Chapter 39: Alterations of Digestive Function in Children

Congenital structural anomalies directly impair feeding and nutrient intake, including cleft lip and palate affecting sucking mechanics, esophageal atresia and tracheoesophageal fistula creating aspiration risk, and infantile hypertrophic pyloric stenosis causing severe projectile vomiting and electrolyte derangement. Anatomical obstructive conditions such as intestinal malrotation with volvulus, Meckel diverticulum, meconium ileus, Hirschsprung disease, and anorectal malformations compromise bowel patency and blood supply, requiring surgical intervention to prevent ischemia and death. Acquired motility disorders including gastroesophageal reflux disease, intussusception, and appendicitis develop through mechanical or inflammatory mechanisms and present with characteristic clinical manifestations requiring prompt diagnosis. Malabsorptive diseases such as cystic fibrosis and celiac disease impair nutrient extraction through pancreatic insufficiency or intestinal villous damage, respectively, leading to severe nutritional deficits and growth failure. The chapter addresses acute and chronic diarrheal conditions caused by viral, bacterial, or parasitic pathogens alongside osmotic diarrhea from lactase deficiency, each producing dehydration and metabolic complications. Hepatobiliary pathology encompasses neonatal jaundice reflecting immature bilirubin metabolism, biliary atresia causing progressive cholestasis and cirrhosis, viral hepatitis acquired through perinatal or fecal-oral transmission, and inborn errors of metabolism such as galactosemia and Wilson disease that accumulate toxic compounds damaging hepatic and neurological tissues. The chapter emphasizes how early identification, nutritional rehabilitation, antimicrobial or immunosuppressive therapy, and surgical correction when indicated represent essential interventions for optimizing pediatric survival and long-term neurodevelopmental and growth outcomes.