Module 5 Guided Questions
Lesson 1: Primary Gastroenterology Issues
What are the common GI problems in children and adults encountered by the primary
... [Show More] care provider?
How are these common GI problems diagnosed and treated?
● Constipation
o The alteration in frequency, consistency, or ease of passage of stool
o More than 3 days without a stool (Normal is daily or QOD)
o Painful stools
o Blood streaked stools
o Organic Causes
Failure to pass meconium in 24-36 hours: Hirsch sprung disease, hypothyroidism, meconium
plug, meconium ileus
Intestinal atresia, strictures, tumors
Chronic lead poisoning
Hypercalcemia
o Inorganic causes
Diet
Transient illness
Travel
Emotional factors
Stool withholding during toilet
training
History of painful stooling
Side effects of many medications
such as iron
o Infants
Rare
Ok to have infrequent stools
o Infants/Toddlers
Occurs with transitions
TX: Add fruits & veggies to diet; small amount of juice (apple or prune). > 1 year old may
need to limit milk
o Early Childhood
Stool withholding
Poor diet
TX: Positive reinforcement. Fruits & veggies; fiber (no bananas). ↑ water; ↓ dairy
o School-Age Child
First time event or ongoing
Stress, change, change in bowel pattern
Fear of using school bathroom
TX: Positive reinforcement; reassurance. DIET. Water.
o Treatment when diet doesn’t work…
MOM (titrate 1-3 tsp bid or qd; 1-3ml/kg/day
Mineral oil (1-5 ml/kg/day; caution aspiration)
Citrucel, Metamucil, Benefiber (daily with plenty of water)
MiraLAX 17 gr (1/2 to 1 capful QD x 2 weeks)
Stool softeners such as Colace or Senokot (short-term)
Obstipation
o Long intervals between stools
Encopresis
o Constipation with soiling or leaking
Hirschsprung’s Disease
o A congenital anomaly that results in mechanical obstruction from inadequate motility in part of
the intestine
o Patho: Absence of ganglion cells in segments of the colon (rectum and distal colon). These cells
are responsible for peristalsis and relaxation of the internal sphincter.
o More common in males
o HX of delayed passage [Show Less]