Clinical Pediatric Gastrointestinal Disease & Diagnosis

The gastrointestinal tract (GIT) arises initially during the process of gastrulation from the endoderm of the trilaminar embryo (week 3) and extends from the buccopharyngeal membrane to the cloacal membrane. The tract and associated organs later have contributions from all the germ cell layers. Digestion is the breakdown of food into smaller particles or individual nutrients. Obesity is the most prevalent nutritional disorder among children and adolescents in the United States. Approximately 21-24% of American children and adolescents are overweight, and another 16-18% is obese; the prevalence of obesity is highest among specific ethnic groups. Chronic abdominal pain(CAP) persists for more than 3 months either continuously or intermittently. Intermittent pain may be referred to as recurrent abdominal pain (RAP). CAP occurs any time after 5 year of age. Up to 10% of children require evaluation for RAP. 

Gastrointestinal defects affect any part of the gastrointestinal tract. This includes the oesophagus that connects mouth with stomach, and stomach to intestines. Food travels through the tract after eating. Barrett's oesophagus is a condition where the cells of the oesophagus (gullet) grow abnormally. The biliary tract refers to the liver, gall bladder and bile ducts, and how they work together to make, store and secrete bile. Biliary disease often presents with upper abdominal pain. The pain quality is a penetrating aching or tightness, typically severe and located in the epigastrium. Appendicitis is inflammation of the appendix. Appendicitis commonly presents with right lower abdominal pain, nausea, vomiting, and decreased appetite. Rumination syndrome, or Merycism, is a chronic motility disorder characterized by effortless regurgitation of most meals following consumption, due to the involuntary contraction of the muscles around the abdomen. Cystic fibrosis (CF) is a genetic disorder that affects mostly the lungs but also the pancreas, liver, kidneys, and intestine.

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