Chronic Diarrhea in Children Flashcards
1
Q
Chronic diarrhea in children - Pathology:
A
- Osmotic vs Secretory
- Villous or microvillous distortion
- Decreased disaccharidase activity (especially lactase)
- Increased permeability of intestinal mucosa
- Secondary allergisation for food antigens
- Dysbacteriosis
- Deconjugation of bile acids
2
Q
Chronic diarrhea in children - Clinical features:
A
Osmotic Vs Secretory
3
Q
Chronic diarrhea in children - Common cause:
A
- Food allergy
- Carbohydrate intolerance (lactose, saccharose).
- Diet (sorbitol, malnutrition)
- Drugs (antibiotics, laxatives, chemotherapy)
- Infections: bacterial, viruses, parasites
- Inflammatory bowel disease (Crohn d, ulcerative colitis)
- Celiac disease
- Nonspecific diarrhea –toddlers diarrhea
4
Q
Chronic diarrhea in children - Diagnostics:
A
- Stool volume >10 gr/kg/day in infants / toddlers
- Stool volume > 200gr/day in older children
- i.e. Typically 3 or more than loose or watery stools in 24 hours or one with pus, blood or mucus
- Duration - > 10-14 days
5
Q
Chronic diarrhea in children - Treatment:
A
- Elimination diet
- to avoid only allergic food(s)
- Hypoallergenic formulas - hydrolyzed protein (Bebilon pepti,Nutramigen)
- Elemental formulas (Elecare, Neocate, Puramino)
6
Q
Chronic diarrhea in children - Complications
A
- poor weight gain or loss
- continuous diarrhea
- night stools waking patient from sleep
- blood and mucous in stools
- failure to thrive
- associated symptoms of systemic disease:
- rash, fever, joint pain
- acid stools, burning sensation with severe inflammation
7
Q
Chronic diarrhea in children - TABLE
A
page 220
Lactosd intolerance and saccharose intolerance
