Gut microbiota in various childhood disorders:Implication and indications

Gut microbiota has a significant role in gut development,maturation,and immune system differentiation.It exerts considerable effects on the child's physical and mental development.The gut microbiota composition and structure depend on many host and microbial factors.The host factors include age,genetic pool,general health,dietary factors,medication use,the intestine's pH,peristalsis,and transit time,mucus secretions,mucous immunoglobulin,and tissue oxidation-reduction potentials.The microbial factors include nutrient availability,bacterial cooperation or antagonism,and bacterial adhesion.Each part of the gut has its microbiota due to its specific characteristics.The gut microbiota interacts with different body parts,affecting the pathogenesis of many local and systemic diseases.Dysbiosis is a common finding in many childhood disorders such as autism,failure to thrive,nutritional disorders,coeliac disease,Necrotizing Enterocolitis,helicobacter pylori infection,functional gastrointestinal disorders of childhood,inflammatory bowel diseases,and many other gastrointestinal disorders.Dysbiosis is also observed in allergic conditions like atopic dermatitis,allergic rhinitis,and asthma.Dysbiosis can also impact the development and the progression of immune disorders and cardiac disorders,including heart failure.Probiotic supplements could provide some help in managing these disorders.However,we are still in need of more studies.In this narrative review,we will shed some light on the role of microbiota in the development and management of common childhood disorders.

Paediatric gastrointestinal disorders in SARS-CoV-2 infection:Epidemiological and clinical implications

The coronavirus disease 2019(COVID-19)pandemic is a threat worldwide for individuals of all ages,including children.Gastrointestinal manifestations could be the initial presenting manifestation in many patients,especially in children.These symptoms are more common in patients with severe disease than in patients with non-severe disease.Approximately 48.1%of patients had a stool sample that was positive for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral RNA.Children typically form 1%-8%of all laboratoryconfirmed cases of SARS-CoV-2.Gastrointestinal manifestations of COVID-19 in children are not rare,with a prevalence between 0 and 88%,and a wide variety of presentations,including diarrhoea,vomiting,and abdominal pain,can develop before,with or after the development of respiratory symptoms.Atypical manifestations such as appendicitis or liver injury could also appear,especially in the presence of multisystem inflammatory disease.In this review,we discussed the epidemiology of COVID-19 gastrointestinal diseases in children as well as their implications on the diagnosis,misdiagnosis,prognosis,and faecal-oral transmission route of COVID-19 and the impact of gastrointestinal diseases on the gut microbiome,child nutrition,and disease management.