Seemed so practical, have included algorithm
Clin Pediatr (Phila). 2019 Jan;58(1):79-87. doi: 10.1177/0009922818806317
Algorithm to Predict Which Children With Chronic Abdominal Pain Are Low Suspicion
for Significant Endoscopic Findings.
Mark JA et al
https://www.ncbi.nlm.nih.gov/pubmed/30306797
- Fecal calprotectin indirectly measure pus or neurophils in stools and indicates inflammatory bowel disease: Must be the upgraded stool leukocyte test…
Clinics (Sao Paulo). 2009 May;64(5):421-5.
The role of fecal calprotectin in investigating inflammatory bowel diseases.
Erbayrak M. et al
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2694246/pdf/cln64_5p421.pdf
Saskatchewan provincial lab instruction here:
patient collection instructions for fecal calprotectin
- transglutamine immunoglobulin A (TTG) is part of the celiac screen used by provincial health. It is only maybe 50% sensitive as there are frequent cases of non-celiac gluten sensitivity around though I’m not sure how prevalent in children.
- significant diarrhea would be 3 or more loose stools/day and/or nocturnal stooling waking from sleep
-
linear growth failure = decrease in 2 or more major height percentiles
-
significant weight loss = decrease in 2 or more major percentiles AND body mass index <25th percentile
-
extraintestinal symptoms of IBD include recurrent oral/anal ulcers, uveitis, arthritis, pyoderma gangrenosum, unexplained fevers
- Helicobacter pylori is thought not important unless actual peptic ulcers (gastritis a non-entity)
- Eosinophilic esophagitis requires > 15 eosinophils/high-powered field on esophageal biopsy after >6 weeks on daily or twice daily proton pump inhibitor.
Comment – there is not only knwledge here, but wisdom as well and I hope it helps some cases
newpainmuse 