza AA. Detection of Giardia lamblia by microscopic examination, rapid chromatographic immunoassay test, and molecular technique. Cureus. 2020;12(9):e10287.

    PubMed  PubMed Central  Google Scholar 

  • Aljomah G, Baker SS, Schmidt K, Alkhouri R, Kozielski R, Zhu L, Baker RD. Anemia in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2018;67(3):351–5.

    Article  PubMed  Google Scholar 

  • Alkalay MJ. Update on celiac disease. Curr Opin Pediatr. 2020;32(5):654–60.

    Article  PubMed  Google Scholar 

  • Alrabadi LS, Porto AF. Assessment of community pediatric providers' approach to a child with celiac disease and available serological testing associated with a large tertiary care center. Clin Pediatr (Phila). 2018;57(10):1199–203.

    Article  Google Scholar 

  • Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders DS, Cellier C, et al. European Society for the study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019;7(5):583–613.

    Article  PubMed  PubMed Central  Google Scholar 

  • Amerine E. Celiac disease goes against the grain. Nursing. 2006;36(2):46–8.

    Article  PubMed  Google Scholar 

  • Bai JC, Fried M, Corazza GR, Schuppan D, Farthing M, Catassi C, et al.; World Gastroenterology Organization. World Gastroenterology Organisation global guidelines on celiac disease. 2016 Retrieved on June 10, 2021, https://www.worldgastroenterology.org/UserFiles/file/guidelines/celiac-disease-english-2016.pdf

  • Banerjee S, Owen C, Chopra S. Sickle cell hepatopathy. Hepatology. 2001;33(5):1021–8.

    Article  CAS  PubMed  Google Scholar 

  • Bangaru S, Agrawal D. Medication effects on fecal occult blood testing-reply. JAMA Intern Med. 2019;179(4):591–2.

    Article  PubMed  Google Scholar 

  • Bartsch SM, Umscheid CA, Nachamkin I, Hamilton K, Lee BY. Comparing the economic and health benefits of different approaches to diagnosing Clostridium difficile infection. Clin Microbiol Infect. 2015;21(1):77.e1–9.

    Article  Google Scholar 

  • Beal SG, Tremblay EE, Toffel S, Velez L, Rand KH. A gastrointestinal PCR panel improves clinical management and lowers health care costs. J Clin Microbiol. 2018;56(1):e01457-17.

    Article  PubMed  Google Scholar 

  • Beattie RM, Walker-Smith JA, Murch SH. Indications for investigation of chronic gastrointestinal symptoms. Arch Dis Child. 1995;73(4):354–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bechtold ML, Ashraf I, Nguyen DL. A clinician's guide to fecal occult blood testing for colorectal cancer. South Med J. 2016;109(4):248–55.

    Article  PubMed  Google Scholar 

  • Benchimol EI, Bernstein CN, Bitton A, Carroll MW, Singh H, Otley AR, et al. Trends in epidemiology of pediatric inflammatory bowel disease in Canada: distributed network analysis of multiple population-based provincial health administrative databases. Am J Gastroenterol. 2017;112(7):1120–34.

    Article  PubMed  PubMed Central  Google Scholar 

  • Benchimol EI, Fortinsky KJ, Gozdyra P, Van den Heuvel M, Van Limbergen J, Griffiths AM. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis. 2011;17(1):423–39.

    Article  PubMed  Google Scholar 

  • Benor S, Russell GH, Silver M, Israel EJ, Yuan Q, Winter HS. Shortcomings of the inflammatory bowel disease serology 7 panel. Pediatrics. 2010;125(6):1230–6.

    Article  PubMed  Google Scholar 

  • Bhatt H, Rao GS. Management of acute liver failure: a pediatric perspective. Curr Pediatr Rep. 2018;6(3):246–57.

    Article  PubMed  PubMed Central  Google Scholar 

  • Blohm ME, Vesterling-Hörner D, Calaminus G, Göbel U. Alpha 1-fetoprotein (AFP) reference values in infants up to 2 years of age. Pediatr Hematol Oncol. 1998;15(2):135–42.

    Article  CAS  PubMed  Google Scholar 

  • Bogdanos DP, Mieli-Vergani G, Vergani D. Autoantibodies and their antigens in autoimmune hepatitis. Semin Liver Dis. 2009;29(3):241–53.

    Article  CAS  PubMed  Google Scholar 

  • Bowlus CL, Arrivé L, Bergquist A, Deneau M, Forman L, Ilyas SI, et al. AASLD primary sclerosing cholangitis and cholangiocarcinoma guidance. hepatology. 2022. Pending publication.

    Google Scholar 

  • Branda JA, Lin TY, Rosenberg ES, Halpern EF, Ferraro MJ. A rational approach to the stool ova and parasite examination. Clin Infect Dis. 2006;42(7):972–8.

    Article  PubMed  Google Scholar 

  • Brierley CH, Burchell B. Human UDP-glucuronosyl transferases: chemical defense, jaundice and gene therapy. BioEssays. 1993;15(11):749–54.

    Article  CAS  PubMed  Google Scholar 

  • Brown KA, Khanafer N, Daneman N, Fisman DN. Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection. Antimicrob Agents Chemother. 2013;57(5):2326–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Buckel WR, Avdic E, Carroll KC, Gunaseelan V, Hadhazy E, Cosgrove SE. Gut check: clostridium difficile testing and treatment in the molecular testing era. Infect Control Hosp Epidemiol. 2015;36(2):217–21.

    Article  PubMed  Google Scholar 

  • Buss S, Leber A, Chapin K, Fey PD, Bankowski MJ, Jones MK, et al. Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. J Clin Microbiol. 2015;11(3):915–25.

    Article  Google Scholar 

  • Bussler S, Vogel M, Pietzner D, Harms K, Buzek T, Penke M, Händel N, Körner A, Baumann U, Kiess W, Flemming G. New pediatric percentiles of liver enzyme serum levels (alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase): effects of age, sex, body mass index, and pubertal stage. Hepatology. 2018;68(4):1319–30.

    Article  CAS  PubMed  Google Scholar 

  • Cabrera-Abreu J, Green A. (Gamma)-glutamyltransferase: value of its measurement in paediatrics. Ann Clin Biochem. 2002;39:22–5. Retrieved from http://ezproxy.cul.columbia.edu/login?url=https://www.proquest.com/docview/201681943?accountid=10226

    Article  CAS  PubMed  Google Scholar 

  • Caio G, Volta U, Sapone A, Leffler DA, De Giorgio R, Catassi C, Fasano A. Celiac disease: a comprehensive current review. BMC Med. 2019;17(1):142.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Carragher F. Chapter 25—paediatric clinical biochemistry. In: Marshall W, Lapsley M, Day A, Ayling R, editors. Clinical biochemistry: metabolic and clinical aspects. 3rd ed. Illinois: Churchill Livingstone; 2014. p. 484–96.

    Chapter  Google Scholar 

  • Carroll KC, Mizusawa M. Laboratory tests for the diagnosis of clostridium difficile. Clin Colon Rectal Surg. 2020;33(2):73–81.

    Google Scholar 

  • Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, et al. American Association for the Study of Liver Diseases. Diagnosis and management of primary sclerosing cholangitis. Hepatology. 2010;51(2):660–78. https://doi.org/10.1002/hep.23294. PMID: 20101749

  • Conrad MA, Rosh JR. Pediatric inflammatory bowel disease. Pediatr Clin N Am. 2017;64(3):577–91.

    Article  Google Scholar 

  • Dahlan Y, Smith L, Simmonds D, Jewell LD, Wanless I, Heathcote EJ, Bain VG. Pediatric-onset primary biliary cirrhosis. Gastroenterol. 2003;125(5):1476–9.

    Article  Google Scholar 

  • De Leo L, Quaglia S, Ziberna F, Vatta S, Martelossi S, Maschio M, Not T. Serum anti-tissue transglutaminase antibodies detected during febrile illness may not be produced by the intestinal mucosa. J Pediatr. 2015;166(3):761–3.

    Article  PubMed  Google Scholar 

  • Deshpande A, Pasupuleti V, Thota P, Pant C, Rolston DD, Sferra TJ, Hernandez AV, Donskey CJ. Community-associated Clostridium difficile infection and antibiotics: a meta-analysis. J Antimicrob Chemother. 2013;68(9):1951–61.

    Article  CAS  PubMed  Google Scholar 

  • Di Sabatino A, Vanoli A, Giuffrida P, Luinetti O, Solcia E, Corazza GR. The function of tissue transglutaminase in celiac disease. Autoimmun Rev. 2012;11(10):746–53.

    Article  PubMed  CAS  Google Scholar 

  • Domínguez-Muñoz JE, Hardt D, Lerch PMM, Löhr MJ. Potential for screening for pancreatic exocrine insufficiency using the fecal Elastase-1 test. Dig Dis Sci. 2017;62(5):1119–30.

    Article  PubMed  CAS  Google Scholar 

  • Dorn L, Finkenstedt A, Schranz M, Prokop W, Griesmacher A, Vogel W, Zoller H. Immunoglobulin subclass 4 for the diagnosis of immunoglobulin subclass 4-associated diseases in an unselected liver and pancreas clinic population. HPB (Oxford). 2012;14(2):122–5.

    Article  Google Scholar 

  • Dubberke ER, Han Z, Bobo L, Hink T, Lawrence B, Copper S, Hoppe-Bauer J, Burnham CA, Dunne WM Jr. Impact of clinical symptoms on interpretation of diagnostic assays for Clostridium difficile infections. J Clin Microbiol. 2011;49(8):2887–93.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dykes SM, Saeed S. Inflammatory bowel disease. In: McInerny T, editor. AAP textbook of pediatric care. Elk Grove Village, IL: AAP Press; 2016. p. 2199–203.

    Google Scholar 

  • El-Chammas K, Majeskie A, Simpson P, Sood M, Miranda A. Red flags in children with chronic abdominal pain and Crohn's disease—a single center experience. J Pediatr. 2013;162(4):783–7.

    Article  PubMed  Google Scholar 

  • Fawaz R, Baumann U, Ekong U, Fischler B, Hadzic N, Mack CL, et al. Guideline for the evaluation of cholestatic jaundice in infants: 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. 2017;64(1):154–68.

    Article  CAS  PubMed  Google Scholar 

  • Fawaz R, Jonas MM. Acute and chronic hepatitis. In: Wyllie R, Haymes JS, Kay M, editors. Pediatric gastrointestinal and liver disease. 6th ed. Philadelphia, PA: Elsevier; 2021. p. 819–37.

    Chapter  Google Scholar 

  • Giannini EG, Testa R, Savarino V. Liver enzyme alteration: a guide for clinicians. CMAJ. 2005;172(3):367–79.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gidrewicz D, Potter K, Trevenen CL, Lyon M, Butzner JD. Evaluation of the ESPGHAN celiac guidelines in a North American pediatric population. Am J Gastroenterol. 2015;110(5):760–7.

    Article  CAS  PubMed  Google Scholar 

  • Gingras BA, Maggiore JA. Performance of a new molecular assay for the detection of gastrointestinal pathogens. Access Microbiol. 2020;2 https://doi.org/10.1099/acm:0.000160.

  • Green PR, Jones R. Chapter: how do I know if I have it? The diagnosis of celiac disease. In: Celiac disease: a hidden epidemic. New York: William Morrow, an imprint of HarperCollins Publishers; 2016. p. 40–63.

    Google Scholar 

  • Griffiths AM. Specificities of inflammatory bowel disease in childhood. Best Pract Res Clin Gastroenterol. 2004;18(3):509–23.

    Article  PubMed  Google Scholar 

  • Grossman AB, Baldassan RN. Inflammatory bowel disease. In: Kliegman R, Stanton B, St. Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016. p. 1819–31.

    Google Scholar 

  • Guandalini S. The approach to celiac disease in children. Int J Pediatr Adolesc Med. 2017;4(3):124–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014;59(1):132–52.

    Article  PubMed  Google Scholar 

  • Gujral N, Freeman HJ, Thomson AB. Celiac disease: prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol. 2012;18(42):6036–59.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hannet I, Engsbro AL, Pareja J, Schneider UV, Lisby JG, Pružinec-Popović B, Hoerauf A, Parčina M. Multicenter evaluation of the new QIAstat gastrointestinal panel for the rapid syndromic testing of acute gastroenteritis. Eur J Clin Microbiol Infect Dis. 2019;38(11):2103–12.

    Article  CAS  PubMed  Google Scholar 

  • Harb R, Thomas DW. Conjugated hyperbilirubinemia: screening and treatment in older infants and children. Pediatr Rev. 2007;28(3):83–91.

    Article  PubMed  Google Scholar 

  • Heyman MB, Kirschner BS, Gold BD, Ferry G, Baldassano R, Cohen SA, et al. Children with early-onset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J Pediatr. 2005;146(1):35–40.

    Article  PubMed  Google Scholar 

  • Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005;40(1):1–19.

    Article  PubMed  Google Scholar 

  • Hill ID, Fasano A, Guandalini S, Hoffenberg E, Levy J, Reilly N, Verma R. NASPGHAN clinical report on the diagnosis and treatment of gluten-related disorders. J Pediatr Gastroenterol Nutr. 2016;63(1):156–65.

    Article  CAS  PubMed  Google Scholar 

  • Himoto T, Nishioka M. Autoantibodies in liver disease: important clues for the diagnosis, disease activity and prognosis. Auto Immun Highlights. 2013;4(2):39–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hiyama E. Pediatric hepatoblastoma: diagnosis and treatment. Transl Pediatr. 2014;3(4):293–9.

    PubMed  PubMed Central  Google Scholar 

  • Holtman GA, Lisman-van Leeuwen Y, Reitsma JB, Berger MY. Noninvasive tests for inflammatory bowel disease: a meta-analysis. Pediatrics. 2016;137(1):e20152126.

    Article  Google Scholar 

  • Hsu D, Leyva-Vega M, D'Mello S, Josyabhatla R, Liebling M, Shtilbans T. Autoimmune pancreatitis and IgG4-associated cholangitis in a toddler. Pediatrics. 2019;144(2):2. Meeting Abstract 826

    Google Scholar 

  • Husby S, Koletzko S, Korponay-Szabó I, Kurppa K, Mearin ML, Ribes-Koninckx C, et al. Hepatology and nutrition guidelines for diagnosing coeliac disease 2020. J Pediatr Gastroenterol Nutr. 2020;70(1):141–56.

    Article  PubMed  Google Scholar 

  • Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, et al. ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, Nutrition. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. 2012;54(1):136–60.

    Article  CAS  PubMed  Google Scholar 

  • Husby S, Murray JA, Katzka DA. AGA clinical practice update on diagnosis and monitoring of celiac disease-changing utility of serology and histologic measures. Expert Rev Gastroenterol. 2019;156(4):885–9.

    Google Scholar 

  • James MW, Scott BB. EMA antibody in the diagnosis and management of coeliac disease. Postgrad Med J. 2000;76(898):466–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Johnston DE. Special considerations in interpreting liver function tests. Am Fam Physician. 1999;59(8):2223–30. PMID: 10221307

    Google Scholar 

  • Johnston RD, Logan RF. What is the peak age for onset of IBD? Inflamm Bowel Dis. 2008;14(Suppl 2):S4–5.

    Article  PubMed  Google Scholar 

  • Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, et al. ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN guidelines for the management of Helicobacter pylori in children and adolescents (update 2016). J Pediatr Gastroenterol Nutr. 2017;64(6):991–1003.

    Article  PubMed  Google Scholar 

  • Kalakonda A, Jenkins BA, John S. Physiology, bilirubin. [updated 2020 Mar 29]. In: Stat pearls [internet]. Treasure Island (FL): Stat Pearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470290/.

    Google Scholar 

  • Kasırga E. The importance of stool tests in diagnosis and follow-up of gastrointestinal disorders in children. Turk Pediatri Ars. 2019;54(3):141–8.

    PubMed  PubMed Central  Google Scholar 

  • Khan K, Schwarzenberg SJ, Sharp H, Greenwood D, Weisdorf-Schindele S. Role of serology and routine laboratory tests in childhood inflammatory bowel disease. Inflamm Bowel Dis. 2002;8(5):325–9.

    Article  PubMed  Google Scholar 

  • Kugathasan S, Judd RH, Hoffmann RG, Heikenen J, Telega G, Khan F, et al. Epidemiologic and clinical characteristics of children with newly diagnosed inflammatory bowel disease in Wisconsin: a statewide population-based study. J Pediatr. 2003;143(4):525–31.

    Article  PubMed  Google Scholar 

  • Kwo PY, Cohen SM, Lim JK. ACG Clinical Guideline: evaluation of abnormal liver chemistries. Am J Gastroenterol. 2017;112(1):18–35.

    Article  CAS  PubMed  Google Scholar 

  • Laborda TJ, Jensen MK, Kavan M, Deneau M. Treatment of primary sclerosing cholangitis in children. World J Hepatol. 2019;11(1):19–36.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lázár-Molnár E, Snyder M. The role of human leukocyte antigen in celiac disease diagnostics. Clin Lab Med. 2018;38(4):655–68.

    Article  PubMed  Google Scholar 

  • Lee HS, Plechot K, Gohil S, Le J. Clostridium difficile: Diagnosis and the consequence of over diagnosis. Infect Dis Ther. 2021;10(2):687–97.

    Google Scholar 

  • Leung AKC, Leung AAM, Wong AHC, Sergi CM, Kam JKM. Giardiasis: an overview. Recent Patents Inflamm Allergy Drug Discov. 2019;13(2):134–43.

    Article  CAS  Google Scholar 

  • Liacouras CA, Piccoli DA, Jacobstein D, Baldassano R. Inflammatory bowel disease. In: Bell LM, editor. Pediatric gastroenterology: the requisites in pediatrics. Philadelphia, PA: Mosby. Elsevier Health Sciences; 2008. p. 131–41.

    Google Scholar 

  • Liu E, Li M, Emery L, Taki I, Barriga K, Tiberti C, et al. Natural history of antibodies to deamidated gliadin peptides and transglutaminase in early childhood celiac disease. J Pediatr Gastroenterol Nutr. 2007;45(3):293–300.

    Article  CAS  PubMed  Google Scholar 

  • Lo Vecchio A, Buccigrossi V, Fedele MC, Guarino A. Acute infectious diarrhea. Adv Exp Med Biol. 2019;1125:109–20.

    Article  PubMed  Google Scholar 

  • Loftus EV Jr. Update on the incidence and prevalence of inflammatory bowel disease in the United States. Gastroenterol Hepatol (N Y). 2016;12(11):704–7.

    Google Scholar 

  • Loomes KM, Emerick KM. Pediatric cholestatic liver disease. In: Wyllie R, Haymes JS, Kay M, editors. Pediatric gastrointestinal and liver disease. 6th ed. Philadelphia, PA: Elsevier; 2021. p. 769–85.

    Chapter  Google Scholar 

  • Lowe D, Sanvictores T, John S. Alkaline phosphatase. [updated 2021 Aug 11]. In: Stat pearls [internet]. Treasure Island (FL): Stat Pearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459201/.

  • Mack DR, Langton C, Markowitz J, LeLeiko N, Griffiths A, Bousvaros A, et al. Laboratory values for children with newly diagnosed inflammatory bowel disease. Pediatrics. 2007;119(6):1113–9.

    Article  PubMed  Google Scholar 

  • Madani S, Kamat D. Clinical guidelines for celiac disease in children: what does it mean to the pediatrician/family practitioner? Clin Pediatr (Phila). 2006;45(3):213–9.

    Article  Google Scholar 

  • Malickova K, Lakatos PL, Bortlik M, Komarek V, Janatkova I, Lukas M. Anticarbohydrate antibodies as markers of inflammatory bowel disease in a central European cohort. Eur J Gastroenterol Hepatol. 2010;22(2):144–50.

    Article  CAS  PubMed  Google Scholar 

  • Manns MP, Czaja AJ, Gorham JD, Krawitt EL, Mieli-Vergani G, et al. Diagnosis and management of autoimmune hepatitis. Hepatology. 2010;51(6):2193–213.

    Article  CAS  PubMed  Google Scholar 

  • Martinez, et al. Primary sclerosing cholangitis immune reactivity pre-transplant is a predictor of recurrent disease after liver transplantation. Oral abstracts (abstracts 1–288). Hepatology. 2019;70:1–187. https://doi.org/10.1002/hep.30940.

    Article  Google Scholar 

  • Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2018;68(2):723–50. https://doi.org/10.1002/hep.29913. PMID: 29624699.

  • McDaniel M. Hepatic function testing: the ABCs of the liver function tests. Physician Assistant Clin. 2019;24:541–50.

    Article  Google Scholar 

  • McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, et al. Clinical Practice Guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):e1–e48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mero S, Kirveskari J, Antikainen J, Ursing J, Rombo L, Kofoed PE, Kantele A. Multiplex PCR detection of Cryptosporidium sp, Giardia lamblia and Entamoeba histolytica directly from dried stool samples from Guinea-Bissauan children with diarrhoea. Infect Dis (Lond). 2017;49(9):655–63.

    Article  CAS  Google Scholar 

  • Mieli-Vergani G, Vergani D. Autoimmune hepatitis in children: what is different from adult AIH? Semin Liver Dis. 2009;29(3):297–306.

    Article  PubMed  Google Scholar 

  • Mitchell EL, Khan Z. Liver disease in Alpha-1 antitrypsin deficiency: current approaches and future directions. Curr Pathobiol Rep. 2017;5(3):243–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mitsuyama K, Niwa M, Takedatsu H, Yamasaki H, Kuwaki K, Yoshioka S, Yamauchi R, Fukunaga S, Torimura T. Antibody markers in the diagnosis of inflammatory bowel disease. World J Gastroenterol. 2016;22(3):1304–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mohapatra S, Singh DP, Alcid D, Pitchumoni CS. Beyond O&P times three. Am J Gastroenterol. 2018;113(6):805–18.

    Article  PubMed  Google Scholar 

  • Moreno M. Celiac disease in children and adolescents. JAMA Pediatr. 2014;168(3):300.

    Article  PubMed  Google Scholar 

  • Morris AJ, Wilson ML, Reller LB. Application of rejection criteria for stool ovum and parasite examinations. J Clin Microbiol. 1992;30:3213–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Nayagam J, Miquel R, Joshi D. Overlap syndrome with autoimmune hepatitis and primary sclerosing cholangitis. Euro Med J Hepatol. 2019;7(1):95–104.

    Google Scholar 

  • Nehls O, Gregor M, Klump B. Serum and bile markers for cholangiocarcinoma. Semin Liver Dis. 2004;24(2):139–54. https://doi.org/10.1055/s-2004-828891. PMID: 15192787

  • Nemes K, Åberg F, Gylling H, Isoniemi H. Cholesterol metabolism in cholestatic liver disease and liver transplantation: from molecular mechanisms to clinical implications. World J Hepatol. 2016;8(22):924–32.

    Article  PubMed  PubMed Central  Google Scholar 

  • Northup PG, Caldwell SH. Coagulation in liver disease: a guide for the clinician. Clin Gastroenterol Hepatol. 2013;11(9):1064–74.

    Article  PubMed  Google Scholar 

  • Otero JL, González-Peralta RP, Andres JM, Jolley CD, Novak DA, Haafiz A. Elevated alkaline phosphatase in children: an algorithm to determine when a "wait and see" approach is optimal. Clin Med Insights Pediatr. 2011;22(5):15–8.

    Google Scholar 

  • Patel D, Teckman JH. Alpha-1-antitrypsin deficiency liver disease. Clin Liver Dis. 2018;22(4):643–55.

    Article  PubMed  Google Scholar 

  • Polage CR, Stoddard GJ, Rolfs RT, et al. Physician use of parasite tests in the United States from 1997 to 2006 and in a Utah cryptosporidium outbreak in 2007. J Clin Microbiol. 2011;49:591–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Prause C, Ritter M, Probst C, Daehnrich C, Schlumberger W, Komorowski L, et al. Antibodies against deamidated gliadin as new and accurate biomarkers of childhood coeliac disease. J Pediatr Gastroenterol Nutr. 2009;49(1):52–8.

    Article  CAS  PubMed  Google Scholar 

  • Ramakrishnan N, Bittar K, Jialal I. Impaired bilirubin conjugation. [updated 2020 Jul 27]. In: StatPearls [internet]. Treasure Island (FL): StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK482483/.

    Google Scholar 

  • Roberts EA, Schilsky ML. American Association for Study of Liver Diseases (AASLD). Diagnosis and treatment of Wilson disease: an update. Hepatology. 2008;47(6):2089–111.

    Article  CAS  PubMed  Google Scholar 

  • Rosen D, Thung S, Sheflin-Findling S, Lai J, Rosen A, Arnon R, Chu J. IgG4-sclerosing cholangitis in a pediatric patient. Semin Liver Dis. 2015b;35(1):89–94.

    Article  CAS  PubMed  Google Scholar 

  • Rosen MJ, Dhawan A, Saeed SA. Inflammatory bowel disease in children and adolescents. JAMA Pediatr. 2015a;169(11):1053–60.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA. American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108(5):656–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sabbagh P, Mohammadnia-Afrouzi M, Javanian M, Babazadeh A, Koppolu V, Vasigala VR, Nouri HR, Ebrahimpour S. Diagnostic methods for Helicobacter pylori infection: ideals, options, and limitations. Eur J Clin Microbiol Infect Dis. 2019;38(1):55–66.

    Article  CAS  PubMed  Google Scholar 

  • Sabery N, Bass D. Use of serologic markers as a screening tool in inflammatory bowel disease compared with elevated erythrocyte sedimentation rate and anemia. Pediatrics. 2007;119(1):e193–9.

    Article  PubMed  Google Scholar 

  • Saeed A, Shorafa E, Shahramian I, Afshari M, Salahifard M, et al. An 11-year-old boy infected with COVID-19 with presentation of acute liver failure. Hepat Mon. Online ahead of Print. 2020;20(6):e104415.

    Article  CAS  Google Scholar 

  • Sairenji T, Collins KL, Evans DV. An update on inflammatory bowel disease. Prim Care. 2017;44(4):673–92.

    Article  PubMed  Google Scholar 

  • Sawhney MS, McDougall H, Nelson DB, Bond JH. Fecal occult blood test in patients on low-dose aspirin, warfarin, clopidogrel, or non-steroidal anti-inflammatory drugs. Dig Dis Sci. 2010;55(6):1637–42.

    Article  CAS  PubMed  Google Scholar 

  • Sciandra I, Piccioni L, Coltella L, Ranno S, Giannelli G, Falasca F, Antonelli G, Concato C, Turriziani O. Comparative analysis of 2 commercial molecular tests for the detection of gastroenteric viruses on stool samples. Diagn Microbiol Infect Dis. 2020;96(1):114893.

    Article  CAS  PubMed  Google Scholar 

  • Shapiro JM, Subedi S, LeLeiko NS. Inflammatory bowel disease. Pediatr Rev. 2016;37(8):337–47.

    Article  PubMed  Google Scholar 

  • Shashidhar H, Integlia MJ, Grand RJ. Clinical manifestations of pediatric inflammatory bowel disease. In: Kirsner JB, editor. Inflammatory bowel disease. Philadelphia: WB Saunders; 2000.

    Google Scholar 

  • Sheiko MA, Sundaram SS, Capocelli KE, Pan Z, McCoy AM, Mack CL. Outcomes in pediatric autoimmune hepatitis and significance of azathioprine metabolites. J Pediatr Gastroenterol Nutr. 2017;65(1):80–5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shieh M, Chitnis N, Monos D. Human leukocyte antigen and disease associations: a broader perspective. Clin Lab Med. 2018;38(4):679–93.

    Article  PubMed  Google Scholar 

  • Simko V. Fecal fat microscopy. Acceptable predictive value in screening for steatorrhea. Am J Gastroenterol. 1981;75:204–8.

    CAS  PubMed  Google Scholar 

  • Singh P, Arora A, Strand TA, Leffler DA, Mäki M, Kelly CP, Ahuja V, Makharia GK. Diagnostic accuracy of point of care tests for diagnosing celiac disease: a systematic review and meta-analysis. J Clin Gastroenterol. 2019;53(7):535–42.

    Article  CAS  PubMed  Google Scholar 

  • Socha P, Janczyk W, Dhawan A, Baumann U, D'Antiga L, Tanner S, et al. Wilson's disease in children: a position paper by the hepatology Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2018;66(2):334–44.

    Article  PubMed  Google Scholar 

  • Sokollik C, McLin VA, Vergani D, Terziroli Beretta-Piccoli B, Mieli-Vergani G. Juvenile autoimmune hepatitis: a comprehensive review. J Autoimmun. 2018;95:69–76.

    Article  CAS  PubMed  Google Scholar 

  • Stockmann C, Pavia AT, Graham B, Vaughn M, Crisp R, Poritz MA, Thatcher S, Korgenski EK, Barney T, Daly J, Rogatcheva M. Detection of 23 gastrointestinal pathogens among children who present with diarrhea. J Pediatr Infect Dis Soc. 2017;6(3):231–8.

    Google Scholar 

  • Sziegoleit A, Linder D. Studies on the sterol-binding capacity of human pancreatic elastase 1. Gastroenterol. 1991;100(3):768–74.

    Article  CAS  Google Scholar 

  • Tajiri H, Takano T, Tanaka H, Ushijima K, Inui A, Miyoshi Y, et al. Hepatocellular carcinoma in children and young patients with chronic HBV infection and the usefulness of alpha-fetoprotein assessment. Cancer Med. 2016;5(11):3102–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Thiagarajah JR, Kamin DS, Acra S, Goldsmith JD, Roland JT. Lencer WI,…PediCODE Consortium. Advances in evaluation of chronic diarrhea in infants. Gastroenterology. 2018;154(8):2045–2059.e6.

    Article  PubMed  Google Scholar 

  • Torres-Miranda D, Akselrod H, Karsner R, Secco A, Silva-Cantillo D, Siegel MO, et al. Use of BioFire FilmArray gastrointestinal PCR panel associated with reductions in antibiotic use, time to optimal antibiotics, and length of stay. BMC Gastroenterol. 2020;20(1):246.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tsampalieros A, Griffiths AM, Barrowman N, Mack DR. Use of C-reactive protein in children with newly diagnosed inflammatory bowel disease. J Pediatr. 2011;159(2):340–2.

    Article  PubMed  Google Scholar 

  • Van Rheenen PF, Van de Vijver E, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ. 2010;341:c3369.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vanga RR, Tansel A, Sidiq S, El-Serag HB, Othman MO. Diagnostic performance of measurement of Fecal Elastase-1 in detection of exocrine pancreatic insufficiency: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2018;16(8):1220–1228.e4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut. 2006;55(3):426–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Veropalumbo C, Del Giudice E, Esposito G, Maddaluno S, Ruggiero L, Vajro P. Aminotransferases and muscular diseases: a disregarded lesson. Case reports and review of the literature. J Paediatr Child Health. 2012;48(10):886–90.

    Article  PubMed  Google Scholar 

  • Villalta D, Tonutti E, Prause C, Koletzko S, Uhlig HH, Vermeersch P, et al. IgG antibodies against deamidated gliadin peptides for diagnosis of celiac disease in patients with IgA deficiency. Clin Chem. 2010;56(3):464–8.

    Article  CAS  PubMed  Google Scholar 

  • Walayat S, Martin D, Patel J, Ahmed U, Asghar MN, Pai AU, Dhillon S. Role of albumin in cirrhosis: from a hospitalist's perspective. J Commun Hosp Intern Med Perspect. 2017;7(1):8–14.

    Article  Google Scholar 

  • Walther A, Tiao G. Approach to pediatric hepatocellular carcinoma. Clin Liver Dis. 2013;2(5):219–22.

    Article  Google Scholar 

  • Wang YK, Kuo FC, Liu CJ, Wu MC, Shih HY, Wang SS, et al. Diagnosis of helicobacter pylori infection: current options and developments. World J Gastroenterol. 2015;21(40):11221–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Warner S, Kelly DA. Liver failure. In: Wyllie R, Haymes JS, Kay M, editors. Pediatric gastrointestinal and liver disease. 6th ed. Philadelphia, PA: Elsevier; 2021. p. 852–71.

    Chapter  Google Scholar 

  • Wood L, Colman J, Dudley F. The relationship between portal pressure and plasma albumin in the development of cirrhotic ascites. J Gastroenterol Hepatol. 1987;2(6):525–31.

    Article  Google Scholar 

  • Woreta TA, Alqahtani SA. Evaluation of abnormal liver tests. Med Clin North Am. 2014;98(1):1–16.

    Article  PubMed  Google Scholar 

  • Wu PE. Medication effects on fecal occult blood testing. JAMA Intern Med. 2019;179(4):591.

    Article  PubMed  Google Scholar 

  • Wyatt A, Kellermayer R. PCR-based fecal pathogen panel testing should be interpreted with caution at diagnosis of pediatric inflammatory bowel diseases. Ann Clin Lab Sci. 2018;48(5):674–6.

    PubMed  Google Scholar 

  • Xuan S, Zangwill KM, Ni W, Ma J, Hay JW. Cost-effectiveness analysis of four common diagnostic methods for Clostridioides difficile infection. J Gen Intern Med. 2020;35(4):1102–10.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yazigi N, Balistreri WF. Bilirubin. In: Fernandes J, Saudubray JM, Van den Berghe G, Tada K, Buist NRM, editors. Inborn metabolic diseases. Berlin, Heidelberg: Springer; 1995.

    Google Scholar 

  • Zholudev A, Zurakowski D, Young W, Leichtner A, Bousvaros A. Serologic testing with ANCA, ASCA, and anti-OmpC in children and young adults with Crohn's disease and ulcerative colitis: diagnostic value and correlation with disease phenotype. Am J Gastroenterol. 2004;99(11):2235–41.

    Article  PubMed  Google Scholar 

  • Zimmerman S, Horner S, Altwegg M, Dalpke A. Workflow optimization for syndromic diarrhea diagnosis using the molecular Seegene Allplex GI-bacteria assay. Eur J Clin Microbiol Inf Dis. 2020;39:1235–50.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Center for Liver Disease and Transplantation, New York-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, USA

    Anna L. Rundle

  2. Pediatric Gastroenterology, Hepatology and Nutrition, Columbia University Medical Center, New York-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, USA

    Nicole Baron

  3. School of Nursing, Columbia University, New York, NY, USA

    Rita Marie John

Authors
  1. Anna L. Rundle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicole Baron
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rita Marie John
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anna L. Rundle .

Editor information

Editors and Affiliations

  1. School of Nursing, Columbia University, New York, NY, USA

    Rita Marie John

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rundle, A.L., Baron, N., John, R.M. (2022). Care of the Child with a Gastrointestinal Disorder. In: John, R.M. (eds) Pediatric Diagnostic Labs for Primary Care: An Evidence-based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-90642-9_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-90642-9_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-90641-2

  • Online ISBN: 978-3-030-90642-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation