Chapter 34: Pediatric Gastrointestinal Problems

Congenital structural anomalies including cleft lip and palate, esophageal atresia with tracheoesophageal fistula, and abdominal wall defects such as omphalocele and gastroschisis require immediate recognition and specialized feeding or surgical interventions to prevent aspiration and infection. The chapter then explores motility and obstructive disorders such as gastroesophageal reflux disease managed through positional therapy and formula modification, hypertrophic pyloric stenosis presenting with characteristic projectile vomiting, Hirschsprung disease involving absent ganglion cells and requiring surgical correction, and intussusception managed through hydrostatic reduction. Malabsorption conditions including lactose intolerance and celiac disease demand dietary modifications and careful nutritional monitoring to prevent failure to thrive. Hepatic disorders, particularly viral hepatitis infections transmitted through different routes, necessitate appropriate isolation precautions and supportive care considering compromised liver function. The chapter concludes with toxicological emergencies and parasitic infections, detailing poison management protocols specific to common pediatric ingestions such as acetaminophen, aspirin, and corrosives, where treatment approaches vary dramatically based on the substance involved and may include chelation therapy, activated charcoal administration, or dilution rather than induced vomiting. Throughout, nursing priorities center on preventing complications, maintaining fluid and electrolyte balance, supporting nutrition, and educating families on prevention and home management strategies.