NursingCase studyPediatric primary care

Pediatric GI case studies: vomiting, reflux, encopresis

Select one of three pediatric gastrointestinal cases — acute vomiting and diarrhoea, chronic sore throat with regurgitation, or stool soiling on a background of constipation — and post a differential diagnosis, the most likely diagnosis and its unique characteristics, a treatment plan with dosages, and family education strategies.

Aug 14, 2026

Editorial process

Last reviewed · August 14, 2026

Written by

Aaron Bishop

MA, Education

assignment interpretation and research-methods coaching across disciplines

Reviewed by

Dr. Nathan Cole

PhD, Rhetoric & Composition

Argumentation and thesis development

On this page

Interpret the task
Assignment instructions
Deliverables
Proposed outline
Research plan
Reference shortlist
Final review

What each case is really presenting

The three cases sit at different points on the acute-to-chronic axis and each one hides its diagnosis behind a symptom that sounds like something else. Jordan is four, has vomited five times and passed one large watery stool, and has not vomited for five hours; the useful work is the dehydration assessment, because three hours since a small dark-yellow void in a quiet, tired child is a mild to moderate deficit, and that estimate is what decides oral rehydration against intravenous fluids. Victoria complains of a chronic sore throat and a bad taste, which sounds like a pharyngeal problem until you notice the burping, the regurgitation and a fluid intake made almost entirely of coffee, tea and carbonated drinks — extra-oesophageal reflux with a normal growth trajectory and negative chest and abdominal examinations. Trish's soiling reads as behavioural and is not: palpable stool in the descending colon and a loaded rectal vault make it overflow incontinence around a faecal impaction.

Because the diagnoses are relatively clear, the marks concentrate in the plan and the education, and both must be specific. Dosages have to be weight-based and complete — for Jordan, oral rehydration solution at a stated millilitres per kilogram over a stated number of hours with a replacement volume for ongoing losses, not simply the words encourage fluids. Trish needs disimpaction before maintenance, and stating that order is the single thing that separates a correct plan from an ineffective one, since starting maintenance polyethylene glycol on an impacted child produces more soiling and a family who conclude the treatment failed. Victoria's plan is mostly non-pharmacologic and the education is the intervention. In every case name what the family should expect, how long it takes, who to contact between visits, and the specific findings that should bring the child back the same day rather than at the next scheduled appointment.

Likely learning objectives

Inferred from the brief — check these against your own rubric.

01
Estimate dehydration severity from history and examination in a young child.
02
Recognise extra-oesophageal presentations of gastro-oesophageal reflux.
03
Distinguish overflow incontinence from behavioural soiling using examination findings.
04
Write weight-based paediatric management with dose, route and duration.
05
Design family education that sets expectations and gives return precautions.

Assignment instructionsQuoted verbatim

Read the full question

Review every instruction before using the planning guidance that follows.

Week 9 To prepare for Differential Diagnosis for Gastrointestinal Disorders: Review “Gastrointestinal Disorders” of the Burns et al. text. Review and select one of the three provided case studies. Analyze the patient information. Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments. Consider strategies for educating patients and families on the treatment and management of the gastrointestinal disorder By Day 3 Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the gastrointestinal disorder. Differential Diagnosis for Gastrointestinal Disorders. Case Study 1 Jordan is a 4-year-old with a 1-day history of vomiting and diarrhea. His mother reports he awoke this morning vomiting and his vomitus contained last night’s dinner. He vomited three more times this morning but has not vomited in 5 hours. Approximately one hour ago, he had a large diarrhea stool that did not contain blood or mucus. He has had small sips of sports drinks since this morning. His last urination occurred 3 hours ago and the volume was small and the color dark yellow. Physical examination reveals a quiet and tired child with normal exam except for increased bowel sounds, but no abdominal distension, pain with palpation, or masses. Case Study 2 Victoria is a 15-year-old who complains of chronic sore throat and bad taste in her mouth. Her height and weight are appropriate for age and she remains on the same growth trajectory since infancy. Abdominal examination and chest examination are negative. History reveals frequent burping and occasional feelings of regurgitating food. Diet history reveals she eats a balanced diet, but her primary sources of fluids are coffee, tea, and carbonated drinks. Differential Diagnosis for Gastrointestinal Disorders. Case Study 3 Trish is a 7-year-old who presents with abdominal pain. Further questioning reveals frequent stool soiling and a history of chronic constipation since infancy. The child does not remember when her last bowel movement was, but her mother reports that she had an ”accident” at a family gathering last night where she defecated in her underwear prior to reaching the bathroom. Physical examination is benign except for the presence of palpable stool in the descending colon and an enlarged rectal vault with hard stool.

Turn the brief into deliverables

01
The case study selected.
02
A differential diagnosis with reasoning from the case findings.
03
The most likely diagnosis and why.
04
The unique characteristics of that disorder.
05
A treatment and management plan including appropriate dosages.
06
Strategies for educating the patient and family.

Differential, diagnosis, dosed plan, family education

Case selected and its key findings

Name the case and extract the findings the diagnosis will rest on.

Differential diagnosis

Give three or four candidates with support and opposition from the case.

Most likely diagnosis

Declare it and explain what makes it identifiable here.

Unique characteristics of the disorder

Set out what separates it from its nearest neighbour.

Treatment and management with dosages

Give the sequence of management with weight-based doses and durations.

Educating the patient and family

Set expectations, give a timeline and name return precautions.

Guideline sources for the three presentations

Recommended databases

StatPearls via NCBI Bookshelf
NASPGHAN clinical guidelines
Burns et al., Pediatric Primary Care
PubMed
A paediatric dosing reference

Search sequence

1.
Find a validated clinical dehydration scale and note what each score implies for management.
2.
Confirm oral rehydration volumes in mL/kg and the replacement rule for ongoing losses.
3.
Read the guideline sequence for functional constipation: disimpaction, then maintenance.
4.
Check the evidence for acid suppression in paediatric reflux before recommending it.
5.
Note the return precautions each guideline gives to families.

Reference shortlist

These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.

Nothing here is cleared for citation until you have read it.

01
Pediatric Dehydration
StatPearls, NCBI Bookshelf · 2023
Severity assessment and oral rehydration volumes for case one.
02
Gastroesophageal Reflux Disease (GERD)
StatPearls, NCBI Bookshelf · 2023
Extra-oesophageal presentations and lifestyle management for case two.
03
Pediatric Functional Constipation
StatPearls, NCBI Bookshelf · 2023
The disimpaction-then-maintenance sequence that case three turns on.
04
Encopresis
StatPearls, NCBI Bookshelf · 2023
Separates overflow incontinence from behavioural soiling, and frames the family education.

Review before submission

Common mistakes

Skipping the dehydration estimate and going straight to a fluid order.
Reading Victoria's sore throat as pharyngitis and never examining the diet history.
Treating Trish's soiling as behavioural despite the palpable stool.
Prescribing maintenance laxative without disimpaction first.
Writing encourage fluids or increase fibre where a dose and a duration were required.
Ending with generic advice instead of expectations and return precautions.

Submission checklist

The chosen case is named at the start.
Each differential is argued from findings in the case.
The primary diagnosis is justified by its distinguishing feature.
Every treatment carries a weight-based dose, route and duration.
Non-pharmacologic management appears alongside any medication.
Family education includes what to expect and when to return.

Use this guide to plan and review your own work. Follow your institution's rules and read our academic-integrity policy.