GI Conditions in Children Flashcards
What are the main causes of abdominal pain?
- constipation
- IBS
- duodenal ulcers
- helicobacter pylori
What are the main GI disorders in children?
- constipation
- recurrent abdominal pain
- gastritis/duodenal ulcers
- GORD
- rectal bleeding
- IBD
- acute diarrhoea
- chronic diarrhoea
What are the main causes of abdominal pain?
- constipation
- IBS
- DU
- IBD
What are the main causes of chronic vomiting?
- GORD
- intestinal obstruction
- DU
What are functional GI disorders?
- no evidence of inflammatory, anatomic, metabolic or neoplastic process explaining subject’s symptoms
What are the causes of chronic diarrhoea?
- IBD
- Malabsorption - coeliac/CF
- constipation
What are the causes of failure to thrive?
- diarrhoea (coeliac, CF)
What are the causes of rectal bleeding?
- IBD
- fissures/haemorrhoids
- polyps
- infection bacterial
What is the criteria for functional GI disorders?
- paediatric rome IV critera
What is constipation?
- infrequency hard stools
- difficulty in defecation = distress
- pass less than 3 stools a week
What is soiling?
Escape of stools into underclothes
What is encopresis?
Passage of normal stools in abnormal places
- behavioural
How does constipation present?
- diarrhoea/soiling
- infrequent bowel movements and painful
- palpable rectal abdominal mass
- acute abdominal pain
- UTIs
- abnormal anus
- neurological abnormalities
What are the types of constipation?
- functional >90%
- organic (anal stenosis/neurologic/hypothyroidism/hirschprung’s)
- rare
How do you diagnose constipation?
- presenting symptoms
- palpable rocks in abdomen
- Marker study (transit time)
- Rectal suction biopsy
- anorectal manometry
How is constipation treated?
- diet
- softener (movicol)
- stimulant (senna/picosulfate)
What is GOR?
- passive regurg of gastric/duodenal contents in oesophagus
- objective damage (oesophagitis)
- subjective severe symptoms (vomiting/heartburn)
How does reflux present over 3 years?
- adult symptoms
- heartburn, vomiting, oesophagitis
What are red flags of GOR?
- haematemesis
- failure to thrive
- sandifers syndrome (back arching, look like seizures)
- aspiration pneumonia
How is GOR investigated?
- 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)
How is GOR treated?
- feed thickening
- reduce acid (PPIs, H2 antagonists)
- promotility agents (domperidone)
- jejunostomy feeds
- Nissen’s fundoplication
What is eosinophilic oesophagitis?
- resistant GORD symptoms
- food sticking
- stopy
- endoscopy to diagnose
How is eoesinophillic oesophagitis treated?
- diet exclusion
- oral budesomide
What is recurrent abdominal pain?
- 1 episode of pain per month for 3 months
- interfere with routine functioning
What is gastritis?
- inflammation of gastric mucosa
- Helicobacter pylori infection
How does gastritis present?
- vomiting
- abdom pain
- haematemesis
- anaemia
How is Helicobacter Pylori diagnosed?
- endoscopy (Clo test, histology)
- Stool antigen
- C13 breath test
How is HP treated?
- amoxicillin
- clarithromycin
- H2 antagonists/PPI
- repeat breath tests/stool after treatment ensuring eradication
What may be the causes of rectal bleeding?
- constipation + fissures
- bacterial infections
- IBD
- polyps
- worms
What is Crohn’s?
- mouth to anus
- transmural inflammation (not just mucosal)
- granulomas
What is UC?
- only rectum/colon
- mucosal inflammation
How does Crohn’s present?
- abdominal pain
- weight loss
- diarrhoea (bloody)
- growth failure/pubertal delay
- raised ESR/CRP/low albumin/Hb
- fever, clubbing, oral ulcers
How does UC present?
- chronic bloody diarrhoea
- abdo pain
- weight loss
How is IBD diagnosed?
- endoscopy and biopsy
- MRI
How is IBD treated?
- steroids
- enteral nutrition
- infliximab (anti-TNF)
THEN - immunosuppressants
- anti-TNF
How does surgery treat IBD?
- medications not working
- obstruction
- poor growth
- colectomy (cures colitis)
What are juvenile polyps?
Haematomas
- painless rectal bleeding
