Continuing Education Courses > Pediatric Functional Gastrointestinal Disorders Remote
Experience Level: Intermediate
Contact Hours: 15
This two day, remote course is offered on Zoom and is the next step for therapists those who focus on the pediatric pelvic floor patient population. It is designed to expand your knowledge of development of normal bowel patterns in children, introduce the new Rome IV criteria (Zeevenhoovenet al. 2017), and review the anatomy and physiology of the GI system with emphasis pediatric Functional Gastrointestinal Disorders (FGID).
According to van den Berg et al, up to 30 percent of children suffer from constipation and account for approximately 3% to 5% of all visits to pediatricians. Early intervention can avoid stool-withholding patterns with worsening constipation leading to prolonged bowel issues into adulthood (Chase, Lewina, 2017) with psychosocial consequences.
This course will delve into the most common types of functional constipation and tests and measures used to assess it. Special emphasis on constipation with coexistence of fecal incontinence (Nurko, Scott. 2011) and the psychological effects of these disorders will also be presented.
Additionally, participants who have not yet been trained will learn external and internal anorectal PFM evaluation of the pediatric perineum. Indications for rectal balloon training and determining the appropriate patient will be instructed with lab. Functional defecatory positions for breathing and PFM relaxation, manual therapy techniques of the abdominal wall and viscera will be taught. Video demonstrations of pediatric patients are also presented. Treatment techniques and progressions, including management of supplements and dietary influences will be discussed.
This course is appropriate for physical therapists, occupational therapists, pediatric nurse practitioners and medical doctors.
Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.
This course is available to pelvic health physical therapists interested in expanding their practice as well as pediatric therapists. It requires Pediatric Pelvic Floor Dysfunction and Incontinence live class. Participants should also have a basic knowledge of biofeedback and pelvic floor muscle anatomy.
What to Gather before the meeting:
For the lab please bring TheraBand medium resistance 4-5 feet long and 10 cuff pound weight or equivalent.
Be sure to wear loose fitting pants for external PFM palpation. Jeans and tight fitting yoga pants are not acceptable.
References: Zeevenhooven, J, Koppen I, Benninga, M. The new Rome IV criteria for functional gastrointestinal disorders in infants and toddlers. Pediatric gastroenterology, Hepatology and Nutrition. January 2017.
Nurko S, Scott S. Coexistence of constipation and incontinence of children and adults. Best practice & research Clinical gastroenterology. 2011;25(1):29-41. doi:10.1016/j.bpg.2010.12.002.
van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol 2006; 101:2401.
Loening-Baucke V. Prevalence, symptoms and outcome of constipation in infants and toddlers. J Pediatr 2005; 146:359.
Chase J, Lewina S. childhood incontinence and pelvic floor muscle function; can be learned from adult research? JPUrol (2017) 13, 94-101
Upon completion of this continuing education seminar, participants will be able to:
1. Understand normal digestive anatomy and physiology
2. Understand the function of the PFM as it relates to defecation
3. Understand FGID in children and be able to identify potential medical “red flags” requiring referral to the physician.
4. Review tests and measures for FGID and be able to refer back to a physician if therapy is not appropriate or advised.
5. Understand medications used for bowel dysfunction and titration for long term bowel health
6. Distinguish if a patient is taking too much or too little medication
7. Assess bowel diaries to better determine rationale for treatment and differential assessment of bowel disorder type
8. Provide education for diet/medication/supplement titration
9. Recognize the psychosocial and behavioral component for proper referral and rectal balloon treatment and determine if psychological referral is necessary.
10. Observe use of perianal surface electromyography (sEMG) and identify PFM discoordination in the pediatric patient
11. Understand how to use sEMG biofeedback to increase or decrease pelvic floor muscle activity and if contraindicated
12. Complete an evaluation of a pediatric patient diagnosed with bowel disorders and be able to determine if any medical red flags are present for further work up.
13. Assess and provide exercises and techniques for diastasis recti.
14. Learn techniques to stimulate BM and rectal sensation using rectal balloon training and OTC medications
15. Treatment progressions for children with pediatric bowel disorders using manual therapy and breathing techniques
16. Implement an appropriate plan of care based on a patient’s symptoms and physical examination
Pre- Recordings: Watch Before the Live Component of the CourseReview of Handouts and Support Material (15 min)
Digestive anatomy and physiology (25 min)
Development of the diaphragm with the PFM (5 min)
Nerve and Blood Supply to the GI System (15 min)
The Brain-Gut Axis (10 min)
Normal bowel patterns from infancy through early childhood (20 min)
Functional Gastrointestinal Disorders (FGID) Infants to adolescents; abdominal pain, IBS, vomiting disorders; organic causes of constipation –such as Hirschsprung’s disease, neurologic bowel and imperforate anus (75 min)
8:00 Introduction and Review Pre-Course Learning
Day Two:8:00 Questions
8:30 Pediatric Diagnostic Testing for bowel dysfunction- anorectal manometry, radiographic studies – indications and assessment
10:00 Anorectal exam and rectal balloon training lecture with video and live balloon demonstration. * Please have rectal balloon present to practice
12:00 Case studies, encopresis, constipation, abdominophrenic dyssynergia
2:00 Interactive Case Study
3:00 Summary and Review
We always want to hear from those interested in hosting our courses. We work with healthcare organizations of all types, sizes, and locations. Please, Contact us about Hosting Pediatric Functional Gastrointestinal Disorders Remote or any other course!
Dawn is wonderful. She does great job covering content and educating pelvic floor.
- Karen Wild, MPT - Arnold, MO
Dawn is a brilliant and engaging presenter. Always great explanation and discussion, very educated and honest with advice and information. Great information on treating the whole child, always providing multiple options for differential diagnosis, fy options, etc.
- Megan Rispoli, PT, DPT - Charlotte, NC
Dawn is incredible. Not only brilliant but an impressive speaker & presenter! She shares practical strategies & real life examples of relevant content. One of the best courses you can attend as a pediatric therapist.
- Brianne Kurcsak, MS, OTR/L - Charlotte, NC
Dawn’s knowledge and experience are amazing resources to full form. She was a wealth of information. Loved the case studies & videos to help apply information and see a day in the life of Dawn. Taylor was knowledgeable and very helpful.
- Jennifer L. Hinkle, MSPT, PRPC - Knoxville, TN
Dawn have allowed me to take my 21 years of pediatrics and orthopedics and seamlessly blend it with my pelvic floor practice! Excellent and applications are immediate! I’ll be using these techniques Monday!
- Dawn Chimento, PT - Whitestone, NY
Wonderful and helpful course – thanks so much!
- Megan Miller - Mechanicsburg, PA
Thank you Dawn for teaching us. Thank you for your passion and love for these kiddos. Many blessing to you.
- Marti Waggoner, PT - Olney, IL
Definitely feel like this course is essential to understanding urinary incontinence.
- Allison Heschle, PT, DPT - Brick, NJ
Great course. Dawn so knowledgeable, dynamic and engaging.
- Vicki Lukert, PT, PRPC - Gainesville, FL
I found the course excellent. So beneficial to do after 2 years of treating kinds following doing Dawn’s paeds course.
-Andrea Becker MCSP - South Africa
Dawn – Thank you for a wonderful course! I am both PT and mom of a childhood disorder. I am learning this course. So many new tools and excitement for using them on the kids on my caseload and my own kid at home!
-Megan Wiedenmann, DPT - Andover, KS