Gastrointestinal tract pediatric patients

Pediatric patients are particularly at risk for Al neurotoxicity. The development of the brain occurs in the first year of life. High permeability of the immature blood-brain barrier to Al, the increased uptake of Al via a relatively poorly developed gastrointestinal tract, immature formation and function of the kidneys and high Al to body ratios probably all contribute to the Al toxicity [144, 145, 162-165], Children not on dialysis were intoxicated by Al-containing phosphate binders and developed encephalopathy [78, 162, 164, 166, 167],... 

Variations in absorption of medications from the gastrointestinal tract, intramuscular injection sites, and skin are important in pediatric patients, especially in premature and other newborn infants. 

Susan S. Baker, M.D., Ph.D., is a professor of pediatrics at the State University of New York at Buffalo and codirector of the Digestive Diseases and Nutrition Center at Children s Hospital of Buffalo. Her research interests are in pediatrics, general nutrition, and the barrier function of the gastrointestinal tract. Dr. Baker received her M.D. from Temple University School of Medicine and her Ph.D. from Massachusetts Institute of Technology. She recently completed service as chair of the American Academy of Pediatrics Committee on Nutrition and chair of the American Board of Pediatrics Gastroenterology Sub Board. Presently, Dr. Baker is chair of the North American Society of Pediatric Gastroenterology and Nutrition Patient Care Committee. 

Inflammatory bowel disease (Crohn s disease and ulcerative colitis) occurs among all age groups but has peaks of incidence in the second and fourth decade of life. Currently, corticosteroid therapy is the most effective treatment for moderate to severe cases of IBD. Ocular pathology in the setting of IBD may be related to inflammation of the gastrointestinal tract or secondary to corticosteroid treatment. The two major ocular side effects of systemic corticosteroid therapy are posterior subcapsular cataract (PSC) and raised intraocular pressure (lOP). Recently, we reported that PSC was detected in 12 of 58 (20.7%) corticosteroid-treated pediatric IBD patients and that 21 patients of the same population (36.2%) had raised lOP. Because pediatric IBD patients continue corticosteroid therapy into adulthood, we analyzed the prevalence of PSC and raised lOP in a series of adult IBD patients. 

The radiological approach to the pediatric upper and lower gastrointestinal (Gl) tract varies according to the clinical condition of the child, the patient s age and the differential diagnostic considerations. 

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