MT is 14 year old with chest pain and dry cough as chief complaints. According to MT, she also experiences, regular heartburns, sore-throat and regurgitation of food. According to MT’s mother, she has a strong liking for coffee and tea and often prefers taking coffee or tea with a snack for dinner.
Guided by the findings of the subjective assessment, gastro-esophageal reflux disease (GERD) and gastritis, featured as the most probable conditions leading to these symptoms. However the laboratory and test findings revealed negative for H. pylori, hence excluding the possibility of gastritis. An ambulatory acid probe test for the esophagus was positive for GERD and coupled with the earlier results of the subjective assessment, it was apparent that GERD was the primary diagnosis. According to Lightdale et al. (2013), acid reflux is a classical symptom of GERD and as such, regurgitation was an additional clue to the possibility of GERD.
The management of this patient’s condition included the use of a proton-pump inhibitor (omeprazole) as well as patient education on the management of the condition. Patient education mainly focused on dietary modifications, notably, reducing the intake of triggers such as acidic foods and drinks as well as eating smaller amounts of foods regularly (Lightdale et al., 2013). On the other hand, a patient follow-up plan was developed whereby the patient would attend check-up clinical appointments after every two weeks to monitor progress.
One of the astounding discoveries during this patient assessment as well as management of the condition was that many gastrointestinal disorders present almost similar symptoms and characteristics and in the absence of a comprehensive patient assessment as well as the use of sound clinical judgment, misdiagnosis can occur. Consistent with the classroom studies, it is imperative to exhaustively conduct all the relevant assessment modalities and incorporate critical thinking and judgment when diagnosing pediatric gastrointestinal disorders. By so doing, this can significantly contribute towards making the accurate diagnosis and hence pursue the most appropriate interventions.
References
Lightdale, J. R., Gremse, D. A., Heitlinger, L. A., Cabana, M., Gilger, M. A., Gugig, R., & Hill, I. D. (2013). Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics, 131(5), e1684-e1695.
