Pediatric gastroenterology

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The vast majority of children presenting with gastrointestinal system complaints will not turn out to have organic disease - all tests will be normal. Appropriate growth and nutrition is paramount in the assessment and treatment of pediatric gastrointestinal disorders. The GI clinical assessment (history and physical) is the preferred modality of diagnosis, since GI tests in children are upsetting, often reinforce the child's concern and should be used sparingly. As with adults, psychological factors can augment or relieve symptoms. The family's response to the child's symptoms needs to be assessed and frequently addressed.

Another important consideration is that the pediatric patient needs to be an active participant in the treatment plan, a consideration that increases with age and is extremely important to the adolescent.

Milk intolerance in infants is one problem. This can be in the form of a cow's milk protein allergy, lactose intolerance (which may be primary or secondary), milk colitis or milk protien anaphylaxis.

Little guys may also present with chronic diarrhea. Differential diagnosis for this may be a milk allergy, Toddler's diarrhea, giarrdiasis, lactose intolerance, Celiac disease, cystic fibrosis, other malabsorption diseases, ulcerative colitis or Crohn's disease (older children).

Children may also have abdominal pain, the differential of which is recurrent abdominal pain of childhood, gastroesophageal reflux disease, constipation, abdominal wall pain, Crohn's disease, Peptic ulcer disease and midgut volvulus.