Common GI conditions Flashcards
Gastro-oesophageal reflux disease
Acid reflux, heart burn, pain, difficulty swallowing
weight loss/poor weight gain, damage to oesophagus, respiratory complications
Medical management- Gaviscon, domperidone, Ranitidine, omeprazole
pH and impedance study
Might need to insert PEG or surgery (Fundoplication)
Constipation
Difficulty in passing stool
Stomach cramps, bloating, lethargy, vomiting, loss of appetite, diarrhoea (overflow)
Cause:
Diet/behaviour related
Treatment for constipation
Medications- lactulose, Movicol, glycerine chip, picolax, enema
Dietician involvement and education
Psychologist support
Antegrade Continence Enema (ACE) procedure
Gastroenteritis
Infective diarrhoea and vomiting
Abdominal pain, fever, fatigue
treatment for Gastroenteritis
Oral rehydration salts, IV fluids, anti-emetics, pain relief
Isolation and infection control precautions!
Crohn’s and ulcerative colitis
Inflammatory bowel disease
Autoimmune disease
Diarrhoea, abdominal pain, blood and mucous in stool, anaemia, weight loss
treatment for Crohn’s and ulcerative colitis
Medications- steroids, immune suppressant, biologics (infliximab)
Dietary- food restrictions, modulen
Surgery
Appendicitis
Inflammation of the appendix-risk of perforation
Vomiting (bile), diarrhoea, fever, abdominal distention, pain RIF
Treatment for appendicitis
NBM, IVAB, abdominal decompression (NGT) and IV ml/ml replacement
Appendectomy
CONsertative TRreatment of Appendicitis in Children study (CONTRACT2)
Risk of abdominal collections and peritonitis
Malrotation and volvulus
Caused by incomplete rotation of the bowel during embryonic development
Can be asymptomatic
Volvulus-twisting of the bowel
Bilious vomits and poor feeding
Treatment for malrotation and volvulus
Contrast study
Surgery- Ladd’s procedure
Pyloric stenosis
Thickened pylorus muscle
Projectile vomits
Poor weight gain
Metabolic alkalosis
Treatment of pyloric stenosis
NBM, NG tube and drainage, fluid and electrolyte correction
Pyloromyotomy
Intussusception
Segment of intestine slides into adjacent bowel
Sudden onset, intermittent pain, vomiting, dehydration, red currant jelly stool
Treatment for Intussusception
Air enema
Surgery
Hirschsprung’s disease
Absence of ganglion cells (nerve cells)
Long or short segment
Abdominal distention, difficulty passing stool/constipation
Can present with enterocolitis
Treatment of Hirschsprung’s disease
Bowel washouts
Rectal biopsy
Surgical repair may be staged- stoma
Anorectal malformation
Absence of anus, incorrect location or connection
Failure to pass meconium
Can have ongoing constipation/incontinence issues (after surgery)
Treatment of Anorectal malformation
Can be single stage surgery or staged
PSARP
Rectal dilations needed
VACTERL association
Oesophageal atresia/TOF
Upper oesophagus does not connect with lower oesophagus and stomach
Tracheoesophageal fistula
Usually diagnosed antenatally
Treatment of Oesophageal atresia/TOF
Secretion management with Replogle tube
Surgery depends on length of oesophagus
May be staged repair
Dilation procedures
Gastroschisis
Abdominal wall defect
Intestines are outside of the abdominal wall
Antenally diagnosed
Treatment of gastroschisis
Silo
Abdominal wall closure
Bowel may need to be resected
Exomphalos/omphalocele
Abdominal wall defect
Organs in umbilical cord sac outside abdominal wall
Minor or major
Antenatally diagnosed
May have long term nutritional implications
Treatment of Exomphalos/omphalocele
May need staged repair
Necrotising enterocolitis
Usually, effects babies born prematurely
Portions of the bowel undergoes ischaemic necrosis
Affects 10% of neonates weighing less than 1.5kg
Distended abdomen, blood in stool, clinical deterioration
Treatments for NEC
NBM, NG feed drainage, IVAB, supportive care
Bowel resection +/- stoma formation
SMall bowel syndrome
Due to surgical removal of bowel
Long term nutritional complications
Diarrhoea, foul smelling stool, bloating, fatigue, anaemia
Requires multiple surgeries
Treatment for Small bowel syndrome
Stoma, PEG/J, CVAD, bowel lengthening (bianchi and STEP)
Management of G.I fluids
Total parental nutrition
