Down Syndrome Children - An Update

Are Gastrointestinal Disorders of Real Concern in Children with Down Syndrome?

Author(s): Mohammed Al-Biltagi

Pp: 223-256 (34)

DOI: 10.2174/9781681081342115010009

* (Excluding Mailing and Handling)

Abstract

Down syndrome (DS) is a systemic disorder affecting the whole body including the gastrointestinal (GI) tract; from the oral cavity and ending with the anal canal that are involved in the food digestion absorption and excretion. These disorders could be anatomical or functional. About 10% of children born with DS have one or more forms of the structural abnormalities which may include tracheoesophageal fistula, congenital diaphragmatic hernia, small bowel obstruction, annular pancreas, and anal anomalies. Functional gastrointestinal disturbances include oral, esophageal, gastric and/or intestinal motility dysfunctions leading to feeding difficulties, prolonged feeding duration, dysphagia, gastro-oesophageal reflux disease, increased risk of aspiration, delayed gastric emptying, constipation, Hirschprung's disease and malnutrition with its effects on general health and physical compromise. These functional disturbances may be difficult to treat and may, in sequence, affect the prognosis of corrective surgeries, and hence need more cautions.

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      • 11. app/Models/ContentAccess.php:647
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314545352 and j.to_ip >=314545352 )) and ((j.from_date <= 1739971617 and j.to_date >= 1739971617 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 8022) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314545352 and j.to_ip >=314545352 )) and ((j.from_date <= 1739971617 and j.to_date >= 1739971617 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 8022) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314545352 and j.to_ip >=314545352 )) and ((j.from_date <= 1739971617 and j.to_date >= 1739971617 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 8022)
      1msalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 1763 and `b`.`banner_from_date` <= 1739971617 and `b`.`banner_to_date` >= 1739971617 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.55msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 1763
      • 3: 1739971617
      • 4: 1739971617
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='dc88c306dac488bbe64b21e62a4a1cff'
      310μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Keywords
    1Keywords.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        gWD6C2tXP0pplmtWxNpCIJbjiUyAJvuSEx5Bs4JK
        uc_cart_id
        dc88c306dac488bbe64b21e62a4a1cff
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/8022" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/8022
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6IjNaNFhzRUp2TnNoVVlKb3NPQU5SeEE9PSIsInZhbHVlIjoiSkd5U1ZLRHU1V1MxeWREYW9TSlZlRFgrM0NiQ2x4N2ZQdDEvYUhSdDdJaz0iLCJtYWMiOiIzMjFjMDJjMDVmOGMxYmJhMmUzZmFiOWQ2MzgyNzg4YmFkOGNkNWQyM2IxYTcwMGU4N2Y4ODM3NThkMDIxZGY4IiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6IjNaNFhzRUp2TnNoVVlKb3NPQU5SeEE9PSIsInZhbHVlIjoiSkd5U1ZLRHU1V1MxeWREYW9TSlZlRFgrM0NiQ2x4N2ZQdDEvYUhSdDdJaz0iLCJtYWMiOiIzMjFjMDJjMDVmOGMx" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Wed, 19 Feb 2025 13:26:57 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkY0bHZvSHZpWHREY3h5SGptVnY5Umc9PSIsInZhbHVlIjoiN2IwWXZBcG9Odld2Y25KYW9FcmhObzIvKzR6TURrZHZ1VUJUS1hRODNNUHByaVkvbmhZd0UxaUdjT2Jna0daYy9MMHI5VEYxa3JJYTNTdmJwZndNMzJzYXV0M2lsZHpZMzdIR1ZMaW0wc2hiT0Mxb2xqb1RDYzNCMUkrVjR5ZUMiLCJtYWMiOiIxNWMwMzRjNWZmYTE5MmIyM2ExMzM2N2Y1MDVkZjY4MzBmNGM0NzgxMzlkMTU1YjBiZTAzN2VhZWU0OTgxNTE2IiwidGFnIjoiIn0%3D; expires=Sat, 22 Feb 2025 01:26:57 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IkY0bHZvSHZpWHREY3h5SGptVnY5Umc9PSIsInZhbHVlIjoiN2IwWXZBcG9Odld2Y25KYW9FcmhObzIvKzR6TURrZHZ1VUJUS1hRODNNUHByaVkvbmhZd0UxaUdjT2Jna0daYy9MMHI5V" 1 => "alphaeurekaselectnet_session=eyJpdiI6IkJ5TWQ3NGp6dllLbE81MTdsTXkxdEE9PSIsInZhbHVlIjoiWmVnMDFMR1VWbVk3d2tVT2NzVHpNTTBXNFpXTGtBR0dvVWc3bUFOYmtycUtmZG9jcXc3VElPZ2ZGL3JucmtrdEUvK1pyRHlFUWxhL3RRWjBYY1EwRFFnMjhrenpXcTROZFVtS3FQUGZtRzdzWFRnTExPT0RsS1E5Q1FyRUlRZ0YiLCJtYWMiOiJmYTAzMDVlZDc5NWE5MjFmMTJmODEzNWJkOTk3YWY5OWE2MGI3Mjk5NWVkOWY0NWQxODI1ZjVhMThlNTBmZGZlIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IkJ5TWQ3NGp6dllLbE81MTdsTXkxdEE9PSIsInZhbHVlIjoiWmVnMDFMR1VWbVk3d2tVT2NzVHpNTTBXNFpXTGtBR0dvVWc3bUFOYmtycUtmZG9jcXc3VElPZ2Z" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkY0bHZvSHZpWHREY3h5SGptVnY5Umc9PSIsInZhbHVlIjoiN2IwWXZBcG9Odld2Y25KYW9FcmhObzIvKzR6TURrZHZ1VUJUS1hRODNNUHByaVkvbmhZd0UxaUdjT2Jna0daYy9MMHI5VEYxa3JJYTNTdmJwZndNMzJzYXV0M2lsZHpZMzdIR1ZMaW0wc2hiT0Mxb2xqb1RDYzNCMUkrVjR5ZUMiLCJtYWMiOiIxNWMwMzRjNWZmYTE5MmIyM2ExMzM2N2Y1MDVkZjY4MzBmNGM0NzgxMzlkMTU1YjBiZTAzN2VhZWU0OTgxNTE2IiwidGFnIjoiIn0%3D; expires=Sat, 22-Feb-2025 01:26:57 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IkY0bHZvSHZpWHREY3h5SGptVnY5Umc9PSIsInZhbHVlIjoiN2IwWXZBcG9Odld2Y25KYW9FcmhObzIvKzR6TURrZHZ1VUJUS1hRODNNUHByaVkvbmhZd0UxaUdjT2Jna0daYy9MMHI5V" 1 => "alphaeurekaselectnet_session=eyJpdiI6IkJ5TWQ3NGp6dllLbE81MTdsTXkxdEE9PSIsInZhbHVlIjoiWmVnMDFMR1VWbVk3d2tVT2NzVHpNTTBXNFpXTGtBR0dvVWc3bUFOYmtycUtmZG9jcXc3VElPZ2ZGL3JucmtrdEUvK1pyRHlFUWxhL3RRWjBYY1EwRFFnMjhrenpXcTROZFVtS3FQUGZtRzdzWFRnTExPT0RsS1E5Q1FyRUlRZ0YiLCJtYWMiOiJmYTAzMDVlZDc5NWE5MjFmMTJmODEzNWJkOTk3YWY5OWE2MGI3Mjk5NWVkOWY0NWQxODI1ZjVhMThlNTBmZGZlIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IkJ5TWQ3NGp6dllLbE81MTdsTXkxdEE9PSIsInZhbHVlIjoiWmVnMDFMR1VWbVk3d2tVT2NzVHpNTTBXNFpXTGtBR0dvVWc3bUFOYmtycUtmZG9jcXc3VElPZ2Z" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "gWD6C2tXP0pplmtWxNpCIJbjiUyAJvuSEx5Bs4JK" "uc_cart_id" => "dc88c306dac488bbe64b21e62a4a1cff" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/8022" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-19 13:26:57GET/chapter/8022112193