Instruction for bowel preparation before colonoscopy in children

Both HD and FC are causes of constipation in children, HD being less common (incidence 1 in 5000). However, it is important to differentiate between the two as the management strategies are different for each of them.  Hirschsprung disease Functional constipation Passage of meconium Delayed Normal (within 48 hour) Onset of symptoms < 1 year age > 1 year age Stool withholding  no May be present Encopresis no May be present Abdominal distension May be present Usually not associated Failure to thrive Commonly present in delayed presentation Usually not a feature Enterocolitis As a complication of HD Not seen Digital rectal examination Tight grip of finger, empty rectum  & Gush of explosive offensive stool as finger is taken out Stool in rectum Barium enema:  Rectosigmoid ratio (R:S) < 1 > 1 Transitional zone present no RAIR (rectoanal inhibitory reflex) absent Present normally Rectal biopsy Ganglion cells absent present Nerve bundles hypertrophied normal...

  HOW TO READ ABOUT A DISEASE A medical student is very accustomed to reading about any medical condition (disease or disorder or syndrome) and after years of practice, they can read and understand about it in a faster way and also can retain that information in their memory easily as they try to gather it in a basic structured format.  It is very common now-a-days for a non-medical person (also called general people) to read about certain medical conditions especially when he/she or any of their family members is diagnosed with any disease and their curiosity arises for the same. If someone can remember a basic structured format, then it becomes much easier to retain the information under each category.  Basic structured format  (when reading or thinking about a medical condition)   Other names of the condition Definition   or introduction  or category of the condition Epidemiology Age group Gender predilection Geographical distribution Import...

  Portal Hypertension in children: approach and evaluation  PORTAL Hypertension (pHTN) in Children Q1: What is portal hypertension? Increase in pressure inside the portal vein is known as portal hypertension.  [ Normally,the portal venous pressure is 1-5 mm Hg.  If it exceeds 12 mm Hg, it becomes clinically significant. Also, another way to define it is the portal pressure gradient (between IVC and portal vein) when it exceeds 5 mm Hg]  Currently, the most commonly used parameter is the Hepatic Venous Pressure Gradient (HVPG) [the difference between the wedged (WHVP) and the free hepatic venous pressures]  Pressure = Flow x Resistance There are two components for a pressure inside the venous lumen to increase. The ‘resistance’ increases due to active myofibroblast or vascular smooth muscle cells in intrahepatic veins; and overall liver disease;  and the ‘flow’  increases due to splanchnic arteriolar dilatation by release of endogenous vasodilator...