Gastrointestinal disorders can affect a child’s growth, mental development and overall immunity and that’s because 70 per cent of the body’s immune system lies in Gastrointestinal (GI) system, shares Dr Priyanka Udawat, Pediatric Gastroenterologist & Hepatologist, IDL Care, SL Raheja Hospital, Mahim – A Fortis Associate
Digestive disorders are placing a growing burden among children in India, leading to increased patterns of clinic visits and hospitalisations. Gastrointestinal disorders can affect a child’s growth, mental development and overall immunity and that’s because 70 per cent of the body’s immune system lies in Gastrointestinal (GI) system.
Here’s a rundown of the most common gastrointestinal problems in children, its causes and common trigger:
Abdominal pain affects four per cent to 10 per cent children and leads to substantial increase in absenteeism from school. It can be functional, or a sign of many GI diseases like constipation, food poisoning, gastroenteritis (stomach flu), worms, acidity and ulcers in stomach. It may also indicate serious problems like appendicitis, liver infection, gall stones, pancreatic inflammation and gluten sensitivity. Increased and regular intake of oily or deep fried, spicy, processed, canned and junk food, can cause abdominal pain amongst children.
According a World Health Organization (WHO) report, more than one to 10 child deaths i.e. about 800,000 deaths each year, are due to diarrohea. Acute diarroheas are mostly due to food or water-borne infections. If it persists for over two weeks, it can cause malnutrition and immensely impact overall growth. Lactose intolerance, food allergies, celiac disease and inflammatory bowel disease are common causes of chronic diarrohea. High intake of carbonated drinks, contaminated or unfiltered water and consumption of stale food can cause diarrohea.
Vomitting in children can be a serious symptom as it could indicate different conditions — overeating, food poisoning, viral infections and at times can lead to Gastroesophageal Reflux Disease (GERD). In certain instances, it can be a cause for serious diseases such as meningitis (infection in the brain), appendicitis, hepatitis and intestinal blockages. Apart from it, consumption of tea, coffee, tangy and fried food can also cause vomitting due to gastritis.
Now-a-days, constipation affects four per cent to 36 per cent of children across the country. Generally, gastiritis first appears between the ages of two to four years. Up to one-third of children aged six to 12yrs are reported to have constipation. If a baby less than six months old is suffering from constipation, structural anomalies of anus or Hirschprung Disease (tight anal muscles) should be ruled out, to chalk out medical or surgical treatment options. This mostly occurs due to potty training stress, a low-fiber diet or diseases like hypothyroid, wheat allergy (Gluten Intolerance) and defects of the spinal cord. Foods which are low in fiber like breads, biscuits, pasta, Nnoodles, etc can cause constipation. Children who avoid eating vegetables, salads and pulses, or drink less fluids, could also suffer from constipation.
Never ignore a child who is refusing to eat food, who is not growing well in weight ad height, and is having yellow eyes, coupled with lethargy and poor concentration in school. Such children may be suffering from anaemia (low haemoglobin), celiac disease and chronic liver disease. Consulting a doctor must be a priority.
Childhood obesity is also a rising concern in India. The modern lifestyle is sedentary, it comprises lot of junk food, lack of outdoor games, increasing screen time (TV, mobile or video games), that facilitate weight gain. Non-alcoholic Fatty Liver Disease (NAFLD) is common amongst obese children and presents with fatty liver and abnormalities in the liver function test. This may progress into fibrosis, cirrhosis and even liver cancers in later life. Oily and fried food, chocolates, ice creams, high-sugary drinks, potatoes and junk food having high calories, must be avoided by obese children.
Increasing use of colouring agents, preservatives, artificial flavours, pesticides and/or trans fats in fast food affects trillions of healthy gut bacteria (gut flora), which are responsible for healthy digestion and immunity.
Celiac disease is a life-long condition involving bouts of severe gastrointestinal distress and other symptoms, triggered by ingestion of gluten proteins that are found in wheat. Rapid increase in the global incidences of celiac disease is alarming! In wheat-eating areas of northern India, one out of every 100 children is affected with this disease. The rising incidence could be due to use of pesticides, adoption of westernised diets, frequent use and abuse of antibiotics, inadequate breastfeeding and disturbed gut flora. If strict life-long gluten restriction is not followed, then the patient may suffer from infertility, short height, low IQ, intestinal cancers and liver disease in future. Food items made from wheat, barley and rye like wheat roti, biscuits, noodles, pasta, burgers, etc. should be strictly avoided because all these items contain gluten. There are many hidden sources of gluten like chocolates, ice creams, sweets etc. So, a detailed diet counselling by an expert is must, so as to prevent complications of this disease.
Inflammatory Bowel Disease (IBD) was more common in developed countries. We now see rising incidences in developing countries as well, which is worrisome. This presents with bloody diarrhoea, anemia and growth retardation. Caffeine, artificial sweeteners, fatty meals, dairy products, fried junk food, non-veg items like red meat, etc., can trigger IBD in young patients.
There are various tests to detect GI diseases in children, including ultrasound of abdomen, blood tests, CT scan of abdomen, etc. Diseases like IBD, celiac disease, food allergies, bleeding in intestines, etc, needs advanced tests like Gastrointestinal Endoscopy (seeing intestines from inside with the help of an endoscope). Manometric procedures can detect motility problems in children who have feeding difficulties or suffer from chronic constipation. Fibro scan of the liver can help detect fatty liver and fibrosis.
Treatment options include medications, nutritional and disease-specific diet counselling, endoscopic therapies, surgery and lifestyle modifications. Early and accurate diagnosis, with advanced investigations followed by holistic approach towards treatment, is needed to prevent long-term health consequences and to improve the child’s overall quality of life.