Transcripts
DR. TARR:
Can you dim the lights a
little; is that possible?
In this x-ray, which was
actually read by the radiologist as being normal,
there was a moderately increased amount of stool,
this fuzzy collection over here, and it may not
project so well throughout the rest of the room.
And there is also a little bit of stool in the
rectum and not much else.
Now, the radiologist, who did
not have access to the patient's story, read
this as a completely normal x-ray.
However, this is a child who
had Hemolytic Uremic Syndrome and upon keeping
her colon empty with some conservative measures,
her symptoms of abdominal pain considerably
improved.
What I would like to do is take
into consideration the hyperreactivity occurrence
that I just discussed. What looks like only a
moderate amount of stool in one x-ray in one
child could cause symptoms that would not be
present in another.
So what we generally encourage
in a child who has a diffuse abdominal pain,
whether or not they've had E. coli infection, is
to keep the gastrointestinal tract as empty as
possible.
Finally, there are some children
who we do clean out; we don't use enemas, we
use oral agents, and if they still have
symptoms, we would say something
else is causing this child's colon to stretch.
Such possibilities include dietary sugars,
fructose and lactose are the two most common
ones. These disorders are best diagnosed by
breath hydrogen tests and usually at pediatric
institutions.
