gastrointestinal dysfunction in children.pptx

7/27/2019 GASTROINTESTINAL DYSFUNCTION IN CHILDREN.pptx

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GASTROINTESTINAL DYSFUNCTION

IN CHILDREN


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FAILURE TO THRIVE

Deceleration fromestablished growthpattern or consistently

below the 5thpercentile for heightand weight on standardgrowth charts;

sometimesaccompanied bydevelopmental delays


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Spitting up or regurgitation

Passive transfer of gastric contents into the

esophagus or mouth


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Vomiting

Forceful ejection of gastric contents; involves

a complex process under central nervous

system control that causes salivation, pallor,

sweating, and tachycardia; usually

accompanied by nausea


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Projectile vomiting

Vomiting accompanied by vigorous peristaltic

waves and typically associated with pyloric

stenosis or pylorospasm


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Nausea

Unpleasant

sensation vaguely

referred to the

throat or abdomen

with an inclination

to vomit


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Constipation Passage of firm or

hard stools orinfrequent passageof stool withassociated

symptoms such asdifficulty expellingthe stools, bloodstreaked stools,and abdominal

discomfort


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Encopresis

Overflow of incontinent stool causing soiling;

often caused by fecal retention or impaction


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Diarrhea

Increase in the numberof stools with increasedwater content as aresult of alterations ofwater and electrolytetransport by thegastrointestinal(GI)tract; may be acute orchronic


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Hypoactive, hyperactive, or absent

bowel sounds

Evidence of intestinal motility problems that

may be caused by inflammation or obstruction


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Abdominal distension

Protuberant contour of the abdomen that may

be caused by delayed gastric emptying,

accumulation of gas or stool, inflammation, or

obstruction


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Abdominal pain

Pain associated with the abdomen that may

be localized or diffuse, acute or chronic; often

caused by inflammation, obstruction or

haemorrhage


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Gastrointestinal bleeding

Bleeding from an upper or lower GI source;

may be acute or chronic


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Hematemesis

Vomiting of bright red blood or denatured

blood that results from bleeding in the upper

GI tract or from swallowed blood from the

nose or oropharynx


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Melena

Passage of dark-colored, tarry stools caused

by denatured blood, suggesting upper GI tract

bleeding or bleeding from the right colon


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Hematochezia

Passage of bright red blood per rectum,

usually indicating lower GI tract bleeding


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Jaundice

Yellow coloration of the skin and sclerae

associated with liver dysfunction


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Dysphagia

Difficulty swallowing caused by abnormalities

in the neuromuscular function of the pharynx

or upper esophageal sphincter or by disorders

of the esophagus


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Dysfunctional swallowing

Impaired swallowing resulting from central

nervous system defects or structural defects of

the oral cavity, pharynx or esophagus; can

cause feeding problems or aspiration


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Fever

Common manifestations of illness in children

with GI disorders; usually associated with

dehydration, infection or inflammation


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GASTROINTESTINAL DIAGNOSTIC

PROCEDURES


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Stool examination

Gross, microscopic,

and chemical

examination of stool

specimen

to detect normal and

abnormal

constituents


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Ova and parasites (O&P)

Microscopic examination of stool contents for

parasites of their eggs

To aid in diagnosis of parasitic infection


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Bacterial Culture

Sample contents grown on culture medium

Detect bacterial pathogens in stool


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Stool assay for viral pathogens

ELISA(enzyme-linked immunosorbent assay)

Detect viral pathogens in stool


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Quantitative fat

Detection of abnormal quantities of fat in

stool

Diagnosis of pancreatic insufficiency or

malabsorption by measuring stool-reducing

substances


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Reducing substances

unabsorbed sugars measured in stool

To detect elevated levels of reducing

substances in stool, which are abnormal and

suggest carbohydrate malabsorption


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pH

Stool pH


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Occult blood guaiac test

Stool smeared on guaiac-impregnated paper,

and 2 drops of developing solution added to

reverse side; blue color indicates hemoglobin

detect presence of blood in stool


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Serology test

Blood test for antibody to H.pylori

assess for exposure to H. pylori


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Urea breath test

Collection of breath after ingestion of isotopic

urea with either carbon 14 or carbon 13;

measures labelled carbon dioxide in expired

air

Determine if there is active infection with

H.pylori in the stomach


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Urease test

Biopsy of stomach, which is stained and

placed in Christensen urea medium which

turns color in presence of H.pylori


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Pancreatic function

pancreatic secretions collected via duodenal

tube under stimulated conditions and

analyzed for water, ions and enzymes

determine functional secretory capacity of

pancreas


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D-Xylose absorption test

D-xylose solution administered orally; serum

levels of D-xylose measured at 30, 60, 90, and120 min

urine collected for total of 5 hr. to measure D-xylose excretion

Evaluate absorptive capacity of small intestinalmucosa

diagnose small-bowel malabsorption caused

by celiac disease


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Hepatobiliary scintigraphy

Nuclear medicine study

Radiopharmaceutical administered

intravenously, then sequential images of liver,

biliary system, and bowel obtained

evaluate conditions of liver and biliary tract

abnormalities and gallbladder disease

diagnosis and monitoring of these conditions,

such as biliary atresia


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Breath hydrogen test

non-invasive study to asses for carbohydrateintolerance

Hydrogen is generated in colon by bacterialfermentation of undigested carbohydrates and is

then absorbed into blood, where it diffuses intoexpired air via lungs

evaluate bacterial overgrowth, lactase or sucrase-isomaltase deficiency

evaluate malabsorption or bacterial overgrowthby detecting rise in expired hydrogen after oralloading with specific carbohydrate


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Esophageal pH monitoring

probe that measures pH placed through nose

into distal esophagus and records pH over

time

determine frequency and duration of gastric

acid reflux into the esophagus

establish association between patient

symptoms(pain, apnea, failure to thrive,

asthma, wheezing) and acid reflux


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Upper GI, colonoscopy; flexible

sigmoidoscopy, anoscopy

Endoscope introduced into area to be

examined

Endoscope has flexible-tip light source and

aspiration and instrument channel

directly visualize GI tract to evaluate

abnormalities, detect lesions, obtain biopsies

perform therapeutic procedures


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Ultrasonography

To locate, measure and delineate abdominal

organs


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Computed tomography (CT)

to visualize horizontal and vertical cross

section of abdomen at any axis

To distinguish density of various tissue

structure or organs

To detect blunt trauma to internal organs and

masses


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Magnetic resonance imaging (MRI)

to visualize internal body structures in any

plane; permits soft tissue discrimination

unavailable with many technique

gastrointestinal dysfunction in children.pptx

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