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Analysis of important issues within the field of Pediatric Gastroenterology: latest research, training, academic and private practice concerns, funding, global health, and other current events.
Thursday, July 31, 2014

There has been an increasing focus on the inorganic arsenic content of rice and the possible health implications of arsenic exposure in infants and children.  As a result, the ESPGHAN Committee on Nutrition has recently published recommendations to limit childhood exposure to inorganic arsenic found in rice.  The commentary has been published ahead of print and the link to the full article is included below.

The publication highlights the ambiguity that exists in the regulation of food-based inorganic arsenic exposure.  Various food safety organizations have attempted to set guidelines on food-based inorganic arsenic exposure.  However, inorganic arsenic is considered a first level carcinogen and any exposure may increase one’s risk for various carcinomas and adverse health effects.  Rice has a much higher concentration of inorganic arsenic compared to other grains due to the physiology of rice and the way it is grown in flooded rice paddies.

Special concern exists regarding the exposure of infants and children to inorganic arsenic due to rice exposure.  Rice and rice products are commonly added to infant formula, food, and drinks.  Rice cereal is often the first and most common infant fortified cereal used due to its wide availability and low allergenic potential.  Rice cereal is often used as a thickening agent for infants with oropharyngeal dysphagia and may also be used as a therapeutic strategy to thicken formula in infants with gastroesophageal reflux.  In infants and children who avoid dietary gluten, rice intake and inorganic arsenic exposure can be much higher than those who do not avoid gluten within their diet.

The ESPGHAN Committee on Nutrition concludes that inorganic arsenic intake in infancy and childhood should be as low as possible.  A variety of grains should be used when possible, and rice with the lowest inorganic arsenic content should be used for infant and childhood products.  Rice drinks should not be used in infants and children, and the risks of rice protein based infant formulas should be weighed when considering these products.

For additional information, please refer to the full publication via the link provided below.  The press release from Wolters Kluwer Health is also included below.


Arsenic in Rice - A Cause for Concern. A Comment by the ESPGHAN Committee on Nutrition

Wolters Kluwer Health: Experts Voice Concerns Over Arsenic in Rice

Thursday, July 03, 2014

The July 2014 supplemental issue of JPGN highlights the distinguished career of Dr. David Branski.  Dr. Branski was presented with the ESPGHAN Distinguished Service Award in May of 2013, in part due to his numerous research contributions within the field of celiac disease.  As discussed by his colleagues in this month’s special feature, Professor Branski authored more than 150 peer-reviewed articles, 45 chapters and review articles, 10 books, and 18 book series.  This includes his contributions to the gastrointestinal section of the recent editions of the Nelson Textbook of Pediatrics.

Dr. Branski was active in many professional organizations, both globally and within his native Israel.  He was also one of the most active members of ESPGHAN.  His attendance at annual ESPGHAN meetings was without interruption since 1980.  He was appointed as ESPGHAN Editor-in-Chief of JPGN in 2010 and served in this capacity until the week that he passed away.  His contributions to JPGN extended well beyond his expected duties and were instrumental in furthering the mission of our journal.  Dr. Branski died in August 2013 after a hard-fought battle with cancer.  He left a lasting legacy within our specialty that will lead to the improvement of childhood health for decades to come.

Along these lines, Dr. Branski’s publications within JPGN and his personal research were instrumental in the development of this July 2014 supplemental issue of JPGN.  The links below include the current JPGN supplemental issue on Celiac Disease, as well as the 2012 ESPGHAN guidelines for diagnosis of Celiac disease co-authored by Dr. Branski.

Presentation of the 2013 ESPGHAN Distinguished Service Award to Professor David Branski

July 2014 Supplement 1; Celiac Disease

January 2012: ESPGHAN Guidelines for the Diagnosis of Coeliac Disease


Thursday, May 29, 2014

The U.S. Consumer Product Safety Commission (CPSC) recently announced that an agreement had been reached with the creator of Buckyballs to issue a voluntary recall of their high-powered magnet toys.  These rare-earth magnets have been marketed within toy stores and large chain stores as desk toys.  Buckyballs and similar products are typically sold in packs of multiples, sometimes numbering 100 or more in a single pack.  Due to their small size, they pose a high risk of accidental ingestion in children and toddlers.  High-powered magnets have also been accidentally ingested by teenagers following their use as non-piercing nose rings, lip rings, and tongue rings.  When multiple magnets are ingested, they pose a substantial risk of intestinal injury, including obstruction, ulceration, and perforation.

The agreement with the creator of Buckyballs is the end result of an administrative case filed nearly two years ago by the CPSC in July 2012.  Pediatric gastroenterologists and NASPGHAN leadership have been instrumental in warning policy makers and consumers about the dangers that these high-powered magnets pose to both children and teenagers, and this recall illustrates the impact that advocacy through our national organization can have on the well-being of our patients.

For more information regarding the recall, a link to the CPSC press release is listed below.  The creator of Buckyballs has agreed to provide funding for a recall trust, which will be controlled by the CPSC.  Once this trust has been established, consumers will be allowed to seek a refund through an online registration process.  The CPSC is asking consumers to sign up for email alerts in order to be notified when the recall has officially started.

Important JPGN publications regarding the emerging trend of magnet ingestion and the management of magnet ingestions in children are listed below as well.  Congratulations to everyone who has worked hard to see this important advocacy issue to this initial step toward completion.

CPSC Recall Information

Magnet-Related Injury Rates in Children: A Single Hospital Experience. JPGN 2013; 57: 14-17

Magnet Ingestions in Children Presenting to US Emergency Departments, 2002-2011. JPGN 2013; 57: 18-22

Management of Ingested Magnets in Children. JPGN 2012; 55: 239-242

Friday, May 02, 2014

Welcome to the journal blog! We hope that this will serve as a forum for discussion of various topics within the field of Pediatric gastroenterology, hepatology, and nutrition. Our blog entries will focus primarily on the impact of current, previous, or future JPGN articles within our field and practice, as well as how they may relate to important current medical news. We also hope to highlight important issues within academic and private practice medicine, including research and funding topics important to physicians and practitioners within Pediatric gastroenterology.

Blog posts will be highlighted on our social media accounts, but we encourage you to sign up for email updates via the included link on if you would like to be alerted to blog entries as they are posted. JPGN has active social media accounts through Facebook ( and Twitter (@JPGNonline). Also, please feel free to comment on blog posts to help generate discussion on these topics. We all learn from the experiences of each other!

About the Author

Dr. Charles Vanderpool
Dr. Charles Vanderpool is the social media director for JPGN. He is currently an assistant professor at Riley Hospital for Children at IU Health in Indianapolis, IN. He received his medical degree through Indiana University and completed residency and fellowship training at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, TN.

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