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Paediatric Hepatology

Pediatric Hepatology : Treatment for Common Liver Diseases in Children & Teenagers

Paediatric Hepatology is a field of treatment that deals with the diagnostics, treatment and the clinical care of liver diseases in children and teenagers. However, this facility also includes Paediatric Gastroenterology treatments; which is treatment of issues pertaining to the organs in the digestive tract of children and teenagers.

Liver and Gastrointestinal Diseases Among Children

 A childhood is a stage where every internal and external organ continues to morph as the child grows up. However, this continual regeneration combined with the diets or the genetic factors can place organs like liver and the gastrointestinal tract in a serious state of vulnerability. To that end, some of the following malignancies can occur:

  1. Acute Liver failure: Acute liver failure is a disastrous condition where there is a rapid damage to about 70% of the liver and as a result, it stops functioning properly.
  2. Non-alcoholic fatty liver disease: Diabetes, diet or certain genetic factors are responsible for this sort of organ malignancy.
  3. Defect with synthesising the Bile liver: Malfunction of the gall bladder or the Intraheptic bile ducts might have some problems.
  4. Cirrhosis: it is a form of chronic liver failure.
  5. Wilson’s disease: this is a type of autoimmune disease where the immune system of the body starts attacking the healthy organs under the presumption that healthy tissues are defective.
  6. Caroli’s Disease: In this disease, abnormal growth is formed on the Intraheptic bile ducts (ducts the carry the bile inside the liver).
  7. Cystic Fibrosis: In this condition, cysts are formed inside the liver that causes the bile to be accumulated in one place and thicken. Further accumulation causes a cirrhosis or scaring of the liver.
  8. Biliary Atrehsia: Mostly notices right after birth, the child’s bile ducts gets blocked, causing the inability to transport bile juice from the liver.
  9. Crohn’s disease: Crohn’s disease refers to the inflammation of the digestive tract. This scenario makes it difficult for the children to be able to process food properly and can be quite painful s well.
  10. Eosinophilic GI disorder: Presence of extra white blood cells in the digestive tract of children, cause inflammation of the area and can escalate to further deterioration of the organ.
  11. Celiac Disease: This disease hampers a child’s ability to be able to process gluten. To that end, they can indulge themselves on wheat protein, barley etc.
  12. Irritable Bowel syndrome: Irritable bowel syndrome makes a child unable to fully control their bowels. This disease is hard to notice when the child is infant, but can be quite a serious detriment as the child grows up.
  13. Cyclic Vomiting disorder: this disease can be easily brushed off as “stomach bug”, but it is quite a serious problem. It starts as a nausea, then drowsiness and it then proceeds with an intense episode of vomiting that causes pain in not just the stomach, but the respiratory system as well.
  14. Bleeding from the bottom GI tract: If the tract inflammation is high enough, it can scar the lower part of gastrointestinal tract that can further causes immense bleeding.
  15. Faecal impaction: When the kids are younger, it is easy for them to get over indulgent to sweets or other cheesy foods that can impact their faecal pathway. Also known as constipation, this condition can be dealt with in the initial period, but can be as intense as causing an anal tear later down the line.
  16. Colic: A colic pain is more common in the infants. While they are not deemed dangerous, they can interrupt the eating and resting schedule of the baby.

Diagnosis in these scenarios

Thankfully, it has become quite easier to get a hold of these liver and gastrointestinal issues pretty early on thanks to many advanced diagnostic tools available in the current scenario:

  1. CT scan or Computer Tomography Scan: this form of scanning makes use of X-Rays from different angles. This way of taking images gives the doctors a cross section perspective of the organs and treating the issue becomes a lot easier.
  2. Liver Biopsy: A small and benign sample of liver is extracted and taken to the lab. The sample is then put under scrutiny of different tests that include imaging tests; reactive tests etc. to figure out the issue.
  3. Molecular techniques: With more and more advanced methods, the molecular techniques of diagnostics procedures are catching wind. These methods include NGC (next generation Cells) tests, antigen genotyping and much more. While this type of diagnostic is a bit more exclusive, it is viable.
  4. Blood tests: A lot of report pertaining to the functioning of liver can be extrapolated via the blood tests.
  5. Capsule Endoscopy: this is a type of an imagine tests where a camera is inserted into a child’s small intestine that takes photographs of the inner layer of the intestines.
  6. GES (Gastric emptying Scan): This diagnostic test is meant to test the stomach’s ability to pass its content to the small intestine.
  7. Upper GI tests: In the upper GI tests, a child is made to ingest a sage contrast material. This material enables the doctors to x-ray the Upper GI tract.
  8. Rectum Biopsy: This test involves removal of a part of the rectum tissue which is then sent to the lab for further testing.

Treatment

Once the diagnostic procedures are complete and the issue with the liver or the digestive tracts are found, the treatment follows accordingly.

For Hepatology, the treatments are as follows:

  1. Infusion treatments: In the case of hepatology related issues, infusion is one of the treatments that can help. It includes blood transfusions, IV medicines, Fluids, etc.
  2. A mild and short term steroid treatment for the case of Wilson’s disease.
  3. If there is a case of Hepatocellular carcinoma, aggressive surgery is one way to treat it, the same goes for cirrhosis.
  4. For the more dire situations, liver transplant is the only treatment left.

 For Gastroenterology, the treatments are as follows:

  1. Bowel management treatment in order to treat the irritable bowel syndrome or the inflamed GI issue.
  2. Celiac treatment involves an adherence to a strict and gluten free diet.
  3. For gastrointestinal motility (gut movement) complications, one of the most well known treatments is the Pyloric Botox injection.
  4. Intestinal transplantation is also a treatment is the issues of the GI tract are at their most desperate and dire.

Clinical Care beyond treatment

Over the course of the treatment and ever before and after it, a clinical care for the children is of an utmost importance. This care is necessary because of the physical and psychological toll it can take on the little ones. The clinical care includes the following:

  1. Proper administration of medicines.
  2. Proper counselling if surgery is taken as a treatment.
  3. Monitoring of the internal body functions to keep the state of organs in check.
  4. Nutritional services to make sure that the child is healthy.
  5. Immunization to prepare the children for their treatment.

With proper knowledge about the issues combined with advanced diagnostics and proper clinical care and treatment, the liver and the GI issues of a child can be dealt with properly.

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