Abdominal Pain Flashcards
causes?
- non organic
- medical
- surgical
medical causes of pain?
- constipation
- mesenteric adenitis
- coeliac
- IBD
- IBS
- abdominal migraine
- infantile colic
- HSP
- DKA
- UTI
- Pyelonephritis
surgical causes?
- appendicitis
- intusussception
- bowel obstruction
- testicular torsion
most common aetiology of constipation
- idiopathic / functional
- low fibre/high milk diet
other secondary causes of constipation to consider?
- Hirschprung’s
- CF
- esp meconium ileus
- hypothyroidism
- bowel obstruction
- spinal cord lesions
- sexual abuse
- anal stenosis
- cows milk intolerance
presentation of constipation?
- straining
- hard stools
- infrquent bowel opening
- soiling
- encopresis
- foecal incontinence
Mx of constipation?
- correct any contributing factors / encourage high fibre diet & good hydration
- laxatives - movicol first line
- disimpaction regimen if impacted, with high dose laxatives
how does infantile colic present?
- inconsolable crying for 3h/day
- presents between 3 weeks - 3 months
Mx of infantile colic?
consider trial of cow’s milk exclusion or hydrolysed milk instead
key features of GORD in infants?
- v common
- self-limiting
pathophysiology of GORD
perfectly normal as in babies there is immaturity of LOS
provided there is normal growth & baby is otherwise well, not a problem
presentation of GORD?
regurgitation, vomiting
problematic GORD:
- FTT
- chronic cough
- hoarse cry
- reluctancy to feed
Ix of GORD?
- H&E sufficient
- pH study gold standard
Mx of simple cases of GOR?
GORD= when it’s complicated
parental reassurance
- small frequent meals
- burping regularly
- not overfeeding
- keep baby upright after feeding
more problematic cases of GORD Mx?
feed thickeners, gaviscon mixed w feeds, ranitidine/omeprazole
as part of what syndrome can GORD present?
Sandifer’ Syndrome:
- GORD
- spastic torcicollis
- dystonic body movements
what must you always consider in a baby that presents with GORD / vomiting / diarrhoea - any GI presentation really?
cow’s milk protein intolerance (CMPI)
when should you consider milk intolerance?
- baby <1 year old
- aversive to feeding
- passing stools tinged w blood / mucus
- passing stools more frequently
Mx of milk intolerance?
- avoidance of cow’s milk protein in breast feeding mothers
- substitute cows milk with hydrolysed formula
difference between cow’s milk protein intolerance and cow’s milk protein allergy?
allergy is a hypersensitivity reaction to a protein in cow’s milk & therefore presents w allergic reaction (angio-oedema, hives etc)
