13. Gastro Presentations

Question 1

What is Encopresis and soiling, how does it present and what is its DDx?

Answer 1

involuntary loss of formed, semiformed, or liquid stool into the child’s underwear in the presence of functional (idiopathic) constipation in a child 4 years of age

S+S = soiled underpants, foul body odour (the smell of stool), lower abdo pain, streaks of blood, bedwetting

DDx = constipation (anxiety, diet, inactivity, dehydration, medication)

Question 2

What is Functional abdo pain, how does it present and what is its DDx?

Answer 2

AKA intractable abdominal pain, is persistent stomach Pain that does not resolve with usual therapeutic treatment

S+S = abdo pain, diarrhoea, constipation, N+V, indigestion

DDx = IBS, food allergy, Crohn’s

Question 3

What is Malabsorption, how does it present and what is its DDx?

Answer 3

Child’s body has trouble absorbing nutrients from food

S+S = malodorous stools, chronic diarrhoea, failure to thrive, weight loss, and subnormal growth, oedema, rickets, bleeding/bruising, pot belly, bone fractures,

DDx = celiac disease, cystic fibrosis, Crohn’s disease, lactose intolerance, chronic pancreatitis

Question 4

What is Toddler diarrhoea, how does it present and what is its DDx?

Answer 4

The cause is not completely understood, common between 1-5y

S+S = >3 watery loose stools/d, pale stools

DDx = lactose intolerance, constipation

Question 5

What is Mesenteric adenitis , how does it present and what is its DDx?

Answer 5

Inflamed lymph glands in the abdomen, which cause abdominal pain - infection (strep, staph, e.col, bartonella henselae, giardia lamblia, adenovirus)

S+S = abdo pain, fever, N+V, diarrhoea, malaise, weight loss

DDx = appendicitis, crohns, acute diverticulitis, cholecystitis, pancreatitis, perforated viscus

Question 6

What is IBD, how does it present and what is its DDx?

Answer 6

• UC = chronic, idiopathic, diffuse mucosal inflammatory disease of the colon
• CD = chronic, idiopathic, trans-mural and patchy, inflammation of one or more segments of the gastrointestinal tract

S+S =

• UC = bloody diarrhoea, abdp pain, rectal bleeding
• CD = diarrhoea, abdominal pain, fatigue, reduced appetite and weight loss

DDx = intestinal tuberculosis, Behçet’s disease, nonsteroidal anti-inflammatory drug enteropathy, IBS, coeliac disease