S5 Ep105: Reflux, Celiac, & Constipation: Rapid Review (Fables from the Cribside!)
Mar 13, 2024
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The podcast touches on pediatric GI disorders like constipation, reflux, and celiac disease. It discusses the nuances of infant reflux, management of reflux in children, symptoms and management of celiac disease, monitoring celiac patients, practical tips for constipation, and specialized treatment strategies for constipation in patients with neurodivergent conditions.
Managing reflux in infants requires careful evaluation beyond typical symptoms like arching and crying.
Celiac disease diagnosis should have a low threshold for testing, utilizing serologic markers and considering patient's age and symptoms.
Functional constipation diagnosis follows Rome IV criteria, focusing on symptoms and tailoring treatments like fiber intake and laxatives.
Deep dives
Reflux in Infants and Children - Normal Physiology and Red Flags
In infants, it is normal to have frequent regurgitation due to the short esophagus. However, signs like arching and crying are not always indicative of GERD, requiring a cautious approach to managing reflux in younger patients. Red flag symptoms like blood-streaked stools and frequent vomiting may necessitate further evaluation beyond typical reflux norms.
Diagnosing Celiac Disease - Presentation and Testing Insights
Celiac disease can present with varied and subtle symptoms, necessitating a low threshold for testing, especially in patients with family history. Serologic markers like IgA and TTG are crucial in diagnosis, with considerations of the patient's age, symptomatology, and the potential need for an endoscopy evaluation. Molecular tests for Celiac disease in Europe follow different guidelines compared to the US, offering alternative diagnostic approaches.
Functional Constipation in Pediatrics - Diagnosis and Management Strategies
Functional constipation diagnosis can be presumptive in the absence of red flags, based on Rome IV criteria, focusing on symptoms like hard stools and fecal incontinence. Treatment emphasizes a balanced intake of fiber and fluid, tailored according to age groups, with osmotic laxatives like PEG 3350 and stimulant laxatives as primary options. Behavioral and dietary changes, along with judicious use of medications, guide the comprehensive management approach.
Pediatric Gastrointestinal Disorders - Reflux, Celiac Disease, and Constipation Insights
The podcast episode delves into common pediatric GI disorders, highlighting key insights on reflux, celiac disease, and constipation. It emphasizes age-specific considerations, diagnostic nuances, and tailored management strategies for each condition. From physiological aspects of reflux in infants to red flag symptoms in celiac disease and the varied presentations of functional constipation, the discussions offer practical guidance for healthcare providers dealing with pediatric patients.
Closing Thoughts and Humor
The episode wraps up with humor and reflections on pediatric GI disorders, showcasing a lighthearted approach to handling challenging conditions like reflux, celiac disease, and constipation. From playful banter to critical insights on diagnosis and treatment, the podcast offers a blend of informative content and entertainment value for healthcare providers navigating complex pediatric gastrointestinal issues.
Recap and review the top pearls from episodes #66 Constipation, #75 Reflux, & #89 Celiac with a few members of our production team! It’s Fables from the Cribside! (FFTC), our series providing a rapid review of recent Cribsiders episodes for your spaced learning.
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