IAP Specialty Series on Pediatric Gastroenterology Ashish Bavdekar, John Matthai, Malathi Sathiyasekaran, SK Yachha
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1IAP SPECIALTY SERIES ON: Pediatric Gastroenterology
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3IAP SPECIALTY SERIES ON: Pediatric Gastroenterology
SECOND EDITION
Founder Editor Dr Nitin K Shah Editors Dr Ashish Bavdekar DCH DNB Consultant Pediatric Gastroenterologist Liver and Gastroenterology Unit Department of Pediatrics, KEM Hospital Pune, Maharashtra, India Dr Malathi Sathiyasekaran MD (Ped) DCH MNAMS DM (Gastro) Consultant Pediatric Gastroenterologist KKCTH and Apollo Children's and Sundaram Medical Foundation, Chennai Tamil Nadu, India Dr John Matthai DCH MD Fel Ped Gastro (Aus) FIAP Pediatric Gastroenterologist Professor and Head Department of Pediatrics PSG Institute of Medical Sciences and Research, Coimbatore Tamil Nadu, India Dr SK Yachha MD (Ped) DM (Gastro) Professor and Head Department of Pediatric Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow, Uttar Pradesh, India Co-ordinating Editor Dr Sailesh Gupta Honorary Secretary General Indian Academy of Pediatrics Kailash Darshan, Kennedy Bridge Mumbai, Maharashtra, India Foreword Dr CP Bansal IAP President 2013 Dr Rohit Agrawal IAP President 2012 IAP National Publication House, Gwalior
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Pediatric Gastroenterology
First Edition: 2008
Second Edition: 2013
9789350903698
Printed at
5Contributors
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9Foreword
Dear Reader,
The book that you hold is the fulfliment of the dreams of the doyens of Indian Academy of Pediatrics. For many years, the need for good Indian books in every specialty of Pediatrics was felt. Indian Academy of Pediatrics has no dearth of great teachers and writers in the various subspecialties to author these books. Their dedicated and diligent labor has created the beautiful and eminently readable book that you hold. An Indian book by Indian authors will appropriately suit the needs of the readers in India and in countries with similar geographical and sociocultural milieus. While the first editions of the IAP subspecialty series were published in 2006, we proudly present to you a second, completely revised and updated edition.
The IAP specialty series books serve the purpose of providing evidence based, authentic and uniform information to IAP members, other Pediatricians, and students of Pediatrics in the country. Guidelines and established protocols on disease management will be very helpful for pediatricians in their everyday practice.
Creating a book is like the birth of a baby. Right from conception to delivery, there is a long and complex process. It is very labor intensive, time consuming work that involves considerable financial expense too. To streamline the entire process from writing to editing to publishing to distribution and sales of books, it was envisioned to have an additional wing of IAP, and which is established as "IAP National Publication House" at Gwalior.
Knowledge has no limits and seekers of knowledge can access the subject from anywhere in the world. We understand that books published by IAP NPH will be read and referred not only in India but in many parts of the world. Objective of IAP NPH therefore is to provide standardised content and world class quality. With this objective, printed books are to be made available throughout the globe and distribution will also be done through online editions. Publishing 7 books at a time is a mammoth task and for this we collaborated with second largest medical publisher in the world, i.e. Jaypee Brothers Medical Publishers (P) Ltd., New Delhi.
What you are reading, the world is also reading. Our writers are getting worldwide exposure and readers are getting world class books at reasonable cost.
It needs to be mentioned here that all authors and editors have dedicated the royalty from sale of books to IAP and have thereby done a selfless service for our mother organization. By buying this book you are also contributing to IAP in a significant manner.
Finally, we express our pride and happiness in being associated with this project and in reaching this valuable book to you. We wish you a happy and contented reading.
Dr CP Bansal
IAP President 2013
Dr Rohit Agrawal
IAP President 201210
11Message
Dear Colleague,
It gives me great pleasure to present this IAP Specialty Series book on Pediatric Gastroenterology.
Need to have IAP books in pediatric specialties was always felt by many. While we have many such specialty books written by individuals, we do not have these books under the fold of IAP. We can standardize the format, contents, style and size by having these books under the banner of IAP. Looking at the need of having IAP Specialty Books and availability of experts within IAP to do this job, we had targeted to publish books on major pediatric specialties under IAP Specialty Series.
IAP published four books under IAP Specialty Series, i.e. Pediatric Infectious Diseases, Rational Antimicrobials Practice in Pediatrics, Pediatric HIV and Pediatric Hematology and Oncology last year. These books were highly appreciated by one and all and this has encouraged us to bring out four more books under the IAP Specialty Series this year, i.e. Pediatric Cardiology, Pediatric Intensive Care, Rational Antimicrobial Practice in Pediatrics and Pediatric Endocrinology besides this book of course!
I am thankful to Editors Dr Ashish Bavdekar, Dr John Matthai, Dr Malathi Sathiyasekaran and Dr SK Yachha for their wonderful and painstaking work. I am thankful to the experts who have contributed articles in this book and the IAP office bearers 2006 and 2007 for helping us with concept and editorial work of the entire IAP Specialty Series. I am sure you will find this book useful and informative and hope that this book become a desk companion for all the practicing pediatricians and postgraduates in pediatrics.
Yours Sincerely
Nitin K Shah
Founder Editor, IAP Specialty Series12
13Preface to Second Edition
Dear Readers
Pediatric Gastroenterology in India has made giant strides in the last few decades. We have moved from Malnutrition, ICC and ORS to Obesity, metabolic liver diseases and liver transplantation. From a handful of trained personnel in few tertiary centers, we now have qualified specialists in almost all regions of India. Advanced laboratory support now enables diagnosis of uncommon GI and liver diseases. The professional competence and technological capabilities available in India in our field are far ahead of any other developing country, and even comparable to the west.
It is time this expertise translates into better medical care of all children in our country. Sharing of knowledge with practicing pediatricians and students is the only way this can be achieved. This book is a small step in that direction. This is the second edition of the book and almost all chapters have been revised and three new chapters have been included. A number of experts have graciously contributed to this book and we express our gratitude to them.
We thank the Indian Academy of Pediatrics and the publishers for supporting this academic initiative. Suggestions from readers to improve the book are welcome.
Ashish Bavdekar
John Matthai
Malathi Sathiyasekaran
SK Yachha14
15Preface to First Edition
In the last two decades, pediatric gastroenterology has come of age as a subspeciality in India. Newer methods of diagnosis and increasing number of pharmaceutical agents have given us more and more alternatives in evaluating and treating children with gastrointestinal disease. We are now able to identify and successfully manage many children with GI problems. On the research side, many important scientific contributions have come from various pediatric gastroenterology and liver units around the country.
This book attempts to cover most of the important problems of GI tract, liver, pancreas and nutrition in children and we hope that it can bridge the gap between general discussions of gastrointestinal problems in standard pediatric textbooks and the otherwise large encyclopedic volumes available to the pediatric gastroenterologist.
A number of experts in pediatric gastroenterology have contributed to this book and we would like to thank all of them for their valuable time and effort in preparing these manuscripts. It is our hope that this book will benefit the practicing pediatrician as well as the young postgraduate who wishes to make his career in pediatric gastroenterology.
We thank the Indian Academy of Pediatrics for the opportunity to edit this important book. We welcome feedback from our readers to help us improve the quality of the subsequent editions.
Ashish Bavdekar
John Matthai
Malathi Sathiyasekaran
Surender Kumar Yachha