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HD2 > GI Conditions in Children > Flashcards

GI Conditions in Children Flashcards

1
Q

What are the main causes of abdominal pain?

A
  • constipation
  • IBS
  • duodenal ulcers
  • helicobacter pylori
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2
Q

What are the main GI disorders in children?

A
  • constipation
  • recurrent abdominal pain
  • gastritis/duodenal ulcers
  • GORD
  • rectal bleeding
  • IBD
  • acute diarrhoea
  • chronic diarrhoea
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3
Q

What are the main causes of abdominal pain?

A
  • constipation
  • IBS
  • DU
  • IBD
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4
Q

What are the main causes of chronic vomiting?

A
  • GORD
  • intestinal obstruction
  • DU
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5
Q

What are functional GI disorders?

A
  • no evidence of inflammatory, anatomic, metabolic or neoplastic process explaining subject’s symptoms
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6
Q

What are the causes of chronic diarrhoea?

A
  • IBD
  • Malabsorption - coeliac/CF
  • constipation
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7
Q

What are the causes of failure to thrive?

A
  • diarrhoea (coeliac, CF)
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8
Q

What are the causes of rectal bleeding?

A
  • IBD
  • fissures/haemorrhoids
  • polyps
  • infection bacterial
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9
Q

What is the criteria for functional GI disorders?

A
  • paediatric rome IV critera
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10
Q

What is constipation?

A
  • infrequency hard stools
  • difficulty in defecation = distress
  • pass less than 3 stools a week
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11
Q

What is soiling?

A

Escape of stools into underclothes

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12
Q

What is encopresis?

A

Passage of normal stools in abnormal places

- behavioural

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13
Q

How does constipation present?

A
  • diarrhoea/soiling
  • infrequent bowel movements and painful
  • palpable rectal abdominal mass
  • acute abdominal pain
  • UTIs
  • abnormal anus
  • neurological abnormalities
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14
Q

What are the types of constipation?

A
  • functional >90%
  • organic (anal stenosis/neurologic/hypothyroidism/hirschprung’s)
  • rare
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15
Q

How do you diagnose constipation?

A
  • presenting symptoms
  • palpable rocks in abdomen
  • Marker study (transit time)
  • Rectal suction biopsy
  • anorectal manometry
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16
Q

How is constipation treated?

A
  • diet
  • softener (movicol)
  • stimulant (senna/picosulfate)
17
Q

What is GOR?

A
  • passive regurg of gastric/duodenal contents in oesophagus
  • objective damage (oesophagitis)
  • subjective severe symptoms (vomiting/heartburn)
18
Q

How does reflux present over 3 years?

A
  • adult symptoms

- heartburn, vomiting, oesophagitis

19
Q

What are red flags of GOR?

A
  • haematemesis
  • failure to thrive
  • sandifers syndrome (back arching, look like seizures)
  • aspiration pneumonia
20
Q

How is GOR investigated?

A
  • depends on presentation
  • pH study/impedence catheter (symptoms association) -> to measure acidity in oesophagus where it should not be, but can also have non-acidic reflex so also measure swallow/upwards reflux
  • barium swallow (anatomical abnormalities)
  • upper GI endoscopy (mucosal abnormalities)
  • clinical score (effect on patient/family)
21
Q

How is GOR treated?

A
  • feed thickening
  • reduce acid (PPIs, H2 antagonists)
  • promotility agents (domperidone)
  • jejunostomy feeds
  • Nissen’s fundoplication
22
Q

What is eosinophilic oesophagitis?

A
  • resistant GORD symptoms
  • food sticking
  • stopy
  • endoscopy to diagnose
23
Q

How is eoesinophillic oesophagitis treated?

A
  • diet exclusion

- oral budesomide

24
Q

What is recurrent abdominal pain?

A
  • 1 episode of pain per month for 3 months

- interfere with routine functioning

25
Q

What is gastritis?

A
  • inflammation of gastric mucosa

- Helicobacter pylori infection

26
Q

How does gastritis present?

A
  • vomiting
  • abdom pain
  • haematemesis
  • anaemia
27
Q

How is Helicobacter Pylori diagnosed?

A
  • endoscopy (Clo test, histology)
  • Stool antigen
  • C13 breath test
28
Q

How is HP treated?

A
  • amoxicillin
  • clarithromycin
  • H2 antagonists/PPI
  • repeat breath tests/stool after treatment ensuring eradication
29
Q

What may be the causes of rectal bleeding?

A
  • constipation + fissures
  • bacterial infections
  • IBD
  • polyps
  • worms
30
Q

What is Crohn’s?

A
  • mouth to anus
  • transmural inflammation (not just mucosal)
  • granulomas
31
Q

What is UC?

A
  • only rectum/colon

- mucosal inflammation

32
Q

How does Crohn’s present?

A
  • abdominal pain
  • weight loss
  • diarrhoea (bloody)
  • growth failure/pubertal delay
  • raised ESR/CRP/low albumin/Hb
  • fever, clubbing, oral ulcers
33
Q

How does UC present?

A
  • chronic bloody diarrhoea
  • abdo pain
  • weight loss
34
Q

How is IBD diagnosed?

A
  • endoscopy and biopsy

- MRI

35
Q

How is IBD treated?

A
  • steroids
  • enteral nutrition
  • infliximab (anti-TNF)
    THEN
  • immunosuppressants
  • anti-TNF
36
Q

How does surgery treat IBD?

A
  • medications not working
  • obstruction
  • poor growth
  • colectomy (cures colitis)
37
Q

What are juvenile polyps?

A

Haematomas

- painless rectal bleeding

HD2 (22 decks)

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