GI Disorders in Childhood

Question 1

What are common causes for paediatric vomiting and haematemesis?

Answer 1

Gastroesophageal reflux, intestinal obstruction, duodenal ulcer

Question 2

What are common causes for malapsorption?

Answer 2

Enteropathy (coeliac disease), fat malabsorption (due to pancreatic insufficiency) or sugar malabsorption (due to lactose intolerance)

Question 3

Define constipation

Answer 3

Infrequent, hard stools OR passing of stools less than 3 times per week

Question 4

What may be organic causes of constipation?

Answer 4

Hirschsprung’s disease, hypothyroidism, neurologic or anal stenosis

Question 5

What is gastritis?

Answer 5

Inflammation of the gastric mucosa often associated with Helicobacter Pylori infection

Question 6

What bacteria is commonly associated with gastritis?

Answer 6

Helicobacter Pylori

Question 7

How does paediatric gastritis present?

Answer 7

Vomiting, abdominal pain, haematemesis, malaena and anaemia

Question 8

What process does Helicobacter Pylori catalyse?

Answer 8

Produces ureas which metabolises urea to ammonia and carbon dioxide

Question 9

How can you test for Helicobacter Pylori infection?

Answer 9

Urea breath test - labelled urea is ingested and if H pylori is present it will be metabolised to ammonia and labelled carbon dioxide, which can then be detected in the breath

Question 10

How is Helicobacter Pylori infection treated?

Answer 10

2 weeks of amoxicillin followed by 6 weeks of PPIs (H2 antagonists)

Question 11

What are the two types of IBD?

Answer 11

Crohn’s and ulcerative collitis

Question 12

Describe Crohn’s disease

Answer 12

Has ‘skip lesions’ and transmural inflammation which leads to the production of granulomas

Question 13

Describe ulcerative collitis.

Answer 13

Only found in the rectum/colon (unlike CD) and involves continuous disease and mucosal inflammation (not transmural)

Question 14

How is IBD treated?

Answer 14

Steroids, 5-ASA, biologicals and exclusive enteral nutrition (CD)