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Pediatric Gastroenterology IAP SPECIALTY SERIES ON Pediatric Gastroenterology IAP SPECIALTY SERIES ON Pediatric Gastroenterology SECOND EDITION Founder Editor Dr Nitin K Shah Editors Dr Ashish Bavdekar Dr Malathi Sathiyasekaran DCH DNB MD (Ped) DCH MNAMS DM (Gastro) Consultant Pediatric Gastroenterologist Consultant Pediatric Gastroenterologist Liver and Gastroenterology Unit KKCTH and Apollo Children’s and Department of Pediatrics, KEM Hospital Sundaram Medical Foundation, Chennai Pune, Maharashtra, India Tamil Nadu, India Dr John Matthai Dr SK Yachha DCH MD Fel Ped Gastro (Aus) FIAP MD (Ped) DM (Gastro) Pediatric Gastroenterologist Professor and Head Professor and Head Department of Pediatric Gastroenterology Department of Pediatrics Sanjay Gandhi Postgraduate Institute of PSG Institute of Medical Sciences and Medical Sciences Research, Coimbatore Lucknow, Uttar Pradesh, India Tamil Nadu, 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 ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi • London • Philadelphia • Panama ® Jaypee Brothers Medical Publishers (P) Ltd Headquarters Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj New Delhi 110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 Email: [email protected] Overseas Offices J.P. Medical Ltd Jaypee-Highlights Medical Publishers Inc. 83 Victoria Street, London City of Knowledge, Bld. 237, Clayton SW1H 0HW (UK) Panama City, Panama Phone: +44-2031708910 Phone: + 507-301-0496 Fax: +02-03-0086180 Fax: + 507-301-0499 Email: [email protected] Email: [email protected] Jaypee Brothers Medical Publishers Ltd Jaypee Brothers Medical Publishers (P) Ltd The Bourse 17/1-B Babar Road, Block-B, Shaymali 111 South Independence Mall East Mohammadpur, Dhaka-1207 Suite 835, Philadelphia, PA 19106, USA Bangladesh Phone: + 267-519-9789 Mobile: +08801912003485 Email: [email protected] Email: [email protected] Jaypee Brothers Medical Publishers (P) Ltd Shorakhute, Kathmandu Nepal Phone: +00977-9841528578 Email: [email protected] Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2013, Jaypee Brothers Medical Publishers All rights reserved. No part of this book may be reproduced in any form or by any means without the prior permis- sion of the publisher. Inquiries for bulk sales may be solicited at: [email protected] This book has been published in good faith that the contents provided by the contributors contained herein are origi- nal, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the contributors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the contributors. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device. Pediatric Gastroenterology First Edition: 2008 Second Edition: 2013 ISBN: 978-93-5090-369-8 Printed at Contributors A Riyaz MD DCH DNB DM (Gastro) BR Thapa MD Pediatric Gastroenterologist Professor and Head Professor and Head of Pediatrics Division of Pediatric Gastroenterology Govt Medical College Hepatology and Nutrition Calicut, Kerala, Karnataka, India Postgraduate Institute of Medical Education and Research Akshay Kapoor Chandigarh, India Attending Consultant Division of Pediatric Gastroenterology and John Matthai DCH MD Fel Ped Gastro (Aus) FIAP Hepatology Pediatric Gastroenterologist Apollo Centre for Advanced Pediatrics Professor and Head Indraprastha Apollo Hospitals, New Delhi, India Department of Pediatrics PSG Institute of Medical Sciences and Anshu Srivastava MD (Ped) DM (Gastro) Research Associate Professor Peelamedu, Coimbatore Department of Pediatric Gastroenterology Tamil Nadu, India Sanjay Gandhi Postgraduate Institute of Medical Sciences Malathi Sathiyasekaran Lucknow, Uttar Pradesh, India MD (Ped) DCH MNAMS DM (Gastro) Consultant Pediatric Gastroenterologist Anupam Sibal Group Medical Director KKCTH, Apollo Children’s and Apollo Hospitals Group Sundaram Medical Foundation, Chennai Senior Consultant, Pediatric Gastroenterology Tamil Nadu, India Hepatology and Nutrition Apollo Centre for Advanced Pediatrics Narendra Kumar Arora MD MNAMS FIAP Indraprastha Apollo Hospitals, New Delhi, India Executive Director INCLEN Trust international Ashish Bavdekar DCH DNB F 1/5, 2nd Floor Consultant Pediatric Gastroenterologist Okhla Phase 1 Liver and Gastroenterology Unit New Delhi, India Department of Pediatrics KEM Hospital, Pune, Maharashtra, India Neelam Mohan Director Bhaskar Raju MD DCH MNAMS (Ped) DM (Gastro) Department of Pediatric Gastroenterology Pediatrician and Pediatric Gastroenterologist Hepatology and Liver Transplantation Dr Mehta Children’s Hospital Medanta 2. McNichol’s Road, Chetpet The Medicity Hospital, Sector–38 Chennai, Tamil Nadu, India Gurgaon (Haryana), India Pediatric Gastroenterology Nitya Wadhwa Saravanapandian MD Centre for Diarrheal Disease and Nutrition Assistant Professor Research Department of Pediatrics Department of Pediatrics PSG Institute of Medical Sciences and Research All India Institute of Medical Sciences Peelamedu, Coimbatore, Tamil Nadu, India New Delhi, India Sheila Bhave MD MRCP (UK) Pankaj Vohra Associate Professor in Pediatrics and MBBS MD Diplomate Am Bd (Ped Gastro) Consultant in Pediatric Research Senior Consultant, Pediatric Gastroenterology KEM Hospital Hepatology and Nutrition Pune, Maharashtra, India Max Healthcare and Holy Family Hospital New Delhi, India Shinjini Bhatnagar Centre for Diarrheal Disease and Nutrition Research Prashant Mathur MBBS DCH DNB PhD MNAMS Department of Pediatrics Scientist ‘D’ All India Institute of Medical Sciences Division of Noncommunicable Diseases New Delhi, India Indian Council of Medical Research Ansari Nagar, New Delhi, India Smita Malhotra Fellow, Division of Pediatric Gastroenterology S Srinivas and Hepatology DCH DNB PDCC (PedGastro) Fellowship (AUS) Apollo Centre for Advanced Pediatrics Consultant Pediatric Gastroenterologist Indraprastha Apollo Hospitals, New Delhi, India Department of Pediatric Gastroenterology Kanchi Kamakoti Child Trust Hospital So Shivbalan MD (Ped) DNB MNAMS Nungambakkam, Chennai, Tamil Nadu, India Consultant Pediatrician Sundaram Medical Foundation Sarah Paul DCH MD (Ped) Dr Rangarajan Memorial Hospital Professor Chennai, Tamil Nadu, India Department of Pediatrics PSG Institute of Medical Subash Gupta Sciences and Research Senior Consultant Liver Transplant Surgery Peelamedu, Coimbatore, Tamil Nadu, India Centre for liver Disease and Transplantation Indraprastha Apollo Hospitals, New Delhi, India Sarath Gopalan Senior Consultant in Pediatric SK Yachha MD DM Gastroenterology Professor and Head Hepatology and Clinical Nutrition Department of Pediatric Gastroenterology Pushpawati Singhania Institute for Liver Sanjay Gandhi Postgraduate Institute of Renal and Digestive Diseases Medical Sciences New Delhi, India Lucknow, Uttar Pradesh, India vi Contributors Sutapa Ganguly VS Sankaranarayanan Professor and Head HOD and Senior Consultant Department of Pediatrics Department of Pediatric Malda Medical College and Hospital Gastroenterology Malda, West Bengal, India Kanchi Kamakoti Child Trust Hospital Numgambakkam, Chennai Ujjal Poddar MD DNB DM Tamil Nadu, India Additional Professor Department of Pediatric Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow Uttar Pradesh, India vii Foreword 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
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