Peds GI Clinic Clerkship Ready: Pediatrics

In Pediatric Gastroenterology (or GI) clinic, you will see patients with a host of gastrointestinal, pancreatic, liver, and nutrition issues. This episode will discuss specific questions that you will want to cover in your history and the elements of a complete GI exam - which is a lot more than just an abdominal exam!
Peds GI clinic covers a host of gastrointestinal, pancreatic, liver and nutrition issues
-3yr fellowship after peds residency 
Before Clinic 

Review what types of patients you will be seeing. It may be a mix of lots of issues, or just a liver transplant clinic. This will tell you what type of prep you should do (conditions to read up on, medications to review, etc) before the day of clinic.
On the day of clinic, review expectations with the attending, fellow or resident physician. Do they want you to see patient independently and write notes, just shadow or somewhere inbetween. Review what questions they always want asked, what exams you should do alone vs with your whole team. Setting expectations before you start will set you up for success! 
Questions: Pain, the PQRST mnemonic is helpful to better understand the pain

Provoked the pain
Quality of the pain
Radiating
Severity 

Specific questions to ask in Peds GI: 

Does pain wakes the patient at night? 
how much school or other activities the Patient has missed because of symptoms? 
Does defecation or passage of gas alleviates pain? 
Any specific dietary changes already tried?

Poop! understand the:

Quality of the stool
Size and caliber of the bowel movement (Use Bristol stool scale)

GERD vs EoE  
A complete GI exam– a lot more than the abdomen!