Description
Pneumonia is the most common cause of morbidity and mortality in children under 5 years old worldwide. Even though the developing world accounts for the vast majority of pediatric pneumonia-related mortality, pneumonia nevertheless has a considerable economic burden in wealthy nations due to high healthcare expenses. In this exercise, the multidisciplinary team's crucial role in the treatment of pediatric pneumonia is reviewed along with the cause, pathophysiology, and presentation of the condition.
Summary Listen
- Chronic abdominal pain in children is frequently functional, meaning no underlying organic disease is present. Functional abdominal pain is classified based on symptoms and location. Differentiating functional from organic pain involves looking for red flags like onset before age 5, weight loss, fever, joint pain, deceleration of growth, GI bleeding, and abnormal lab results. Organic pain also tends to wake children up at night and have specific radiation patterns.
- History and physical examination play a crucial role in diagnosing functional abdominal pain. The Rome IV criteria prioritize history and examination. Important factors include pain characteristics, associated symptoms, dietary history, bowel habits, and lifestyle. Basic investigations include CBC, urine and stool analysis, and abdominal ultrasound. Additional investigations may be considered based on specific symptoms.
- Effective reassurance and education of parents and children are essential components of managing functional abdominal pain. Gut-brain interaction is important to explain, with many children experiencing primary or secondary hyperalgesia. Pharmacological interventions, cognitive behavioral therapy, guided imagery, and hypnosis can also be helpful.
- Management includes reassurance, lifestyle modifications, food habit changes, and identifying dietary triggers. If no improvement, pharmacological therapy targeting symptom patterns is considered. Non-pharmacological therapies like psychological and behavioral therapy, hypnotherapy, and probiotics can also be utilized. Functional constipation should be ruled out and treated.
- Specific medications can address different symptom presentations. Antispasmodics can be used for IBS. Tricyclic antidepressants require careful consideration of benefits versus risks. PPIs or H2 receptor blockers may be trialed for epigastric pain syndrome. Laxatives can be used for IBS with constipation. Flunarizine, Pizotifen, and Propranolol are options for abdominal migraine.
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About the Speakers
Dr.Bharat Parmar
Consultant Radiation Oncologist and Pain and Palliative Care PhysicianYashoda Hospitals
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