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1. Lower GI Bleeding in Children.
Subfile: Digestive Diseases
Format (FM): BROCHURE (08).
Language(s) (LG): English.
Year Published (YR): 2003.
Audience code (AC): PATIENT (400).
Corporate Author (CN): North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
Source (SO): Flourtown, PA: American Society for Pediatric Gastroenterology, Hepatology and Nutrition. 2003. 1 p.
Availability (AV): Available from North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). PO Box 6, Flourtown, PA 19031. (215) 233-0808. Fax: (215) 233-3939. Website: www.naspgn.org. PRICE: Full-text available online at no charge; contact organization for print copies.
Abstract (AB): The large intestine (colon) and rectum are frequent sites of bleeding, known as lower GI (gastrointestinal) bleeding. The most common reasons for passage of bright red blood through the rectum are: local irritation by cuts (fissures) or hemorrhoids, polyps, infections, and inflammation. This brief fact sheet considers lower GI bleeding in children. The fact sheet defines the condition, outlines etiology (causes) and epidemiology (how common the condition is), then discusses treatment options and anticipated prognosis. The fact sheet notes that the treatment of lower GI bleeding depends on the cause and the location of the bleeding. Endoscopy is the best way to determine the cause of GI bleeding and will be recommended if the bleeding suggests a polyp or a diagnosis of colitis. Local fissures and hemorrhoids are managed with diet modification, stool softeners, and topical creams and ointments. For more information, readers are encouraged to visit www.naspghan.org (the web site of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition).
Major Descriptors (MJ): Digestive System Diseases. Gastrointestinal Bleeding. Children. Symptoms. Etiology. Diagnosis. Patient Care Management.
Minor Descriptors (MN): Rectum. Large Intestine. Colon. Diagnostic Tests. Parent Education. Polyps. Hemorrhoids. Constipation. Complications. Endoscopy. Epidemiology. Prognosis.
Verification/Update Date (VE): 200307.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 09556.
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2. Constipation in Children.
Subfile: Digestive Diseases
Format (FM): BROCHURE (08).
Language(s) (LG): English.
Year Published (YR): 2003.
Audience code (AC): PATIENT (400).
Corporate Author (CN): North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
Source (SO): Flourtown, PA: American Society for Pediatric Gastroenterology, Hepatology and Nutrition. 2003. 1 p.
Availability (AV): Available from North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). PO Box 6, Flourtown, PA 19031. (215) 233-0808. Fax: (215) 233-3939. Website: www.naspgn.org. PRICE: Full-text available online at no charge; contact organization for print copies.
Abstract (AB): Constipation is defined as either a decrease in the frequency of bowel movements, or the painful passage of bowel movements. This brief fact sheet considers the problem of constipation in children. The fact sheet defines the condition, outlines etiology (causes), the symptoms that can accompany the constipation (including stomach pain, poor appetite, crankiness) and epidemiology (how common the condition is), then discusses treatment options. Constipation can begin when there are changes in the diet, the time of toilet training, following travel, or after a viral illness. In most cases, there is no need for diagnostic testing prior to treatment for constipation. Treatment of constipation varies according to the source of the problem and the child’s age and personality. Some children may only require changes in diet such as an increase in fiber, fresh fruits, or in the amount of water they drink each day. For more information, readers are encouraged to visit www.naspghan.org (the web site of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition).
Major Descriptors (MJ): Digestive System Diseases. Constipation. Children. Symptoms. Etiology. Diagnosis. Patient Care Management.
Minor Descriptors (MN): Parent Education. Complications. Epidemiology. Diet Therapy. Dietary Fiber. Abdominal Pain. Fluids. Travel. Habits. Psychosocial Factors.
Verification/Update Date (VE): 200307.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 09558.
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3. Antroduodenal Manometry: Questions and Answers.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): PATIENT (400).
Author (AU): DiLorenzo, C.
Source (SO): Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 2002. [2 p.].
Availability (AV): Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217-8076. (888) 964-2001 or (414) 964-1799. E-mail: iffgd@iffgd.org. Website: www.iffgd.org. PRICE: $1.00 for nonmembers; single copy free to members.
Abstract (AB): This fact sheet familiarizes parents with the diagnostic test called antroduodenal manometry that is used to check the motility (movement capability) of the lower part of the stomach (the antrum). The fact sheet defines gastrointestinal motility, then discusses motility disorders, the antroduodenal manometry test, what happens during the test, how long the procedure can be expected to take, and the discomfort that the child will experience during the test. Antroduodenal manometry is a way to measure and identify any abnormalities in the coordination and strength of the muscle contractions in the stomach and the duodenum. Abnormalities in strength or coordination of contractions may cause improper digestion and result in symptoms including anorexia (lack of appetite), nausea, gagging, vomiting, abdominal distention, abdominal pain, diarrhea, and constipation. The child may feel some discomfort due to inserting an IV, lying still for an extended period of time, and possibly from injections of medications and removal of the tube. The measurement of pressure during the antroduodenal manometry is painless; the child will not feel the tube inside his or her stomach or intestine. The fact sheet includes the contact information for the International Foundation for Functional Gastrointestinal Disorders (IFFGD, www.iffgd.org).
Major Descriptors (MJ): Digestive System Diseases. Stomach. Manometry. Diagnostic Tests. Symptoms. Diagnosis. Children. Gastrointestinal Motility. Duodenum.
Minor Descriptors (MN): Small Intestine. Motility Disorders. Preoperative Care. Complications. Large Intestine. Pathophysiology. Patient Care Management. Parent Education.
Verification/Update Date (VE): 200207.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 08920.
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4. Do We Need Colonic Manometry to Diagnose Functional Fecal Retention?.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): PATIENT (400).
Author (AU): Cocjin, J.
Source (SO): Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 2002. [2 p.].
Availability (AV): Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217-8076. (888) 964-2001 or (414) 964-1799. E-mail: iffgd@iffgd.org. Website: www.iffgd.org. PRICE: $1.00 for nonmembers; single copy free to members.
Abstract (AB): This fact sheet helps parents understand the uses of colonic manometry to diagnose functional fecal retention. Functional fecal retention is the most common cause of childhood constipation. It is most often due to frightening or painful defecation experiences, which result in voluntary avoidance of passing stools. Repeated retention of feces causes an increase in size of stools leading to more painful defecation experiences and further attempts to avoid defecation. The fact sheet reviews the diagnostic criteria for functional fecal retention in children, then considers the diagnostic process, which entails a detailed history and thorough physical examination. The fact sheet then outlines treatment goals and strategies, and the indications for colonic manometry. Treatment goals are to educate the child and family about the problem, to use medication to ensure painless defecation, and to provide continuing availability for guidance and effective reassurance. Colonic manometry may be used as a last resort to determine whether or not there is organic disease present that is contributing to the fecal retention. The strength of muscle contractions inside the colon is measured during colon manometry; manometry is the measurement of pressure within the colon. For a small group of patients with atypical histories or a lack of response to medical management, colonic manometry results in prompt, accurate diagnosis. The fact sheet includes the contact information for the International Foundation for Functional Gastrointestinal Disorders (IFFGD, www.iffgd.org).
Major Descriptors (MJ): Digestive System Diseases. Defecation. Symptoms. Diagnosis. Children. Functional Colonic Disorders. Manometry.
Minor Descriptors (MN): Complications. Diagnostic Tests. Behavior. Pain. Drug Therapy. Dietary Fiber. Chronic Disease. Etiology. Parent Education. Patient Selection. Psychological Factors.
Verification/Update Date (VE): 200207.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 08922.
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5. Disorders of Defecation in Children: What is the Role of the Surgeon?.
Subfile: Digestive Diseases
Format (FM): NEWSLETTER ARTICLE (35).
Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): HEALTH PROFESSIONALS (100). PATIENT (400).
Author (AU): Langer, J.C.
Source (SO): Digestive Health in Children. 2(1): 1-3. Spring 2002.
Availability (AV): Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 964-1799. Fax (414) 964-7176. Website: www.iffgd.org.
Abstract (AB): This article answers some common questions about the role of the surgeon in managing disorders of defecation in children. The inability to defecate in children is usually due either to a problem with formation of the anus or with the inability of the colon to push the stool from one end to the other. The inability to control the passage of stool may be due to inadequate muscle, impaired sensation, or severe constipation (with overflow incontinence). The author first reviews the physiology of normal defecation and the pathology that might cause defecation disorders. The author then describes the symptoms of different causes of defecation disorders and the types of surgical procedures that may be used to correct those disorders. Topics include low anorectal malformations, high anorectal malformations, the indications for colostomy, Hirschsprung’s disease, persistent constipation, colonic motility disorders, the inability to control defecation (fecal incontinence), techniques to improve sphincter function, and surgical aids to bowel management.
Major Descriptors (MJ): Digestive System Diseases. Defecation. Children. Pathology. Anatomy. Complications. Fecal Incontinence. Surgery. Patient Care Management.
Minor Descriptors (MN): Physiology. Anus. Rectum. Colostomy. Patient Selection. Surgical Techniques. Congenital Anomalies. Hirschsprung Disease. Sphincter. Motility Disorders. Constipation.
Verification/Update Date (VE): 200207.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 08885.
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6. Pediatric Anorectal Disorders.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Di Lorenzo, C.
Source (SO): Gastroenterology Clinics of North America. 30(1): 269-287. March 2001.
Availability (AV): Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32821-9816. (800) 654-2452.
Abstract (AB): Anorectal disorders are common in children; it is estimated that 10 percent of children are brought to medical attention because of a defecation disorder, and constipation is the chief complaint in 3 to 5 percent of all visits to pediatricians. This article explores pediatric anorectal disorders, emphasizing the differences between children and adults in terms of clinical presentations, pathophysiology, diagnosis, and treatment. Topics include constipation, functional nonretentive fecal soiling, Hirschsprung’s disease, other colonic neuromuscular disorders, children with neurologic handicap (including cerebral palsy and spinal dysraphism), and imperforated anus. The author stresses that the child’s developmental stage; the interaction between patient, family, and peers; and the presence of behavioral and psychological comorbidity need to be assessed carefully in any diagnosis of pediatric anorectal disorders. There are three periods when a child is particularly vulnerable to developing constipation: the introduction of cereals and solid food in the diet of an infant, toilet training, and the start of school. Childhood functional constipation is a clinical diagnosis that can be made in most cases on the basis of a typical history and an essentially normal physical examination. The most successful approach to a child with functional constipation includes a combination of parental education, behavioral modification, and medial intervention. 3 figures. 2 tables. 58 references.
Major Descriptors (MJ): Digestive System Diseases. Children. Constipation. Incidence. Etiology. Diagnosis. Therapy. Patient Care Management. Anorectal Disease. Functional Colonic Disorders.
Minor Descriptors (MN): Diagnostic Tests. Pathogenesis. Physiology. Symptoms. Drug Therapy. Patient Selection. Defecation. Fecal Incontinence. Diet Therapy. Behavior Modification. Rehabilitation. Patient Education. Parent Education. Neurological Disorders. Hirschsprung Disease.
Verification/Update Date (VE): 200107.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 08363.
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7. Review of the Causes of Lower Gastrointestinal Tract Bleeding in Children.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24). REVIEW (46).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Rayhorn, N.; Thrall, C.; Silber, G.
Source (SO): Gastroenterology Nursing. 24(2): 77-83. March-April 2001.
Availability (AV): Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (410) 528-8555.
Abstract (AB): Bleeding may occur anywhere along the gastrointestinal (GI) tract, which covers a large surface area and is highly vascularized. Pediatric patients who present with blood in their stools (bowel movements) are a special challenge for the health care team. Seeing blood in the child’s stools, the caregiver and child may become extremely anxious, fearing a devastating diagnosis. This article reviews the causes of lower GI tract bleeding in children. The differential diagnosis of this symptoms in infants and children includes numerous possibilities ranging from benign disorders, which require little or no treatment at all, to serious diseases that require immediate intervention. A complete history, including progression, duration, frequency, and severity of symptoms, is essential in assessing GI bleeding. Associated symptoms that help define the diagnosis include vomiting, diarrhea, constipation, abdominal pain, anorexia (lack of appetite), rash, joint pain or swelling, weight loss, fever, irritability, history of GI bleeding, or history of hematological or immunological disorders. Constipation with fissure (a tear in the anus) formation is the most common cause for rectal bleeding in toddlers and school age children. Infection is one of the more common causes of bleeding from the lower GI tract; infections can be due to Salmonella, Shigella, Campylobacter jejuni; Yersinia enterocolitica, Escherichia coli, Clostridium difficile, or Entamoeba histolytica. Other causes include swallowed blood, hemorrhoids, inflammatory bowel disease (IBD), intussusception (a portion of the bowel turns in on itself, creating an obstruction), polyps, lymphonodular hyperplasia, Meckel’s diverticulum, allergic colitis, Henoch Schonlein purpura, hemolytic uremic syndrome (HUS), enterocolitis, child sexual abuse, and Munchausen syndrome by proxy.
Major Descriptors (MJ): Digestive System Diseases. Gastrointestinal Bleeding. Hemorrhage. Children. Etiology. Symptoms. Diagnosis.
Minor Descriptors (MN): Infants. Diagnostic Tests. Risk Factors. Constipation. Abdominal Pain. Diarrhea. Bacterial Infections. Patient Care Management. Nursing Care. Fissure. Hemorrhoids. Inflammatory Bowel Disease.
Verification/Update Date (VE): 200107.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 08368.
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8. Childhood Constipation: Evaluation and Treatment.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24). REVIEW (46).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Youssef, N.N.; Di Lorenzo, C.
Source (SO): Journal of Clinical Gastroenterology. 33(3): 199-205. 2001.
Availability (AV): Available from Lippincott Williams and Wilkins, Inc. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2300.
Abstract (AB): This article reviews the evaluation and treatment of childhood constipation, a common condition. The authors estimate that between 5 and 10 percent of pediatric patients have constipation or encopresis (fecal soiling). Constipation is the second most referred condition in pediatric gastroenterology practices, accounting for up to 25 percent of all visits. The authors lay out a practical approach for those physicians not familiar with constipation in children. The diagnosis of constipation requires careful history taking and interpretation. Diagnostic tests are not often needed and are reserved for those who are severely affected. The daily bowel habits of children are extremely susceptible to any changes in routine environment. Constipation and subsequent fecal retention behavior often begins soon after a child has experienced a painful evacuation. Childhood constipation can be difficult to treat and often requires prolonged support by physicians and parents, explanation, medical treatment, and most importantly, the child’s cooperation. 1 figure. 5 tables. 31 references.
Major Descriptors (MJ): Digestive System Diseases. Children. Constipation. Diagnosis. Therapy.
Minor Descriptors (MN): Psychosocial Factors. Parent-Child Relations. Professional-Patient Relations. Patient Education. Symptoms. Pain. Fecal Incontinence. Drug Therapy. Behavior Modification. Diagnostic Tests.
Verification/Update Date (VE): 200204.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 08717.
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9. What I Need to Know About Hirschsprung’s Disease.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): PATIENT (400).
Corporate Author (CN): National Digestive Disease Information Clearinghouse (NDDIC), National Institutes of Health.
Source (SO): Bethesda, MD: National Digestive Disease Information Clearinghouse (NDDIC), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health. 2001. 21 p.
Availability (AV): Available from National Digestive Diseases Information Clearinghouse (NDDIC). 2 Information Way, Bethesda, MD 20892-3570. (800) 891-5389 or (301) 654-3810. Fax (301) 634-0716. E-mail: nddic@info.niddk.nih.gov. Website: www.niddk.nih.gov. PRICE: Full-text available online at no charge; single copy free; bulk copies available. Order number: DD-198.
Abstract (AB): This booklet provides information for parents about Hirschsprung’s disease (HD), a disease of the large intestine that causes constipation. The booklet covers a description of HD, the causes of HD, the genetic risks for passing HD to one’s children, the symptoms of the condition, diagnostic strategies for confirming HD, treatment options, and what to expect after surgical treatment (coping with constipation, diet and nutrition, preventing infection). In children with HD, the nerves cells in some or all of the large intestine are missing, resulting in a lack of movement of stool and constipation. Symptoms of HD usually show up in newborns or very young children. Diagnostic tests used for confirming HD include barium enema x ray, manometry, and intestinal biopsy. Surgical treatments include pull-through surgery, colostomy, and ileostomy. After treatment, most children with HD lead normal lives. The booklet is written in nontechnical language, with medical terms defined in the glossary. The booklet concludes with a list of information resource organizations and a brief description of the activities of the National Digestive Diseases Information Clearinghouse, a Federal government agency that provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. 13 figures.
Major Descriptors (MJ): Digestive System Diseases. Hirschsprung Disease. Symptoms. Diagnosis. Etiology. Therapy. Surgery. Children. Patient Care Management.
Minor Descriptors (MN): Infants. Parent Education. Patient Education. Diagnostic Tests. Diet Therapy. Dietary Fiber. Fluids. Large Intestine. Rectum. Muscles. Pathology. Surgical Techniques. Colostomy. Ileostomy.
Verification/Update Date (VE): 200308.
Notes (NT): CP: No.
Accession Number (AN): DD DC 08910.
URL (LK): http://www.niddk.nih.gov/health/digest/pubs/hirsch/hirsch.htm
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10. Hirschsprung’s Disease: An Overview.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): PATIENT (400).
Author (AU): Langer, J.C.
Source (SO): Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 2001. [2 p.].
Availability (AV): Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217-8076. (888) 964-2001 or (414) 964-1799. E-mail: iffgd@iffgd.org. Website: www.iffgd.org. PRICE: $1.00 for nonmembers; single copy free to members.
Abstract (AB): This fact sheet offers an overview of Hirschsprung’s disease, a genetic disorder that results in the absence of nerve cells in the wall of the bowel. Collections of nerve cells (ganglia) control the coordinate contraction and relaxation of the bowel wall, called peristalsis, that is necessary for bowel contents to advance. Without this action, the bowel remains collapsed and stools cannot pass. Bowel contents build up behind the obstruction, resulting in constipation. The fact sheet describes the condition in infants and very young children, the emergency conditions that can accompany Hirschsprung’s disease, diagnostic strategies, and treatment options. To diagnose Hirschsprung’s disease, a barium enema x ray tests is used to identify the narrow collapsed segment of bowel as well as the dilated bowel in front of the affected regions. Treating Hirschsprung’s disease requires surgery to remove the affected bowel and then to join the healthy bowel segments. There are several different surgical approaches, each with a high rate of success. The fact sheet includes the contact information for the International Foundation for Functional Gastrointestinal Disorders (IFFGD, www.iffgd.org).
Major Descriptors (MJ): Digestive System Diseases. Hirschsprung Disease. Symptoms. Diagnosis. Surgery. Infants. Children. Constipation.
Minor Descriptors (MN): Complications. Diagnostic Tests. Surgical Techniques. Large Intestine. Pathophysiology. Fecal Incontinence. Colostomy. Postoperative Complications.
Verification/Update Date (VE): 200207.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 08915.
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11. Chronic Intestinal Pseudo-Obstruction in Children: An Overview.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): PATIENT (400).
Author (AU): Hyman, P.E.
Source (SO): Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 2001. [2 p.].
Availability (AV): Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217-8076. (888) 964-2001 or (414) 964-1799. E-mail: iffgd@iffgd.org. Website: www.iffgd.org. PRICE: $1.00 for nonmembers; single copy free to members.
Abstract (AB): This fact sheet helps parents understand chronic intestinal pseudo-obstruction (CIP) in children, the name given to a number of rare disorders that cause impaired gastrointestinal motility (movement in the digestive tract). A diagnosis of CIP is based on symptoms and changes that occur when the intestine is blocked and surgery is needed. However, in pseudo-obstruction, the symptoms are caused not by a surgically correctable tumor, twist, or ulcer in the bowel, but by a problem having to do with the strength or coordination of the contractions that move along the contents of the bowel. Children with CIP often complain of poor appetite, nausea, vomiting, heartburn, abdominal pain, and constipation. The fact sheet reviews the symptoms of CIP, the diagnostic tests used to confirm the condition, and treatment options. About 10 percent of infants with CIP improve spontaneously over months or years. For the remaining 90 percent, there are no cures for the neuromuscular diseases that cause CIP, but there are nutritional, medical, and surgical options available to promote normal growth and development. Treatment options include supplemental feeding, total parenteral nutrition, surgery, and drug therapy. The fact sheet includes the contact information for the International Foundation for Functional Gastrointestinal Disorders (IFFGD, www.iffgd.org).
Major Descriptors (MJ): Digestive System Diseases. Intestinal Pseudo-obstruction. Symptoms. Diagnosis. Therapy. Infants. Children. Motility Disorders.
Minor Descriptors (MN): Gastrointestinal Motility. Drug Therapy. Parenteral Nutrition. Complications. Diagnostic Tests. Surgery. Diagnostic Tests. Parent Education. Patient Care Management.
Verification/Update Date (VE): 200207.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 08918.
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12. Chronic Constipation in Children: Rational Management.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24). REVIEW (46).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): DiPalma, J.A.; Gremse, D.A.
Source (SO): Consultant. 42(12): 1723-1732. November 2001.
Availability (AV): Available from Cliggott Publishing Company. 55 Holly Hill Lane, Box 4010, Greenwich, CT 06831-0010.
Abstract (AB): This article reviews a strategy of rational management of chronic constipation in children. The authors note that irregular bowel habits are a common cause of chronic constipation in children; illness and travel are among the disruptions in daily routine that can result in stool withholding. Medical conditions, such as diabetes and Hirschsprung disease, and medications, including methylphenidate, analgesics, and cough syrups, can also cause constipation. Encopresis (fecal incontinence, or involuntary loss of stool), anal outlet bleeding, and rectal pain caused by anal fissures are associated with chronic constipation; hemorrhoids rarely develop in children. Barium enemas, survey films, and colonic transit studies can detect and define functional or structural obstruction. Physicians should recommend regular postprandial (after a meal) toilet visits; moderate exercise; and increased fluid and fiber intake, using a ‘medicinal’ fiber product if necessary. Parents should be discouraged from excessive use of laxatives and cathartics. Options for long term therapy include mineral oil and osmotic laxatives. 3 tables. 69 references.
Major Descriptors (MJ): Digestive System Diseases. Constipation. Children. Patient Care Management. Symptoms. Diagnosis. Diagnostic Tests. Therapy.
Minor Descriptors (MN): Fecal Incontinence. Pain. Etiology. Fissure. Habits. Exercise. Dietary Fiber. Fluids. Parent Education. Laxatives.
Verification/Update Date (VE): 200207.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 08984.
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13. Constipation in Infants and Children: Evaluation and Treatment.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Baker, S.S, et al.
Source (SO): In: American Academy of Pediatric. Pediatric Clinical Practice Guidelines and Policies: A Compendium of Evidence-based Research for Pediatric Practice. Elk Grove Village, IL: American Academy of Pediatrics. 2001. p. 95-128.
Availability (AV): Available from American Academy of Pediatrics. P.O. Box 927, 141 Northwest Point Boulevard, Elk Grove Village, IL 60009-0927. (800) 433-9016. PRICE: $47.95 (members) plus $6.25 shipping and handling; $52.95 for nonmembers; plus $8.95 shipping and handling. ISBN: 1581100701.
Abstract (AB): Constipation, defined as a delay or difficulty in defecation, present for two or more weeks, is a common pediatric problem encountered by both primary and specialty medical providers. This publication offers clinical practice guidelines for the management of pediatric constipation. The guidelines were formulated by the Constipation Subcommittee of the Clinical Guidelines Committee of the North American Society for Pediatric Gastroenterology and Nutrition. The Constipation Subcommittee, consisting of two primary care pediatricians, a clinical epidemiologist, and pediatric gastroenterologists, based its recommendations on an integration of a comprehensive and systematic review of the medical literature combined with expert opinion. The Subcommittee developed two algorithms to assist with medical management, one for older infants and children, and the second for infants less than one year of age. The guidelines provide recommendations for management by the primary care provider, including evaluation, initial treatment, follow up management, and indications for consultation by a specialist. The report is designed as a general guideline to assist providers of medical care in the evaluation and treatment of constipation in children. 77 references.
Major Descriptors (MJ): Digestive System Diseases. Constipation. Children. Infants. Patient Care Management. Guidelines.
Minor Descriptors (MN): Symptoms. Risk Factors. Diagnosis. Diagnostic Tests. Parent Education. Therapy. Prevention. Defecation.
Verification/Update Date (VE): 200301.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 09204.
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14. Childhood Constipation: Finally Some Hard Data About Hard Stools! (editorial).
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 2000.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): DiLorenzo, C.
Source (SO): Journal of Pediatrics. 136(1): 4-7. January 2000.
Availability (AV): Available from Mosby, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-3318. (800) 453-4351 or (314) 453-4351. Fax (314) 432-1158. Website: www.mosby.com.
Abstract (AB): It is estimated that 55 million adults in the United States (approximately 28 percent of the population) are constipated. Similar data are not available on the prevalence in children, although it has been reported that 34 percent of toddlers in the United Kingdom and 37 percent of Brazilian children younger than 12 were considered by their parents to be constipated. This editorial offers a review of the literature on childhood constipation, focusing on research studies that quantified the prevalence of the problem. The editorial also serves as an introduction to two related articles in the same issue of Journal of Pediatrics. The author notes that the most common cause of constipation in pediatrics is a decision made by the child to delay defecation after experiencing a painful or frightening evacuation. Treatment is based on addressing all the factors that have contributed to its development. The evacuations are made more pleasant by stool softeners. The fear of defecation is overcome by avoiding anally invasive procedures (such as enemas) and by using positive reinforcement to make the process less intimidating. Key to successful treatment is a thorough understanding by the family of the pathophysiology of childhood constipation. The author applauds the authors of the other articles for addressing this poorly studied subject. Progress in the understanding of colonic motility disorders and the pathophysiologic mechanisms responsible for treatment failures will help in the selection of patients who may benefit from the use of cisapride and dietary changes. Development of safe prokinetics with a more selective action on colonic motility will undoubtedly facilitate their use in the treatment of childhood constipation. 12 references.
Major Descriptors (MJ): Digestive System Diseases. Constipation. Children. Epidemiology. Etiology. Therapy.
Minor Descriptors (MN): Patient Care Management. Psychological Factors. Gastrointestinal Motility. Drug Therapy. Diet Therapy. Pathophysiology. Prevalence. Behavior Modification.
Verification/Update Date (VE): 200004.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07575.
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15. Cisapride for the Treatment of Constipation in Children: A Double-Blind Study.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 2000.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Nurko, S., et al.
Source (SO): Journal of Pediatrics. 136(1): 35-40. January 2000.
Availability (AV): Available from Mosby, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-3318. (800) 453-4351 or (314) 453-4351. Fax (314) 432-1158. Website: www.mosby.com.
Abstract (AB): This article reports on a study undertaken to determine whether cisapride is effective in treating children with constipation. The double blind, placebo controlled study included children with chronic constipation who were randomly assigned to treatment with cisapride or placebo for 12 weeks. Forty children were enrolled, and 36 completed the therapy. Treatment successes occurred in 13 of 17 subjects in the cisapride group (76 percent) and 8 of 19 subjects in the placebo group (37 percent). The odds ratio for response after cisapride administration was 8.2 times higher. During cisapride therapy, there was a significant improvement in the number of spontaneous bowel movements per week and a significant decrease in the number of fecal soiling episodes per day, percentage with encopresis, number of laxative doses per week, percentage using laxatives, and total gastrointestinal transit time. With placebo, there were no significant changes in the number of spontaneous bowel movements, percentage with encopresis, or total gastrointestinal time; but there was a significant decrease in the number of fecal soiling episodes per day and the number of laxative doses per week. The authors conclude that cisapride was effective in treating children with constipation. The authors note, however, that cisapride is not recommended as the first line drug for children with constipation. Dietary fiber and other behavior changes are recommended first. 1 figure. 2 tables. 27 references.
Major Descriptors (MJ): Digestive System Diseases. Constipation. Children. Drug Therapy. Cisapride.
Minor Descriptors (MN): Gastrointestinal Motility. Motility Disorders. Laxatives. Fecal Incontinence. Drug Effects.
Verification/Update Date (VE): 200004.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07576.
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16. Appendicitis in Children: New Insights Into an Old Problem.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 2000.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Gregory, T., ed.
Source (SO): Patient Care. 34(5): 183-188, 191-195. March 15, 2000.
Availability (AV): Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956.
Abstract (AB): Acute appendicitis is the most common reason for emergency abdominal surgery in childhood. Despite strong emphasis on early surgical intervention, the morbidity and mortality of acute appendicitis in children remain high. This review article clarifies the symptoms to look for in the patient’s history, the signs to assess during the physical examination, and the degree of confidence to place in various laboratory tests and radiologic studies. The authors reiterate that a thorough but speedy evaluation is essential when examining a child with possible appendicitis. Recent studies show that in ambiguous cases, computed tomography (CT scan), especially when performed with rectal contrast, is an excellent adjudicator. The authors review the anatomy and physiology of the appendix, then detail each step of the physical examination. After a discussion of the appropriate laboratory tests, the authors remind readers of the more common pediatric illnesses that mimic appendicitis, including gastroenteritis, constipation, mesenteric adenitis, urinary tract infection (UTI), inflammatory bowel disease (IBD), pelvic inflammatory disease (PID), ovarian cyst, and pneumonia. 8 figures. 2 tables. 22 references.
Major Descriptors (MJ): Digestive System Diseases. Children. Appendicitis. Diagnosis. Diagnostic Tests.
Minor Descriptors (MN): Morbidity. Gastrointestinal Diseases. Anatomy. Physiology. Appendix. Abdominal Pain. Symptoms. Epidemiology. Patient Care Management. Physical Examination.
Verification/Update Date (VE): 200007.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07704.
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17. Childhood Defecation Disorders: Constipation and Soiling.
Subfile: Digestive Diseases
Format (FM): NEWSLETTER ARTICLE (35).
Language(s) (LG): English.
Year Published (YR): 2000.
Audience code (AC): PATIENT (400).
Author (AU): Hyman, P.
Source (SO): Participate. 9(3): 4-6. Fall 2000.
Availability (AV): Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 964-1799. Fax (414) 964-7176. E-mail: iffgd@iffgd.org. Website: www.iffgd.org.
Abstract (AB): This article is the second in a two part series on pediatric functional gastrointestinal (GI) disorders that may prompt parents to bring their child to the doctor for constipation or fecal soiling. In this article, the author focuses on non retentive fecal soiling and functional fecal retention. Functional refers to a disorder where the primary problem is not due to disease or visible tissue damage or inflammation; in this article, the author uses functional to refer to symptoms that occur within the expected range of the body’s behavior. Functional fecal retention is defined in children by the passage of large or enormous bowel movements at intervals less than twice per week, and the attempt to avoid having bowel movements on purpose. Accompanying symptoms include soiling of the underclothes, irritability, abdominal cramps, and decreased appetite. Functional fecal retention begins when there is a painful bowel movement and the child learns to fear the urge to have a bowel movement. After diagnosis, treatment goals include family and patient education, medication as necessary to assure painless defecation, and the provision of continued availability and interest in the child’s problem. Fecal soiling refers to passage of bowel movements into the underclothing, or other inappropriate places. Fecal soiling commonly accompanies functional fecal retention, or after a chronic problem with diarrhea. Functional non retentive (not associated with fecal retention) fecal soiling is diagnosed in children older than 4, who have bowel movements in places and at times that are inappropriate, at least once a week for 3 months, in the absence of a disease to explain it. Treatment goals are to help the parent to understand that there is no medical disease, and to accept a referral to a mental health professional. Parents need guidance to understand that soiling is a symptom of emotional upset, not simply bad behavior. 1 table.
Major Descriptors (MJ): Digestive System Diseases. Constipation. Defecation. Psychological Factors. Functional Colonic Disorders. Children. Fecal Incontinence. Impacted Feces.
Minor Descriptors (MN): Rectum. Parent Education. Patient Education. Behavior Modification. Prevention. Drug Therapy. Abdominal Pain. Diarrhea. Symptoms. Risk Factors.
Verification/Update Date (VE): 200104.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 08087.
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18. Childhood Functional Gastrointestinal Disorders.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 2000.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Hyman, P.E., et al.
Source (SO): In: Drossman, D.A., et al., eds. Rome II: The Functional Gastrointestinal Disorders. 2nd ed. McLean, VA: Degnon Associates, Inc. 2000. p. 533-575.
Availability (AV): Available from Degnon Associates, Inc. Rome II Management, 6728 Old McLean Village Drive, McLean, VA 22101. Fax: 703-556-8729. Email: giworkingteam@degnon.org. Website: www.romecriteria.org. PRICE: $79.95 plus shipping and handling. ISBN: 965683729.
Abstract (AB): Childhood functional gastrointestinal disorders include a variable combination of often age-dependent, chronic or recurrent symptoms not explained by structural or biochemical abnormalities. Functional symptoms during childhood are sometimes accompaniments to normal development (e.g., infant regurgitation), or they may arise from maladaptive behavioral responses to internal or external stimuli (e.g., functional fecal retention often results from painful defecation or coercive toilet training). This chapter on childhood functional bowel disorders is from a text that reviews the diagnosis, pathophysiology, and treatment of functional gastrointestinal disorders. The chapter covers vomiting, including infant regurgitation, infant rumination syndrome, and cyclic vomiting syndrome; abdominal pain, including functional dyspepsia, irritable bowel syndrome, abdominal migraine, and aerophagia (swallowing excessive amounts of air); functional diarrhea; and disorders of defecation, including infant dyschezia, functional constipation, functional fecal retention, and functional non-retentive fecal soiling. For each condition, the authors discuss definition, epidemiology, diagnostic criteria, clinical evaluation, physiologic features, psychological features, and treatment options. A listing of recommendations for future research concludes each section of the chapter. 1 table. 107 references.
Major Descriptors (MJ): Digestive System Diseases. Gastrointestinal Tract. Functional Colonic Disorders. Children. Abdominal Pain. Gastrointestinal Motility. Patient Care Management. Diagnosis. Therapy.
Minor Descriptors (MN): Defecation. Complications. Dyspepsia. Vomiting. Fecal Incontinence. Epidemiology. Symptoms. Physiology. Psychological Factors. Pathology. Risk Factors. Diagnostic Tests. Research Methodology. Quality of Life. Morbidity. Etiology.
Verification/Update Date (VE): 200404.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 09950.
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19. Chronic Abdominal Pain in Childhood: Diagnosis and Management.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24). REVIEW (46).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Lake, A.M.
Source (SO): American Family Physician. 59(7): 1823-1830. April 1, 1999.
Availability (AV): Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org.
Abstract (AB): More than one third of children complain of abdominal pain lasting 2 weeks or longer. This article discusses the diagnosis and management of chronic abdominal pain in childhood. The diagnostic approach relies heavily on the history provided by the parent and child to direct a step wise approach to investigation. If the history and physical examination suggest functional abdominal pain, constipation, or peptic disease, the response to an empiric course of medical management is of greater value than multiple exclusionary investigations. A symptom diary allows the child to play an active role in the diagnostic process. The medical management of constipation, peptic disease, and inflammatory bowel disease involves nutritional strategies, pharmacologic intervention, and psychological support. The authors recommend careful followup to monitor compliance with treatment, restoration of normal activities, and appropriate family interventions. Support groups for the family and the child can be invaluable. Most important, the child must feel that the family physician understands that the pain is real, that the child’s input is as valuable as the parents’, and that information shared in confidence will be kept confidential if at all possible. One figure summarizes the algorithmic approach to the child with probable peptic disease. 1 figure. 3 tables. 19 references.
Major Descriptors (MJ): Digestive System Diseases. Abdominal Pain. Children. Chronic Disease. Diagnosis. Patient Care Management.
Minor Descriptors (MN): Symptoms. Diagnostic Tests. Patient History. Constipation. Vomiting. Peptic Ulcer. Nausea. Gastroesophageal Reflux Disease. Inflammatory Bowel Disease. Drug Therapy. Diet Therapy.
Verification/Update Date (VE): 200108.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07201.
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20. How to Resolve Stool Retention in a Child: Underwear Soiling is Not a Behavior Problem.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Griffin, G.C.; Roberts, S.D.; Graham, G.
Series (SE): (Pediatrics Series).
Source (SO): Postgraduate Medicine. 105(1): 159-161, 165-166, 172-173. January 1999.
Abstract (AB): Many parents do not realize that their child has stool retention when they bring him or her for an office visit. This article guides primary care providers in the diagnosis and patient management of these children and their parents. The authors discuss how and why stool retention gets started, and they summarize the complaints parents often have when they bring in their child. A complete treatment regimen is described and compiled in a form that can be sent home with parents (a chart of strategies for parents to use immediately and on an ongoing basis). The authors note that stool retention is the most common cause of underwear soiling in children who have been toilet trained. Management begins with educating parents that leaking of liquid stool around impaction and onto underwear is completely involuntary, so the child should never be scolded or embarrassed. Stool retention may begin because of unpleasant or unavailable toilet facilities, constipation, or painful elimination and often becomes self perpetuating. The impaction must be removed immediately; magnesium citrate solution is usually effective. To allow the rectum to return to its normal size, which can take a long time, stool must be kept soft and movable with administration of mineral oil and appropriate dietary choices (e.g., fruit, juice, fiber). Recurrence is common, so ongoing measures and followup are important. 1 figure. 1 table. 16 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Constipation. Children. Obstruction. Impacted Feces. Patient Care Management.
Minor Descriptors (MN): Fecal Incontinence. Symptoms. Risk Factors. Etiology. Parent Education. Drug Therapy. Prevention. Dietary Fiber.
Verification/Update Date (VE): 200001.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07080.
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21. When ‘Little Accidents’ Turn Serious: Understanding Fecal Incontinence.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): PATIENT (400).
Author (AU): Dorsky, R.; Dorsky, L.T.
Source (SO): Digestive Health and Nutrition. p. 22-25. November-December 1999.
Availability (AV): Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. E-mail: DHN@gastro.org.
Abstract (AB): This article discusses fecal incontinence (encopresis) in children, delineating when this behavior becomes a serious problem and what actions to take to correct it. Fecal incontinence is defined as soiling of a child’s underpants (or leaking of stool) at a time when the child should be toilet trained (after ages 2 to 3 for girls; 2 to 4 for boys). It occurs in conjunction with chronic constipation, which results when a child does not completely empty his or her bowel when sitting on the toilet, or refuses to use the toilet altogether. By becoming alert to the warning signs of encopresis, parents can often prevent the problem from worsening. The author reviews the common schedule a child will follow for defecation; the variety of factors that can contribute to the development of constipation, including toilet training forced at too young an age; not drinking enough fluids; holding back because of a particularly painful bowel movement in the past; stress in the family such as a birth, death, divorce, or unfamiliar surroundings; the child’s typical behavior after soiling, notably denial; and strategies for addressing the problem of encopresis. One sidebar offers tips on toilet training.
Major Descriptors (MJ): Digestive System Diseases. Fecal Incontinence. Children. Constipation. Patient Care Management. Defecation.
Minor Descriptors (MN): Parent Education. Toilet Training. Psychosocial Factors. Fluids. Stress. Parent-Child Relations. Behavior Modification.
Verification/Update Date (VE): 200001.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07337.
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22. Pediatric Gastrointestinal Disease. 2nd ed.
Subfile: Digestive Diseases
Format (FM): MONOGRAPH/BOOK (32).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Wyllie, R.; Hyams, J.S., eds.
Source (SO): Philadelphia, PA: W.B. Saunders Company. 1999. 823 p.
Availability (AV): Available from W.B. Saunders Company. Book Order Fulfillment Department, 11830 Westline Industrial Drive, Saint Louis, MO 63146-9988. (800) 545-2522 or (314) 453-7010. Fax (800) 568-5136 or (314) 453-7095. E-mail: wbsbcs@harcourt.com. Website: customerservice.wbsaunders.com. PRICE: $155.00 plus shipping and handling. ISBN: 0721674615.
Abstract (AB): This medical textbook covers all facets of clinical pediatric gastrointestinal disease. The text emphasizes a clinical focus and incorporates anatomy and physiology considerations into each chapter rather than a separate section. The book is organized into distinct sections, starting with the common clinical problems and followed by organ specific diseases. General chapters on clinical problems cover chronic abdominal pain of childhood and adolescence, vomiting, diarrhea, constipation and encopresis (fecal soiling), failure to thrive, gastrointestinal hemorrhage, eating disorders and obesity, jaundice, ascites, caustic ingestion and foreign bodies, abdominal masses in pediatric patients, and abdominal surgical emergencies. Sections on diseases of the esophagus, stomach, and the small and large bowel (intestine) are followed by chapters reviewing the clinical facets of pediatric liver disease. Specific chapters include gastrointestinal reflux, achalasia and other motor disorders, congenital anomalies, gastric motility disorders, bezoars (a mass of food, hair or other components found in the stomach or intestine), maldigestion and malabsorption, celiac disease, short bowel syndrome, enteric parasites, Crohn’s disease, ulcerative colitis, polyps, appendicitis, hernia, Hirschsprung’s disease, neoplasms (cancerous and noncancerous), hepatitis, gallbladder diseases, and liver transplantation. The last two sections review diseases of the pancreas and basic nutrition in children, including pancreatitis, cystic fibrosis, nutritional assessment, parenteral (outside the digestive system, for example, intravenous nutrition) and enteral nutrition, and the management of diarrhea. Each chapter offers black and white photographs and figures and concludes with extensive references. A detailed subject index concludes the text.
Major Descriptors (MJ): Digestive System Diseases. Gastrointestinal System. Children. Adolescents. Diagnosis. Therapy. Symptoms. Patient Care Management. Pathophysiology.
Minor Descriptors (MN): Abdominal Pain. Vomiting. Diarrhea. Constipation. Hemorrhage. Eating Disorders. Liver Diseases. Ascites. Surgery. Drug Therapy. Congenital Anomalies. Stomach. Esophagus. Motility Disorders. Celiac Disease. Inflammatory Bowel Disease. Pancreas. Nutrition. Diagnostic Tests. Professional Education.
Verification/Update Date (VE): 200004.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 07495.
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23. Nutritional Considerations Following Total Colectomy for Motility Disorders.
Subfile: Digestive Diseases
Format (FM): NEWSLETTER ARTICLE (35).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): PATIENT (400).
Author (AU): Vanderhoof, J.A.
Source (SO): Messenger. 9(3): 4-7. 1999.
Availability (AV): Available from American Pseudo-obstruction and Hirschsprung’s Disease Society, Inc. 158 Pleasant Street, North Andover, MA 01845. (978) 685-4477. Fax (978) 685-4488.
Abstract (AB): This article reviews the nutritional considerations for patients following total colectomy (removal of the colon) for motility disorders. The article is from a newsletter for people with Hirschsprung’s disease (HD), a motility disorder of the large bowel caused by absence of parasympathetic ganglion (nerve) cells. The most common symptom of HD is constipation; associated symptoms include abdominal pain and distention, bilious vomiting, anorexia, and failure to thrive. Once the diagnosis has been confirmed, the only definitive treatment of children with HD is operative relief of the functional obstruction. The author reviews colon anatomy and physiology, the consequences of resection, the use of parenteral nutrition (supplemental feeding that bypasses the gastrointestinal tract), and the use of enteral feeding (tube feeding). The author notes that the amount of bowel resected in HD is variable. Parenteral nutrition is useful in Hirschsprung’s disease, particularly total colon Hirschsprung’s disease, especially as necessary to maintain fluid and electrolyte balance. Enteral nutrition is often initially accomplished with tube feeding and ultimately, a modified oral nutrition program becomes the mainstay of nutrition. Of prime importance is a balanced nutritional program. Absolute restriction of any particular food group should be avoided unless a direct negative correlation with stool output is identified. 2 figures. 1 table.
Major Descriptors (MJ): Digestive System Diseases. Hirschsprung Disease. Children. Infants. Nutrition. Postoperative Care.
Minor Descriptors (MN): Colectomy. Postoperative Complications. Malnutrition. Enteral Nutrition. Parenteral Nutrition.
Verification/Update Date (VE): 200004.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07364.
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24. Functional Childhood Constipation: A Practical Approach.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24). REVIEW (46).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Khan, S.; Di Lorenzo, C.
Series (SE): (Pediatric Functional Bowel Disorders, Series Number 5).
Source (SO): Practical Gastroenterology. 23(12): 16, 20-22, 24-26, 33-34. December 1999.
Availability (AV): Available from Shugar Publishing, Inc. 99B Main Street, Westhampton Beach, NY 11978. (631) 288-4404. Fax (631) 288-4435. E-Mail: info@practicalgastro.com.
Abstract (AB): Constipation is a common childhood problem and is frequently encountered by the primary care physician and the pediatric gastroenterologist alike. Although the presentation of constipation in infancy raises concerns about organic etiologies, the large majority of infantile and childhood presentations of constipation have a functional basis. This review article emphasizes the concepts basic to the recognition and management of functional childhood constipation from the perspective of a primary care physician. Data obtained through a careful history and physical examination should enable the physician in most cases to confidently establish the diagnosis of functional constipation and exclude less common organic disorders. Infants and older children with atypical features or intractable constipation may require diagnostic investigations. Most children recover satisfactorily after being managed with a combination of incentive based behavior modification and stool softeners. The authors note that early recognition and initiation of behavior modification and pharmacotherapy in children favorably influences prognosis. Children with intractable constipation and those suspected of having underlying organic etiologies can therefore be identified by the primary care physician and referred to a subspecialist for further evaluation. 1 figure. 3 tables. 15 references.
Major Descriptors (MJ): Digestive System Diseases. Constipation. Children. Patient Care Management. Diagnosis. Therapy.
Minor Descriptors (MN): Infants. Diagnostic Tests. Etiology. Risk Factors. Behavior Modification. Drug Therapy. Dietary Fiber. Psychological Factors.
Verification/Update Date (VE): 200008.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07571.
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25. What to Do When Your Child Gets Sick.
Subfile: Digestive Diseases
Format (FM): MONOGRAPH/BOOK (32).
Language(s) (LG): English. Spanish.
Year Published (YR): 1999.
Audience code (AC): PATIENT (400).
Author (AU): Mayer, G.; Kuklierus, A.
Source (SO): Whittier, CA: Institute for Healthcare Advancement. 1999. 181 p.
Availability (AV): Available from Institute for Healthcare Advancement. 15111 East Whittier Blvd., Suite 460, Whittier, CA 90603. (800) 434-4633. Fax (562) 907-1963. Website: www.iha4health.org. PRICE: $14.95 plus shipping and handling; bulk copies available. ISBN: 0828114404.
Abstract (AB): This reference book uses simple everyday language and illustrations to provide information on common childhood illnesses and health problems. Written in nontechnical language designed to be accessible to adults at any reading level, the book features 11 topical chapters: safety tips, caring for the sick child, the newborn baby, the child’s eyes, the child’s ears and nose, the child’s mouth and throat, the child’s breathing, the child’s stomach, bed wetting, the child’s skin, and what to do when the child gets hurt. Topics related to digestive diseases include infection, jaundice, swallowing foreign objects, blood in the bowel movements, colic, constipation, diarrhea, food allergies, hernia, spitting up, stomach pain, vomiting, and poisoning. The book features extensive illustrations, with topics simplified to key points on each page. The book’s content is simplified through the use of short, active sentences and single syllable words where appropriate. For most of the topics, the book follows a similar style covering a definition (what is it?), symptoms (what do I see?), how to care for the child (what can I do at home?), how to know when to call the doctor or nurse, and further information (what else should I know about this condition?). The book concludes with a word list (a glossary of terms), a subject index, and a list of acknowledgments. The book is available in either Spanish or English.
Major Descriptors (MJ): Digestive System Diseases. Children. Parent Education. Patient Care Management. Home Care. Symptoms. Diagnosis.
Minor Descriptors (MN): Limited Reading Skills. Patient Education. Delivery of Health Care. Risk Factors. Complications. Jaundice. Constipation. Diarrhea. Vomiting. Food Allergies. Abdominal Pain. Stomach.
Verification/Update Date (VE): 200007.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 07689.
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26. Increasing Oral Fluids in Chronic Constipation in Children.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1998.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Young, R.J.; Beerman, L.E.; Vanderhoof, J.A.
Source (SO): Gastroenterology Nursing. 21(4): 156-161. July-August 1998.
Availability (AV): Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (410) 528-8555.
Abstract (AB): Increasing the amount and type of fluid intake in children with simple constipation remains a common intervention recommended by both the medical profession and lay consumers. However, there is no research or physiologic basis for increasing overall water intake and or high osmolarity liquid intake in order to produce softer or more frequent stools. This article reports on a project undertaken to identify whether a concerted effort to increase liquid intake would lead to an effect on stooling characteristics. Ninety children completed the entire study as assigned (59 girls, 31 boys). Neither increasing water intake nor increasing hyperosmolar liquid intake significantly increased stool frequency or decreased consistency or difficulty with passage. The authors conclude that nurses need to be proactive in changing commonly held thoughts regarding the treatment of pediatric constipation. Advising new parents of what is acceptable in stooling patterns is important. Encouraging a high insoluble fiber intake is more beneficial in promoting healthy stool patterns than any amount of increased liquid intake. Advising parents of constipated children to increase liquid intake is not helpful and should not be recommended unless history suggests that the child’s liquid intake is inadequate for a normal child of that age and activity level. 3 figures. 4 tables. 19 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Constipation. Children. Fluids. Fluid Therapy.
Minor Descriptors (MN): Dehydration. Defecation. Dietary Fiber. Colon. Physiology.
Verification/Update Date (VE): 199907.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07023.
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27. Bowel and Bladder Management.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): HEALTH PROFESSIONALS (100). COMMUNITY SERVICE PROFESSIONALS (200).
Author (AU): Blackman, J.A.
Source (SO): In: Blackman, J.A. Medical Aspects of Developmental Disabilities in Children Birth to Three. 3rd ed. Gaithersburg, MD: Aspen Publishers, Inc. 1997. p. 11-23.
Availability (AV): Available from Aspen Publishers, Inc. 7201 McKinney Circle, Frederick, MD 21704. (800) 234-1660 or (800) 638-8437. PRICE: $40.00. ISBN: 0834207591.
Abstract (AB): Many infants and young children with developmental disabilities have complex needs related to their bowel and bladder functions. This chapter is part of a book designed to educate health and social service professionals about the medical challenges presented by children (ages 1 to 3) with developmental disabilities. The chapter discusses the management of constipation, intestinal ostomies, and clean intermittent catheterization. For each topic, the author provides information about cause, incidence, medical management, course, accompanying health problems, and possible alternative treatments or problems. The author points out that bowel and bladder problems can interfere with education or therapy services. Black and white photographs and line drawings illustrate some of the concepts presented. 5 figures. 2 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Constipation. Congenital Disorders. Colostomy. Ileostomy. Children. Infants. Urination. Anus. Therapy. Equipment and Supplies. Gastrointestinal Diseases. Colon. Catheters.
Minor Descriptors (MN): Cathartics. Hirschsprung Disease. Diet. Enterocolitis, Pseudomembranous.
Verification/Update Date (VE): 199805.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 01863.
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28. Hirschsprung’s Disease.
Subfile: Digestive Diseases
Format (FM): FACT SHEET (22).
Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): PATIENT (400).
Corporate Author (CN): American Pseudo-obstruction and Hirschsprung’s Disease Society, Inc. (APHS).
Source (SO): North Andover, MA: American Pseudo-obstruction and Hirschsprung’s Disease Society, Inc. 1997. 2 p.
Availability (AV): Available from APHS. 158 Pleasant Street, North Andover, MA 01845-2797. (508) 685-4477. Fax (508) 685-4488. E-mail: aphs@mail.tiac.net. PRICE: Single copy free.
Abstract (AB): This fact sheet provides basic information about Hirschsprung’s disease, its diagnosis, and treatment. Hirschsprung’s disease is a serious childhood condition caused by the absence of nerve cells in the wall of the bowel. The portion of bowel without these nerve cells (ganglia) does not relax and remains collapsed. Bowel contents build up behind the obstruction. The most life-threatening emergency in Hirschsprung’s disease is enterocolitis, a severe inflammatory condition of the bowel wall. To diagnose Hirschsprung’s disease, a barium enema xray test is used to identify the narrow collapsed segment of bowel as well as the dilated bowel in front of the affected regions. A biopsy is then necessary to confirm the absence of ganglia. Treating Hirschsprung’s disease requires surgery to remove the affected bowel and then join the healthy bowel segments. The fact sheet briefly reviews the three surgical techniques that are used to treat Hirschsprung’s disease. The fact sheet concludes that, for most children with Hirschsprung’s disease, there are no longterm complications after successful surgery. However, a significant minority of children are troubled with persistent constipation, encopresis (stool incontinence), or persistent enterocolitis.
(AA-M).
Major Descriptors (MJ): Digestive System Diseases. Hirschsprung Disease. Health Education. Patient Education. Diagnosis. Surgery. Children.
Minor Descriptors (MN): Diagnostic Tests. Symptoms. Gastrointestinal Motility. Postoperative Complications. Physiology.
Verification/Update Date (VE): 199710.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 06046.
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