Christophe Faure

• MD
• Professor at Université de Montréal

The International Network on Esophageal Atresia (INoEA) stands as a beacon of collaboration in addressing the complexities of this congenital condition on a global scale. The eleven board members, from various countries (USA, Canada, France, Australia, Italy, Sweden, Germany, and The Netherlands) and backgrounds (pediatric gastroenterology, pediatr...

Background Pediatric intestinal pseudo-obstruction (PIPO) is a rare, heterogeneous and severe gut motility disorder. It is associated with a high morbidity and mortality rate. The etiology of PIPO can be either primary (sporadic or familial), secondary or idiopathic. In primary forms, 50 to 75% of patients will present symptoms in the first month o...

BACKGROUND. Glucosensing elements are widely distributed throughout the body and relay information about circulating glucose levels to the brain via the vagus nerve. However, while anatomical wiring has been established, little is known about the physiological role of the vagus nerve in glucosensing. The contribution of the vagus nerve to inflammat...

Background: Vagus nerve stimulation (VNS) reduced inflammation induced by lipopolysaccharide (LPS) in an adult rat sepsis model. A multi-dimensional heart rate variability (HRV) index reliably tracked the inflammatory profile in near-term sheep fetuses. The effects of VNS on neonates are not known. First, in a neonatal piglet model of sepsis, we pr...

Objectives: Aerodigestive disorders encompass various pathological conditions affecting the lungs, upper airway, and gastrointestinal tract in children. While advanced care has primarily occurred in specialty centers, many children first present to general pediatric gastroenterologists with aerodigestive symptoms necessitating awareness of these c...

Background and Aim To assess the outcomes of children born with esophageal atresia/tracheoesophageal fistula (EA-TEF) with concomitant SARS-CoV-2 infection. Methods An international survey was circulated to the International Network of Esophageal Atresia ( INoEA) members from April 2020 to May 2022. Information on demography, type of EA-TEF, co-mor...

Oesophageal atresia-tracheoesophageal fistula (EA-TEF) is a common congenital digestive disease. Patients with EA-TEF face gastrointestinal, surgical, respiratory, otolaryngological, nutritional, psychological and quality of life issues in childhood, adolescence and adulthood. Although consensus guidelines exist for the management of gastrointestin...

Purpose: Anorexia Nervosa (AN) is a serious and potentially lethal mental disorder characterised by a deliberate quest to reduce one's weight. It can have multiple physical and psychological consequences. The clinical presentation of AN can include gastrointestinal symptoms, however, the pathophysiology of these symptoms in the context of AN remai...

Chronic intestinal pseudo-obstruction (CIPO) represents the most severe end of the spectrum of gut motility disorders comprising a group of rare, heterogeneous, and disabling disorders of the gastrointestinal (GI) tract characterized by absent or ineffective intestinal peristalsis. Clinical experience and research show considerable differences betw...

Functional lumen imaging probe (FLIP) is a device that measures luminal parameters in the esophagus including cross-sectional area, pressure, diameter, and distensibility index using impedance planimetry. FLIP may also help identify anterograde and retrograde contractile activity in the esophageal body analyzed by the FLIP 2.0 system. This relative...

Esophageal atresia is a common congenital anomaly associated with esophageal and gastric dysmotility. The dysmotility may be caused by intrinsic factors and operative manoeuvres. Adequate understanding of the esophageal dysfunction is mandatory in order to treat and ultimately prevent complications.

Visceral sensitivity is a complex phenomenon that is regarded as a key pathophysiological factor in children with disorders of brain-gut interaction. Techniques developed in adults have been adapted to children making possible measures of visceral sensory thresholds of stomach and colon. This chapter reviews the barostat technique and the satiety d...

The diverse functions of the GI tract are dependent on highly coordinated sensory and effector mechanisms, which monitor the GI lumen and wall, respond to specific cues and interact with a diversity of cell types within the GI tract. In conjunction with a drive to maintain homeostasis within the body and control gut inflammation, the effector mecha...

A series of well-regulated cellular and molecular events result in the compartmentalization of the anterior foregut into the esophagus and trachea. Disruption of the compartmentalization process leads to esophageal atresia/tracheoesophageal fistula (EA/TEF). The cause of EA/TEF remains largely unknown. Therefore, to mimic the early development of t...

Background The aim of this study was to establish the feasibility and safety of the use of indocyanine green technology during pediatric intestinal resections. While indocyanine green fluorescence angiography (ICG-FA) has been advocated as an imaging technique to assess bowel perfusion in adults, few studies have evaluated this technology in a pedi...

Fecal incontinence is defined as an involuntary passage of gas or stool through the anus. It affects 5% of the active population and greatly impedes the quality of life of those affected – one-third of patients experiencing a reduction in social or professional activities and nine out of ten patients reporting that their quality of life has decreas...

Constipation, in the medical community, is often identified as a condition where the daily stools are low in number (the “normal” daily frequency being estimated as 1 ± 3 bowel movements/day) and/or weight (the “normal” weight of stools being approximately 200 g/day).

The digestive tract begins, we often forget, with the oral cavity. The teeth grind the food before the tongue and the striated muscles of the pharynx push it into the esophagus.

Esophageal atresias/tracheoesophageal fistulas (EA/TEF) are rare congenital anomalies caused by aberrant development of the foregut. Previous studies indicate that rare or de novo genetic variants significantly contribute to EA/TEF risk, and most individuals with EA/TEF do not have pathogenic genetic variants in established risk genes. To identify...

Objectives: After surgical repair, up to 70% of esophageal atresia (EA) patients suffer from gastroesophageal reflux disease (GERD). The ESPGHAN/NASPGHAN guidelines on management of gastrointestinal complications in EA patients was published in 2016. Yet, the implementation of recommendations on GERD management remains poor.We aimed to assess GERD...

Background: This report describes a unique case of long-term survival of a young girl who was diagnosed with severe, rapidly progressive lysosomal acid lipase deficiency (LAL-D; historically "Wolman disease") at three months of age and began receiving therapeutic interventions at four months of age. This disease involves rapidly progressive multis...

The presence of endoscopically visible breaks in the mucosa at/or immediately above the gastroesophageal junction is a sign of reflux esophagitis, but the presence of endoscopically normal esophageal mucosa does not exclude a diagnosis of non-erosive reflux disease. Reflux esophagitis may affect the mucosa in a patchy fashion, and, as such, multipl...

Background: Chronic intestinal pseudo-obstruction is a rare disorder and represents the most severe form of gastrointestinal dysmotility with significant morbidity and mortality. Emerging research shows considerable differences between the adult and pediatric population with intestinal pseudo-obstruction and the term Pediatric Intestinal Pseudo-Ob...

Esophageal atresias/tracheoesophageal fistulas (EA/TEF) are rare congenital anomalies caused by aberrant development of the foregut. Previous studies indicate that rare or de novo genetic variants significantly contribute to EA/TEF risk, and most individuals with EA/TEF do not have pathogenic genetic variants in established risk genes. To identify...

The contribution of the vagus nerve to inflammation and glucosensing in the fetus is not understood. We hypothesized that vagotomy (Vx) will result in hyperglycemia and this will be enhanced during systemic and organ-specific inflammation. Efferent vagus nerve stimulation (VNS) should reverse this phenotype. Near-term fetal sheep (n=57) were surgic...

A series of well-regulated cellular and molecular events result in the compartmentalization of the anterior foregut into the esophagus and trachea. Disruption of the compartmentalization process leads to esophageal atresia/tracheoesophageal fistula (EA/TEF). Therefore, the objective is to differentiate pluripotent stem cells (PSCs), namely, embryon...

Esophageal atresia/tracheoesophageal fistula (EA/TEF) is the most common congenital anomaly of the upper gastrointestinal tract affecting 1 in 3,000 which could stem from a developmental anomaly of the foregut. The cause is not fully understood. We generated three iPSC cell lines using peripheral blood mononuclear cells (PBMCs) from EA/TEF type C p...

Introduction: The detailed expression pattern of calretinin immunohistochemistry in the transition zone (TZ) of Hirschsprung disease (HSCR) has not yet been reported. This study aims to examine the value of calretinin immunohistochemistry for more accurately determining the distal and proximal border of the TZ in short segment HSCR. Methods: Specim...

Background: Functional luminal imaging probe (FLIP) measures pressure-geometry relationships of digestive luminal space. When used in esophageal disorders, it provides several luminal parameters that help better understand the pathophysiology. Data about the potential utility of FLIP in pediatrics are scarce and there is no standardized use in chi...

Purpose: Indocyanine green fluorescence angiography (ICG-FA) is a validated non-invasive imaging technique used to assess tissue vascularization and guide intraoperative decisions in many surgical fields including plastic surgery, neurosurgery, and general surgery. While this technology is well-established in adult surgery, it remains sparsely used...

Purpose Recent studies have identified transanastomotic tubes (TATs) as a risk factor for the development of anastomotic strictures after repair of esophageal atresia with tracheoesophageal fistula (EATEF). We further investigated these findings in a multicenter study. Methods We conducted a retrospective cohort study at three university-affiliate...

Esophageal atresias/tracheoesophageal fistulas (EA/TEF) are rare congenital anomalies caused by aberrant development of the foregut. Previous studies indicate that rare or de novo genetic variants significantly contribute to EA/TEF risk, and most individuals with EA/TEF do not have pathogenic genetic variants in established risk genes. To identify...

Background Aims Hirschsprung disease (HSCR) is a life-threatening birth defect in which the distal colon is devoid of enteric neural ganglia. HSCR is treated by surgical removal of aganglionic bowel, but many children continue to have severe problems after surgery. We studied whether administration of glial cell derived neurotrophic factor (GDNF) i...

Objectives: The aim of this study was to assess whether clinicians approached the management of children with esophageal atresia (EA) in accordance with the 2016 European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)/North American Society of Paediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines o...

Hirschsprung disease (HSCR) is a complex genetic disorder of neural crest development resulting in incomplete formation of the enteric nervous system (ENS). This life-threatening neurocristopathy affects 1/5000 live births, with a currently unexplained male-biased ratio. To address this lack of knowledge, we took advantage of the TashT mutant mouse...

Objectives: Esophageal dysmotility is common in patients with esophageal atresia (EA). High-resolution impedance manometry (HRIM) and Pressure Flow analysis (PFA) allow characterization of biomechanical events that drive bolus flow. The aims were to assess esophageal motility in children with EA, using pressure flow analysis, and to test whether t...

Esophagus and trachea arise from a common origin, the anterior foregut tube. The compartmentalization process of the foregut into the esophagus and trachea is still poorly understood. Esophageal atresia/tracheoesophageal fistula (EA/TEF) is one of the most common gastrointestinal congenital defects with an incidence rate of 1 in 2,500 births. EA/TE...

We investigated activation status, cytotoxic potential, and gut homing ability of the peripheral blood Natural Killer (NK) cells in Crohn disease (CD) patients. For this purpose, we compared the expression of different activating and inhibitory receptors (KIR and non-KIR) and integrins on NK cells as well as their recent degranulation history betwe...

In adults, vagus nerve stimulation (VNS) reduces inflammation. In neonates, the effects of VNS are not known. An electrocardiogram (ECG)-derived heart rate variability (HRV) index reliably tracks the inflammatory response induced by low-dose lipopolysaccharide (LPS) in near-term sheep fetuses. We evaluated the VNS effect on the systemic inflammator...

Objective: To evaluate outcomes of patients with esophageal atresia (EA) on systematic treatment with proton pump inhibitors (PPI) since the neonatal period and to determine factors associated with successful discontinuation of PPI. Study design: Longitudinal cohort study with prospective data collection of 73 EA patients, over 11 years systemat...

Background Killer-cell Immunoglobulin-like Receptor (KIR) genes encode receptors, which are mainly expressed on, and control functional activities of, Natural Killer (NK) cells. There exist six distinct activating KIR genes in humans, who differ from one another with respect to the repertoire of these genes. Because activated NK cells can potential...

Objectives and Study Clinical course in oesophageal atresia (OA) patients is frequently complicated by gastroesophageal reflux disease, which is thought to be a risk factor for formation of anastomotic strictures. It is currently recommended that OA patients be treated systematically with proton pump inhibitors (PPI) after surgical repair. However,...

Background Esophageal dysmotility is common in patients with esophageal atresia (EA). High-resolution impedance manometry (HRIM) and pressure flow analysis (PFA) allow characterization of biomechanical bolus flow and swallow properties. The aim of this study was to characterize esophageal motility and bolus flow propulsion in children who underwent...

Purpose This study aims to characterize risk factors for Hirschsprung-associated enterocolitis (HAEC). We hypothesize that earlier pull-through surgery is associated with lower risks of developing postoperative HAEC. Methods A comparative study of 171 Hirschsprung patients treated from 1990 to 2017 was performed. Patients without HAEC were compare...

Purpose This study examines the impact of postoperative noninvasive ventilation strategies on outcomes in esophageal atresia–tracheoesophageal fistula (EA-TEF) patients. Methods A single center retrospective chart review was conducted on all neonates followed at the EA-TEF Clinic from 2005 to 2017. Primary outcomes were: survival, anastomotic leak...

Background Pediatric intestinal pseudo-obstruction (PIPO) is a rare and severe gut motility disorder associated with a high morbidity and a high mortality rate. The majority of PIPO are of primary origin. Prenatal symptoms can be detected in about 20 % of children and the symptoms start by one year of age in 80%. Up to 60 - 80% of patients require...

Objectives Endoscopic follow-up after esophageal atresia (EA) tracheoesophageal fistula (TEF) repair is recommended to detect esophageal histopathological complications. We investigated the prevalence of histopathologically proven esophageal complications (peptic esophagitis, gastric metaplasia, and eosinophilic esophagitis) and assessed the predic...

Objectives: The Bristol Stool Form Scale (BSFS) is inadequate for non-toilet trained children. The Brussels Infant and Toddler Stool Scale (BITSS) was developed, consisting of 7 photographs of diapers containing stools of infants and toddlers. We aimed to evaluate inter-observer reliability of stool consistency assessment among parents, nurses and...

Background: Scoliosis has been reported after repair of esophageal atresia with or without tracheoesophageal fistula (EA-TEF). This study aims to investigate the prevalence and natural history of scoliosis and associated congenital vertebral anomalies in patients operated for EATEF. Methods: A retrospective review of patients operated for EA-TEF...

Toll-IL-1Receptor (TIR)-8 is an atypical member of the IL-1 receptor family (IL-1RF). Recently, it was shown to act as the second sub-unit of the receptor for IL-37, the first being IL-18Rα chain. IL-37 is a potent anti-inflammatory cytokine belonging to the IL-1 family that exerts anti-inflammatory, immune deviating and metabolic effects. We found...

Aim This prospective study evaluated the incidence of functional gastrointestinal disorders (FGIDs) during infancy, on their own or combined with other symptoms. Methods We asked 273 French paediatricians with a specific interest in FGIDs to provide feedback on 2,757 infants aged 0‐6 months from March 2013 to January 2014. Gastrointestinal health...

Objectives: Chronic intestinal pseudo-obstructive (CIPO) conditions are considered the most severe disorders of gut motility. They continue to present significant challenges in clinical care despite considerable recent progress in our understanding of pathophysiology, resulting in unacceptable levels of morbidity and mortality. Major contributors...

Purpose of review: Guidelines were recently published highlighting why esophageal atresia (EA) patients are prone to complication risks, and the need for long-term follow-up. In this review, we will focus on how to investigate and treat potential complications, as well as the pros and cons of different investigative and treatment modalities, and w...

Chronic intestinal pseudo-obstruction (CIPO) represents the most severe end of the spectrum of gut motility disorders comprising a group of rare, heterogeneous, and disabling disorders of the gastrointestinal (GI) tract characterized by absent or ineffective intestinal peristalsis. Pediatric CIPO results from developmental and pathological processe...

Visceral sensitivity is a complex phenomenon that is regarded as a key pathophysiological factor in children with functional gastrointestinal disorders (FGID). In the recent years, techniques have been developed in adults and adapted to children making possible measures of visceral sensory thresholds of stomach and colon. This chapter reviews the b...

Esophageal atresia is a common congenital anomaly associated with esophageal and gastric dysmotility. The dysmotility may be caused by intrinsic factors and operative maneuvers. Thorough understanding of the esophageal dysfunction is necessary in order to provide appropriate treatment and ultimately prevent complications.

The GI tract has a rich afferent innervation that can detect mechanical, chemical, and thermal stimuli. Sensory information reaching the cortex can give rise to conscious sensations, painful or not. Abnormal heightened visceral sensitivity may lead to functional gastrointestinal disorders, and visceral hypersensitivity is considered a crucial patho...

Whether or not one believes in the theory of evolution, it is apparent that some of the first multicellular organisms to have inhabited the earth, including the presumptive earliest ancestors of humans, were elongated structures with a core gut tube (The quest for food: a natural history of eating, New York, 2007; Genesis 46:605–13, 2008). In the a...

The objective of the present study is to describe a cohort of complex esophageal atresia and the yield of genetic tests performed for such patients. We selected 45 patients with complex esophageal atresia (EA), namely those having at least one associated anomaly. We reviewed their medical records to assess clinical features, other diagnoses, and ge...

BACKGROUND: Advancements in critical care have been instrumental in the observed improvement in survival and complication rates in Oesophageal atresia-Tracheo-Oesophageal Fistula (OA-TOF). Nearly all neonates with OA-TOF undergo assisted ventilation at some point in the course of their post operative care. Post operative assisted ventilation strate...

Esophageal dysmotility is almost universal after esophageal atresia (EA) repair and is mainly related to the developmental anomaly of the esophagus. Esophageal dysmotility is involved in the pathophysiology of numerous symptoms and comorbidities associated with EA such as gastroesophageal reflux disease, aspiration and respiratory complications, an...

Background: Rumination is defined by effortless regurgitation within seconds or minutes of ingested food. The aim of this study was to determine the high resolution esophageal manometry (HREM) pattern in children with rumination syndrome. Patients and methods: HREM was evaluated in 15 pediatric patients with rumination syndrome according to the...

INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategies, and highlight the necessity of experience and...

Introduction The Bristol Stool Form Scale (BSS) which consists of 7 photographs of different stool forms allows assessment of stool consistency (scale 1 for hard lumps to scale 7 for watery stools), in an objective manner in adults. The BSS is also sometimes used to characterise the stools of infants and young children. Despite its use, there is ge...

Objectives: Patients with esophageal atresia/tracheo-esophageal fistula (EA-TEF) can develop Barrett's esophagus as a long-term consequence of their condition. Intestinal metaplasia (IM), a risk factor for developing adenocarcinoma of the esophagus, has not been well characterized in the pediatric population. Methods: Retrospective review of EA-...

This volume provides a comprehensive and up-to-date theoretical review and practical guide on pediatric gastrointestinal motility and functional disorders. The latest edition includes extensively revised and new chapters to reflect the rapidly growing field of pediatric neurogastroenterology. New topics covered include neurobiology of pain in child...

Introduction: Scoliosis reported after esophageal atresia (EA) repair may be secondary to thoracotomy or due to associated congenital vertebral anomaly. However, the prevalence and natural history of scoliosis in patients with EA are not clear. Aim: To review the prevalence and natural history of thoracogenic scoliosis and associated congenital...

Background: Esophageal atresia (EA) is one of the most common congenital digestive anomalies. With improvements in surgical techniques and intensive care treatments, the focus of care of these patients has shifted from mortality to morbidity and quality-of-life issues. These children face gastrointestinal (GI) problems not only in early childhood...

Contexte L’ustekinumab est un anticorps monoclonal dirigé contre la sous-unité p40 de l’interleukine-12/23. Il a été montré supérieur au placebo dans l’induction de la réponse et le maintien de la rémission chez les patients adultes atteints de maladie de Crohn modérée à sévère, mais pas encore étudié en pédiatrie. Buts de l’étude Décrire la sécur...

In 2006, a consensus concerning functional gastrointestinal intestinal disorders (FGIDs) in infants and toddlers was described. At that time little evidence regarding epidemiology, pathophysiology, diagnostic work-up, treatment strategies and follow-up was available. Consequently the criteria for the clinical entities were more experience than evid...

Introduction EA-TEF patients can develop Barrett's esophagus (BE) which requires careful follow-up. Chronic reflux is associated with BE in adults, but incidence and risk factors for developing BE in EA-TEF are unknown. Aim To determine 1- The incidence of gastric metaplasia (GM) and 2- Factors associated with GM in EA-TEF patients. Methods Retro...

Background Vascular anomalies may be associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF). Our main objective is to report their incidence in a cohort of EA/TEF patients while describing clinical presentation, diagnosis and consequences. The secondary objective is to determine the diagnostic value of esophagram in the diagnos...

Objectives To study the prevalence of Barrett esophagus (BE) (gastric and/or intestinal metaplasia) in adolescents treated for esophageal atresia (EA). Methods This multicentric, prospective study included patients 15 to 19 year-old with medical history of EA. An upper endoscopy with standardized esophageal staged biopsies (at least 12) under gene...

Introduction Early introduction of non-nutritive sham feeds in long gap esophageal atresia (LGEA) has been reported in the literature to help prevent long-term oral aversion. Aim To report the safety of sham feeds in LGEA; To develop a protocol for routine sham feeds in LGEA. Methods A retrospective chart review of LGEA management was performed o...

Introduction Patients with esophageal atresia/tracheo-esophageal fistula (EA-TEF) can develop gastric (GM) or intestinal metaplasia (IM) of the esophagus. However IM, which is a major risk factor for adenocarcinoma, has not been well characterized in children. Aim Identify and evaluate EA-TEF children with IM. Methods Retrospective review of EA-T...

Objective: Necrotizing enterocolitis of the neonate is an acute inflammatory intestinal disease that can cause necrosis and sepsis. Chorioamnionitis is a risk factor of necrotizing enterocolitis. The gut represents the biggest vagus-innervated organ. Vagal activity can be measured via fetal heart rate variability. We hypothesized that fetal heart...

Objective: To study the prevalence of Barrett esophagus (BE) (gastric and/or intestinal metaplasia) in adolescents treated for esophageal atresia (EA). Summary of background data: EA patients are at high risk of BE. Methods: This multicenter prospective study included EA patients aged 15 to 19 years. All eligible patients were proposed an uppe...

Hirschsprung's disease (HSCR) is a severe congenital anomaly of the enteric nervous system (ENS) characterized by functional intestinal obstruction due to a lack of intrinsic innervation in the distal bowel. Distal innervation deficiency results from incomplete colonization of the bowel by enteric neural crest cells (eNCCs), the ENS precursors. Her...

Background Epigenetic modifications such as DNA methylation are widely being studied in Crohn’s disease (CD). So far, studies using peripheral blood or intestinal tissue have not identified any consistent methylation signals that could enable discriminating between individuals with and without risk for CD. This lack of consistency may be related to...