Paediatric gastroenterology for General Physicians
How pediatric gastroenterology is tested
Written for DHA, SMLE, DOH, QCHP, OMSB, MOH, NHRA and Kuwait MOH — the same GP licensing mix, not a pediatric gastroenterology specialist paper.
Paediatric GI is dehydration plus ORS, the surgical abdomens of infancy, and constipation that is functional until red flags say otherwise.
ORS is first-line in most gastroenteritis. IV fluids are for shock or failed oral. Intussusception is colic, red currant, and air enema in a stable child.
Pyloric stenosis is the 3–6 week old with projectile vomiting and a hypochloraemic alkalosis you correct before theatre. Hirschsprung is delayed passage of meconium.
Who gets IV fluids in diarrhoea?
Shock, persistent vomiting that blocks ORS, or severe dehydration. The well thirsty child gets oral rehydration, not a routine drip.
Intussusception — first investigation if stable?
Ultrasound, then pneumatic/hydrostatic reduction if no peritonitis. Theatre if perforated or shocked.
Functional constipation — the trap?
Disimpaction then maintenance polyethylene glycol. Do not jump to manometry because a toddler withholds stool after a painful crack.
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