ABSTRACT
Nocturnal enuresis (NE) is increasingly seen as part of a heterogeneous phenomenon that at times will include daytime lower urinary tract symptoms such as urgency, frequency and wetting - with reduced bladder storage, usually due to an overactive bladder. In turn, these may be associated with constipation and/or faecal soiling. This paper discusses these considerations in the management of NE.
Subject(s)
Constipation/complications , Nocturnal Enuresis , Urinary Bladder, Overactive/complications , Urinary Tract Infections/complications , Child , Cholinergic Antagonists , Humans , Nocturnal Enuresis/epidemiology , Nocturnal Enuresis/etiology , Nocturnal Enuresis/physiopathology , Nocturnal Enuresis/therapy , Polyuria/complications , Polyuria/etiology , Prevalence , Sleep Arousal Disorders/complications , Sleep Arousal Disorders/etiologyABSTRACT
AIM: This article describes the association of severe iron-deficiency anaemia with Helicobacter pylori gastritis. RESULTS: We report three children who had symptomatic iron-deficiency anaemia with no obvious clinical cause and refractory to iron replacement therapy. All three underwent a diagnostic endoscopy and were found to have H. pylori gastritis. Histopathology confirmed inflammatory changes consisting of dense bands of clusters of plasma cells within the lamina propria and two of the three adolescents were noted to have numerous H. pylori in gastric crypts and glands. Two of the three cases had a urease positive test. Iron deficiency was successfully corrected following antibiotic eradication of H. pylori infection. CONCLUSIONS: This case series highlights the importance of considering H. pylori infection as a cause of refractory iron-deficiency anaemia in adolescents, even in the absence of gastrointestinal symptoms.
Subject(s)
Anemia, Iron-Deficiency/microbiology , Helicobacter Infections/complications , Helicobacter pylori , Severity of Illness Index , Adolescent , Anemia, Iron-Deficiency/physiopathology , Child , Endoscopy , Female , Helicobacter Infections/diagnosis , Helicobacter Infections/physiopathology , Humans , MaleABSTRACT
Engaging children in a clinical setting is kind to the child and their family, and is a useful clinical tool. Each of us will have our own way of getting through a child's fears and defences. Tomfoolery, distraction and imaginary play can lead to a rewarding clinical interaction.