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Pediatric Functional Gastrointestinal Disorders (FGID): Evaluation and Management – November 2019

November 1, 2019 - November 3, 2019
Registration Information

Course Instructor: Dawn Sandalcidi, PT, RCMT, BCB-PMD

Dawn specializes in pelvic muscle dysfunction (incontinence and pain), orthopedic manual therapy, and TMJ treatment. She is the leading expert in the field of pediatric incontinence in physical therapy. She has trained medical professionals in manual therapy since 1992 both nationally and internationally. Dawn is certified by the Biofeedback Institute of America for pelvic muscle biofeedback treatment.

 

Dawn has actively been treating patients for the past 32 years and owns a private practice in Denver, Colorado, develops educational materials for health care providers through Progressive Therapeutics and provides consulting services through Physical Therapy Specialists. In addition she is an affiliate faculty member at Regis University Department of Physical Therapy in Denver, CO where she teaches pelvic muscle dysfunction/ women’s health physical therapy, as well TMJ.

 

Dawn received her degree in physical therapy in 1982 from SUNY Upstate Medical Center in Syracuse, New York. She participated in extensive international postgraduate studies in manual and manipulative therapy of the spine and extremities in Germany, Switzerland and New Zealand. In 1992, Dawn completed an additional two-year residency to become a certified instructor of the Mariano Rocabado techniques for the spine, pelvis and craniomandibular joints (RCMT). Dawn also received her BCB-PMD Board Certified Biofeedback in Pelvic Muscle Dysfunction.

Please note:

To register for this course, please download the following registration forms in pdf format and email it to info@pelvichealthsolutions.ca or fax it to 888-653-4533

download the PDF
Pediatric Functional Gastrointestinal Disorders – November 2019

Course Description:

This 2.5 day course 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 (Zeevenhooven et 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.

 

Course Objectives:

  1. Understand 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
  5. Understand medications used for bowel dysfunction and titration for long term bowel health
  6. Assess bowel diaries and provide education for diet/medication/supplement titration
  7. Recognize the psychosocial and behavioural component for proper referral and rectal balloon treatment
  8. Observe use of perianal surface electromyography (sEMG) and identify PFM discoordination in the pediatric patient
  9. Understand how to use sEMG biofeedback to increase or decrease pelvic floor muscle activity
  10. Complete an evaluation of a pediatric patient diagnosed with bowel disorders
  11. Assess and provide exercises and techniques for diastasis recti.
  12. Learn techniques to stimulate BM and rectal sensation using rectal balloon training and OTC medications
  13. Treatment progressions for children with pediatric bowel disorders using manual therapy and breathing techniques
  14. Implement an appropriate plan of care based on a patient’s symptoms and physical examination

 

Prerequisites:

Pediatric Incontinence & Pelvic Floor Dysfunction Live Course (level 1) is required. In order to participate in the rectal component of this course, including balloon catheters, you must have completed PHS (or equivalent or be approved) level 1 internal training. If you do not have level 1 internal training, you are welcome to register but will need to sit out internal labs.

Participants should have a basic knowledge of biofeedback and pelvic floor muscle anatomy.

All participants must also complete the required pre-readings/assignments prior to the class.

 

Audience:

This course is open to physiotherapists, naturopathic doctors, physicians, pediatric nurse practitioners and nurses. Content is not intended for use outside the scope of the learner’s license or regulation. This course should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.

 

Hours:

Friday: 1:00pm-5:00pm

Saturday: 8:00am-5:30pm

Sunday: 8:00am – 4:00pm

Registration begins on the first day 15 minutes prior to the start time.

 

Please Note:

This course is both lecture and lab format

 


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

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