Çocuk ve Ergen Hastada Temel Gastrointestinal Yakınmalar ve Endoskopik İşlemler
Özet
Çocuk ve ergen hastada gastrointestinal (GİS) yakınmalar; her yaş grubuna özgü fizyolojik, anatomik ve psikososyal özellikler nedeniyle erişkin gastroenterolojisinden belirgin biçimde ayrışır. Bu popülasyonda en sık karşılaşılan sorunlar; infantlarda gastroözofageal reflü (GER) ve kolik, okul öncesi çocuklarda fonksiyonel kabızlık ve karın ağrısı, okul çağı ile ergenlerde ise fonksiyonel dispepsi, irritabl bağırsak sendromu (İBS), inflamatuvar bağırsak hastalığı (İBH) ve çölyak hastalığıdır. Büyüme ve gelişmenin birincil izlem parametresi olması, ebeveyn ile çocuğun ayrı ayrı iletişim gereksinimi ve endoskopik işlemlerde zorunlu genel anestezi/ derin sedasyon uygulaması pediatrik gastroenterolojinin ayırt edici özellikleridir. Bu bölüm; GER/GÖRH, beyin-bağırsak etkileşimi bozuklukları (DGBI; eski ad: fonksiyonel GİS bozuklukları), kabızlık, çölyak hastalığı, eozinofilik özofajit (EoE), H. pylori, İBH ve pediatrik endoskopik işlemleri ESPGHAN, NASPGHAN, ESGE ve Roma V kılavuzları çerçevesinde ele almaktadır.
Gastrointestinal (GI) complaints in children and adolescents differ substantially from adult gastroenterology owing to the unique physiological, anatomical and psychosocial characteristics of each developmental stage. The most common conditions include gastroesophageal reflux (GER) and colic in infants, functional constipation and abdominal pain in preschool children, and functional dyspepsia, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and coeliac disease in school-age children and adolescents. Monitoring growth as the primary outcome, the need for separate communication with the child and parents, and the requirement for general anaesthesia or deep sedation for endoscopy are hallmarks of paediatric gastroenterology. This chapter addresses GER/GERD, disorders of gut-brain interaction (DGBI; formerly functional GI disorders) (Roma V), constipation, coeliac disease, eosinophilic oesophagitis, H. pylori, IBD and paediatric endoscopy according to ESPGHAN, NASPGHAN, ESGE and Roma V guidelines.
Referanslar
Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric Gast-roesophageal Reflux Clinical Practice Guidelines: Joint Re-commendations of NASPGHAN and ESPGHAN. J Pediatr Gastroenterol Nutr. 2018;66(3):516-554.
Husby S, Koletzko S, Korponay-Szabó I, et al. European So¬ciety Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. J Pediatr Gastroenterol Nutr. 2020;70(1):141-156.
Benninga MA, Nurko S, Faure C, et al. Lower and Biliary Disorders of Gut-Brain Interaction: Child and Adolescent (Roma V). Gastroenterology. 2026;170(6):1367-1385.
Rosen R, Benninga MA, Nurko S, et al. Roma V Pediatric Upper Gastrointestinal Disorders of Gut-Brain Interaction. Gastroenterology. 2026;170(6):1347-1366.
Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and Treatment of Functional Constipation in Infants and Child¬ren: Evidence-Based Recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014;58(2):258- 274.
Dellon ES, Liacouras CA, Molina-Infante J, et al. Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference. Gastro-enterology. 2018;155(4):1022-1033.e10.
Jones NL, Koletzko S, Goodman K, et al. Joint ESPGHAN/ NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017;64(6):991-1003.
Ruemmele FM, Veres G, Kolho KL, et al. Consensus Guide¬lines of ECCO/ESPGHAN on the Medical Management of Pediatric Crohn’s Disease. J Crohns Colitis. 2014;8(10):1179- 1207.
Turner D, Ruemmele FM, Orlanski-Meyer E, et al. Mana¬gement of Paediatric Ulcerative Colitis, Part 1: Ambulatory Care — ECCO/ESPGHAN. J Pediatr Gastroenterol Nutr. 2018;67(2):257-291.
Turner D, Ruemmele FM, Orlanski-Meyer E, et al. Manage¬ment of Paediatric Ulcerative Colitis, Part 2: Acute Severe Colitis — ECCO/ESPGHAN. J Pediatr Gastroenterol Nutr. 2018;67(2):292-310.
Tringali A, Thomson M, Dumonceau JM, et al. Paediatric Gastrointestinal Endoscopy: ESGE and ESPGHAN Guideline. Endoscopy. 2017;49(11):1024-1041.
Drossman DA, Chang L, Chey WD, et al. Disorders of Gut-Brain Interaction and the Roma V Process. Gastroente¬rology. 2026;170(6):1083-1098.
Bontems P, Kalach N, Vanderpas J, et al. Helicobacter pylori infection in children. Helicobacter. 2021;26(Suppl 1):e12844.
Furuta GT, Katzka DA. Eosinophilic Esophagitis. N Engl J Med. 2015;373(17):1640-1648.
Hauer AC, Stern M. Pediatric Celiac Disease. Dtsch Arztebl Int. 2019;116(33-34):553-561.
Kliegman R, St. Geme JW, Blum NJ, et al. Nelson Textbook of Pediatrics. 21st ed. Philadelphia: Elsevier; 2020.
