While arguably there is some competition for this role, I assert that among all organ systems, the pediatric gastroenterologic system offers the greatest range of pleasure-producing and distressing experiences, with enormous direct and indirect impacts on a child’s physical and psychosocial well-being. The neonate’s immediate and obvious comfort from suckling, leading to ever closer ties with his or her mother, starkly contrasts with the great distress felt by both mother and infant in the presence of gastroesophageal reflux disease. The joy and excitement in discovering new foods are contrarily matched by the despair and anxiety associated with food allergies. Physical and mental growth and development—so impactful on a child’s ability to thrive in society—are greatly influenced by the integrity and function of the gastrointestinal (GI) system. Malabsorption, anorexia, and motility problems can greatly disrupt this critical platform for normal development. Given the importance of the GI system and the many ways in which dysfunction can be easily detected, it is not surprising that GI manifestations are often the presenting symptoms in a multiorgan disease process.
Therefore, we are fortunate that the last few decades have witnessed many advances in our understanding of pathophysiology of gastroenterologic disorders at the molecular level, leading to many new diagnostic, prevention, and treatment options. In this issue, the authors present and discuss these important breakthroughs. They also devote considerable attention to those disorders for which major breakthroughs are yet to come, but outline the smaller successes that have allowed for earlier detection and treatment that at least modify the associated discomfort and adverse effects. This is a field of practice that is rapidly changing, and the authors have done a wonderful job of capturing the important events therein. General pediatricians, pediatric gastroenterologists, and other pediatric practitioners will have much to learn from the content of this issue.
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