Scientific examination of diarrhea in children

What are the examination methods for pediatric diarrhea? Diarrhea in children also has a certain impact on the child's physical health. Many people are also concerned about the examination methods for pediatric diarrhea. The following will introduce the examination methods for pediatric diarrhea. I hope the following introduction can help everyone.

1. Laboratory examination

1. Routine blood tests and biochemical tests can reveal the presence of anemia, leukocytosis, diabetes, and electrolyte and acid-base balance. Examination of fresh stool is the most important step in diagnosing the cause of acute and chronic diarrhea, and can reveal bleeding, pus cells, protozoa, eggs, lipomas, undigested food, etc. Occult blood tests can detect non-obvious bleeding. Stool culture can reveal pathogenic microorganisms. Differentiating between secretory diarrhea and hyperosmotic diarrhea sometimes requires examination of stool electrolytes and osmotic pressure.

2. Small intestinal absorption function test:

(1) Fecal fat determination: The simplest qualitative examination method is to stain a fecal smear with Sudan III and observe fat droplets under a microscope. Fecal fat content above 15% is usually positive.

(2) D-xylose absorption test: A positive result reflects malabsorption caused by jejunal disease or bacterial overgrowth in the small intestine. In diseases with only pancreatic exocrine insufficiency or only involving the ileum, the xylose test is normal.

(3) Vitamin B12 absorption test: When the ileum is dysfunctional or resected too much, the intestinal bacteria are too long, or there is pernicious anemia, the urinary excretion of vitamin B12 is lower than normal.

(4) Pancreatic function test: Abnormal function indicates that small intestinal malabsorption is caused by pancreatic disease.

(5) Breath test:

① 14C-glycine breath test: When the ileum is dysfunctional or too much intestinal bacteria is removed, the 14CO2 exhaled from the lungs and the 14CO2 excreted from the feces will increase significantly.

② Hydrogen breath test: It is valuable in diagnosing lactose or other disaccharide malabsorption, excessive bacterial growth in the small intestine, or rapid small intestinal transit.

(II) Imaging diagnosis

1. X-ray examination: X-ray barium meal, barium enema and abdominal plain film can show gastrointestinal lesions, motor function status, gallstones, pancreatic or lymph node calcification. Selective angiography and CT are particularly valuable for diagnosing digestive system tumors.

2. Endoscopic examination Proctoscopy and sigmoidoscopy and biopsy are easy to operate and have early diagnostic value for cancer in the corresponding intestinal segments. Fiber colonoscopy and biopsy can observe and diagnose lesions in the entire colon and terminal ileum. Enteroscopy is not easy to operate and can observe lesions in the duodenum and proximal jejunum and perform biopsies. ERCP is of great value when bile duct and pancreatic lesions are suspected.

3. Type B ultrasound scanning is a non-invasive and non-radioactive examination method and should be used first.

4. Small intestinal mucosal biopsy For diffuse small intestinal mucosal lesions, such as tropical sprue, celiac disease, Whipple's disease, diffuse small intestinal lymphoma (α heavy chain disease), etc., a small intestinal biopsy tube can be inserted through the mouth to aspirate the small intestinal mucosa for pathological examination to confirm the diagnosis.