Peds GI Flashcards
Evaluation of Dehydration
% of weight lost is objective measure
- delayed capillary refill, urine output, specific gravity
- serum electrolytes and such not needed for mild dehydration
Treating vomitting
ondansetron
- almost all children who have vomitting and dehydration can be treated with ORT (oral rehydration therapy)
Oral Rehydration Therapy
diarrhea and not dehydrated –> normal diet
- ORT as effective as IV therapy with mild to moderated dehydration
- early refeeding does not prolong diarrhea
IV Therapy for dehydration
20 mL/kg of normal sline or NS with 5% dextrose
Pharmacologic agents
probiotic –> NOT YOGURT
- routine use of drugs NOT recommended
Colic
starts by 3 weeks of age and peak occurs at 6 weeks
Crying Infant
Rule out other causes for irritability and crying (otitis, intussusception, hairs around penis, fingers, toes)
Retentive Encopresis
80-95% involve constipation and retention
- soil small quantities of loose fecal matter several stimes a day
Chronic Constipation
90-95% is functional
Nonretentive encopresis
inappropriate soiling without evidence of fecal constipation/retention
Management of retentive encopresis
Polyethylene glycol –> Miralax (0.5-1 g/kg/day) –> soiling accidents likely
- expect treatment to last 2x as long as duration
- can try this first to avoid trauma of rectal manipulation
Recurrent Ab Pain syndrome
prepubertal pain with 2 peaks in frequency
- 5-7 y.o. (school separation)
- 8-12 y.o.
IBS
occurs infrequently before late adolescence –> intestinal dysmotility
Peptic Disorder
(+) family history, early morning, early satiety
Cyclic Vomiting/periodic syndrome/abdominal migraine
family history of migraines, other autonomic features (pallor, diarrhea, lethargy)
- headache is rare in children with cyclic vomiting syndrome
