GI 3 Flashcards
two disorders of IBD
1) Ulcerative colitis
2) Crohn’s disease (serious complication, growth failure)
treatment of Crohn’s
- pharmacological
- nutritional
- surgical
goals of Crohn’s
- control disease by remission and preventing relapse (maintain adequate nutrition)
- decrease inflammation
- correct nutritional deficit
- provide relief of symptoms
- no cure (management)
nutritional management of Crohn’s
- dietary modifications
- vitamins
- oral supplements
- hyperalimentation
meds for Crohn’s
- antibiotics
- antidiarrheal preparations
- anti inflammatory agents
- immunosuppressants
- analgesics or narcotics (be careful with narcotics in kids, can further compound bowel function)
describe surgery for Crohn’s
- surgery is NOT curative
- palliative to improve QOL and sumptoms
- 70% of pts will require surgery eventually (drain, close, remove, repair)
describe ulcerative colitis
-acute or chronic inflammation of colon
-characterized by bloody diarrhea
s/s: abd pain, bloody D, urgency, tenesmus
diagnostics of UC
- radiological
- endoscopic
- evaluate characteristics and location of lesions
treatment of UC
- disease control (induce remission, prevent replace, normal growth)
- *CURABLE with surgery (ileostomy)
describe gastroenteritis
- inflammation of stomach and intestines
- acute or chronic
- results in: D/V, abd pain, fever
- *high risk if at day care or preschool
diagnostics of gastroenteritis
- rectal/stool culture
- blood culture
causes of gastroenteritis
- allergy
- viral or bacterial (giardia and rotavirus are most common)
- parasites
- food poisoning
treatment of gastroenteritis
- *contact precautions (hand washing) to prevent spread
- acetaminophen for fever
- NO antidarrheals (for kids ever)
- antibiotics for shigella or giardia
- fluid replacement (oral or IV solutions up to 2x maintenance)
what is important to replace if V
electrolytes
**small amounts of fluids in frequent intervals
describe vomiting and causes of it
- forceful expulsion of stomach contents
- consequences: metabolic alkalosis, dehydration
- causes: allergic reaction, overfeeding, infection, CNS disorder, meds, pyloric stenosis, intussusception
describe diarrhea
- loose watery stools
acute: <14 days (ie/viral infection)
chronic: >14 days
causes of D
- infection (ROTAVIRUS)
- parasitic infestation
- association with URI, UTI, OM
- diet
- meds
- IBS
- can be r/t anxiety or travel
s/s of D
- hyperactive BS
- at least 3 loose/liquid stools a day
- urgency
- abd pain
- cramping
consequences of D
- dehydration
- electrolyte imbalance
- metabolic acidosis
- malnutrition
what should you not give as a fluid replacement
gatorade and juice, have a lot of sucrose and can increase D
describe constipation
- peaks between 2-4 years
- idiopathic or functional
- difficulty/infrequent passage of hard stool (straining, abd pain, withheld)
how to manage constipation
- dietary (increase fluids and water)
- occasional stool softener
management of chronic constipation
- needs bowel cleansing and maintenance therapy
- laxative (milk of magnesia and miralax)
- bowel retraining (regular toileting 2x/day)
describe encopresis
- stool incontinence beyond age when normally able to control bowel
- soiling is involuntary and without warning
- usually results of fecal impaction and enlarged rectum
- *goal: establish regular bowel habits
