Medicine Notes Paediatrics Notes
An overview of the common paediatric conditions - from neonates to developmental delay and all the common childhood-specific illnesses organised by body system. Includes tips on history taking and examination along with investigations and management. Concise yet thorough enough for finals examinations. Colour coded including diagrams...
The following is a more accessible plain text extract of the PDF sample above, taken from our Paediatrics Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:
Gastrointestinal Problems in Children
Nutrition in childhood
Milk provides all the nutrients an infant needs for first 6 months of life
Newborn infants require 150ml/kg/day of fluid
Milk contains
Carbohydrate
Fat
Protein (casein, lactalbumin and lactoferrin)
Calcium
First colostrum is produced from breast – thin yellow milk, high in immunoglobulins
Breastmilk is deficient in vitamin K therefore all newborns offered Vit K at birth to prevent haemolytic disease of the newborn
Weaning starts around 6 months
Should not have cow’s milk until 1 year old
Start finger feeding at 7-9 months
At 9 months – eating mashed up adult food
Constipation
In normal children the frequency of bowel movements ranges from >2/day to none for several days
Infrequent bowel movements are common in exclusively breastfed babies
Constipation = passage of a hard, infrequent stools with painful defaecation
Soiling = faecal staining of the underwear and results from leakage of liquid stool around impacted faeces when a child is constipated. Often mistaken for diarrhea
Encoparesis = voluntary passage of a formed stool in inappropriate places (including underwear) by a child who is mature enough to be continent. Indicative of severe behavioral problems.
Causes of constipation – an overview
Acute causes | Chronic causes |
---|---|
Fluid depletion Caused by fever or hot weather May require laxatives Bowel obstruction Rare and due to congenital gut malformations Usually presents as an acute abdomen May present as constipation with vomiting and abdominal pain | Functional constipation Common, even more so in diabled children Often stems from withholding from painful defeacation May cause megacolon Management includes laxative, bowel training and diet Hirschprungs Disease Onset in newborn period or infancy Failure to thrive and abdo. Distension Diagnosis by rectal biopsy |
Examination
Review growth chart – Hirschprungs accompanied by FTT
Abdominal distension – hard, indentifiable faeces often palpated in RIF
Anorectal examination not usually indicated but will reveal hard stools/anal fissure may be found on inspection of anus
Investigation
Plain abdo xray – not normally required
May show enormous quantities of faeces in the colon
Rectal biopsy if ? hirschprungs disease
Functional constipation
Constipation often stems from painful passage of a hard stool, causing an anal fissure
Child withholds further stools to avoid pain
Water is reabsorbed from the colon – making the stools harder and more painful to pass
Becomes a self-perpetuating cycle
The restum becomes stretched and colonic dilatation may occur (megacolon)
Management of constipation
Evacuation of the bowel
Diet – in simple cases diet alone is effective
Laxatives
Osmotic e.g lactulose, movicol
Bowel stimulants e.g senna
Enemas – rarely required
Manual evacuation under GA – in severe cases
Maintenance
Stools should be kept soft by either diet or laxatives for 3-6 months
...
Buy the full version of these notes or essay plans and more in our Paediatrics Notes.
An overview of the common paediatric conditions - from neonates to developmental delay and all the common childhood-specific illnesses organised by body system. Includes tips on history taking and examination along with investigations and management. Concise yet thorough enough for finals examinations. Colour coded including diagrams...
Ask questions 🙋 Get answers 📔 It's simple 👁️👄👁️
Our AI is educated by the highest scoring students across all subjects and schools. Join hundreds of your peers today.
Get Started