Peds GI Disorders

Abdominal Pain

Acute Appendicitis

Celiac disease

Cleft Lip and/or Cleft Palate



  • Path:
    • Ulcerative colitis is an inflammatory bowel disease (IBD) in which the lining of the large intestine (colon or bowel) and rectum becomes inflamed.
    • Inflammation usually begins in the rectum and lower (sigmoid) intestine and spreads upward to the entire colon.
  • Causes:
    • diarrhea, or frequent emptying of the colon.
    • As cells on the surface of the lining of the colon die and slough off, ulcers (open sores) form, causing pus, mucus, and bleeding.
  • Presentation:
    • Abdominal pain
    • Bloody diarrhea
    • Fatigue
    • Weight loss
    • Loss of appetite
    • Rectal bleeding
    • Loss of body fluids and nutrients
    • Anemia caused by severe bleeding





Feeding Problems

Failure To Thrive

Food allergies

Gallbladder diseases


  • MC cause:
    • Rotavirus and norovirus
    • E.coli 0157 – leads to HUS
    • Bloody stools – salmonella, shigella, campylobacter, enterocolitis, C. difficile
  • Presentation:
    • dehydration – abnormal respiratory pattern and skin turgor, prolonged capillary refill
  • Diagnosis:
    • stool studies only needed for diarrhea > 14 days or bloody
  • Treatment:
    • main – early oral rehydration solution (ORS)
    • probiotics
    • no anti-diarrheal
    • resume a normal diet as soon as possible

Gastrointestinal bleeding


Gastroesophageal Reflux (GERD)

Hirschsprung Disease

Hypertrophic Pyloric Stenosis

Inflammatory bowel disease

Crohn’s Disease

Ulcerative Colitis

Intestinal Atresia

  • Types:
    • 1) Duodenal: “Double-bubble”
    • 2) jejunal/ilieal: “Apple-core”

Duodenal Atresia

Intractable Vomiting


Irritable bowel syndrome

  • Presentation:
    • Recurring Belly pain
    • Continuous Pain for more than 3 months is long-term (chronic).
    • Diarrhea or constipation
    • Upset stomach (nausea)
    • Dizziness
    • Loss of appetite
    • Swelling (bloating) and gas
    • Cramping
    • Immediate bowel movement 
    • incomplete emptying
    • Mucus in the stool
  • Cause:
    • Problems with how food moves through their digestive system
    • Extreme sensitivity of the inside of their bowel to stretching and motion
    • Stress
    • Too much bacteria growing in their bowel
  • Risks:
    • Family history
    • Teens > younger children
    • Affects boys and girls equally

Osmosis / CC BY-SA
  • Diagnosis:
    • Blood tests – anemia, an infection, or an illness caused by inflammation or irritation.
    • Urine analysis and culture – help check for urinary tract infections.
    • Stool sample – checks for bacteria and parasites that may cause diarrhea.
    • Stool samples for occult blood – If blood is found, there may be inflammation in the GI (gastrointestinal) tract.
    • Lactose breath hydrogen test – see if child can’t digest lactose (is lactose intolerant).
    • Abdominal X-ray
    • Abdominal ultrasound
    • EGD (esophagogastroduodenoscopy) or upper endoscopy)
    • Colonoscopy
  • Management:
    • Lactose intolerant – limit lactose. 
    • Use lactase/Lactaid
    • High fiber for children who have constipation.
    • Add good bacteria (probiotics) regulated by the FDA.
    • Stress management

Intestinal pseudo-obstruction

Liver disease


Malrotation with volvulus

Meckel Diverticulum

Motility disorders

Necrotizing enterocolitis

Nutrition Issues

Pancreatic diseases

Parasitic Infections

Peptic ulcers



Short gut (bowel) syndrome

Tracheoesophageal Fistula

File:Tracheoesophageal Fistula Types.svg“File:Tracheoesophageal Fistula Types.svg” by Jmarchn is licensed under CC BY-SA 3.0

  • Diagnosis:
    • screening tool Prenatal US reveal polyhydramnios, the absence of gas in the stomach, a distended esophageal pouch, and in-utero growth retardation.
    • Plain x-ray – exclude complications such as aspiration pneumonia and to have more clues to confirm the diagnosis
    • Nasogastric tube insertion –  inserted to confirm the diagnosis of esophageal atresia. as the nasogastric tube will coil in the mediastinum and one would visualize the radiopaque line of the catheter.
    • Multidetector-row computed tomography scans – used to confirm the diagnosis of a tracheoesophageal fistula without the use of a contrast medium.
  • Treatment:
    • 1. Echocardiography – performed prior to surgery to rule out a right-sided aortic arch.
    • 2. Surgical repair – performed under general anesthesia with endotracheal intubation.
    • 3. Surgical repair – delayed in neonates with very low birth weight or aspiration pneumonia. All other infants should be operated within the first days of life.
    • 4. Surgery involves Primary ligation of the fistula and anastomosis of the esophageal segments