When your child has tummy troubles


Causes of abdominal pain in children can range from constipation and food poisoning to UTIs and appendicitis. — Positive Parenting

Gastroinstestinal (GI) symptoms, such as abdominal pain, diarrhoea, constipation and vomiting, are common reasons for parents to seek medical consultation for their children.

The GI tract extends from the mouth to the anus, and includes the pharynx (throat), oesophagus, stomach, small intestine and large intestine, as well as organs such as the liver and pancreas, which secrete enzymes and other important substances into the GI tract to facilitate digestion.

The normal functioning of the GI system can be affected by various factors, such as infections, gastroesophageal reflux, food allergies, inflammation and other digestive disorders.

Here are some common GI symptoms that can present in babies and children:

> Abdominal pain

Children can experience abdominal pain ranging in intensity from mild and transient to severe and chronic.

The pain can be generalised or localised to a specific area of the abdomen, often causing considerable discomfort to the child.

Most of the causes are not serious, but it is important to consult your doctor to ensure that serious problems are not missed.

Possible causes: Common causes are constipation, gastroenteritis (e.g. rotavirus, typhoid infection), food poisoning, food allergy and psychosocial stress.

Other causes include appendicitis, inflammatory bowel disease (IBD), urinary tract infection (UTI), gallstones, bowel obstruction, peptic ulcers and many others.

Beware: Seek immediate medical attention if the abdominal pain is very severe and unbearable, or if it keeps coming back for a prolonged period.

Be alert for other significant features such as weight loss, high fever, blood in the stools or severe vomiting.

If there is any doubt at all, seek medical advice as many different conditions can present with abdominal pain.

> Diarrhoea

This refers to frequent, loose and watery stools.

Diarrhoea is a common problem that may last one or two days and typically subsides on its own, but it can also go on for one to two weeks.

It could be a sign of a more serious problem if it persists for longer.

Possible causes: Short-term diarrhoea is usually caused by food poisoning, gastroenteritis (e.g. rotavirus infection), food intolerance, reaction to medicines and other causes.

Long-term or chronic diarrhoea may be due to irritable bowel syndrome (IBS), chronic gastrointestinal infections, ulcerative colitis, Crohn’s disease, endocrine disorders and other conditions.

Beware: Dehydration is one of the major concerns when a child has diarrhoea.

Watch out for signs of dehydration, e.g. decreased frequency of urination, lack of tears when crying, and extreme thirst.

Other serious features include decreased alertness, inability to tolerate oral fluids, frequent vomiting and high fever.

Assessment by a doctor is necessary to ensure that dehydration is detected and treated early.

> Constipation

Constipation refers to the infrequent and difficult passage of small amounts of hard, dry stools.

Bowel movements may be associated with pain in the anus and blood in the stools.

It can happen to children of all ages, but is particularly common among potty-training toddlers and younger schoolchildren.

Most cases can be alleviated if addressed early and appropriately.

Possible causes: Potty training stress, lack of fibre or liquid in the diet, IBS, withholding of stools, change in routine or medications can all cause constipation.

Beware: Consult a doctor if the problem continues or if there are other significant features such as weight loss or vomiting.

Encopresis (involuntary passing of motion) is a possible complication of chronic constipation with stool retention that may require medical consultation.

> Vomiting

This occurs when the contents of the stomach are forced out of the mouth.

It is not simply regurgitating.

Common causes of vomiting include gastroenteritis due to viral or bacterial infection.

Possible causes: There are many other diverse causes of vomiting, e.g. motion sickness, food poisoning, UTI or fever.

It could also happen because a child has eaten too much, or becomes overexcited, nervous or worried.

Serious illnesses such as meningitis, appendicitis and intestinal blockages may also cause vomiting.

Beware: Persistent vomiting is not normal, therefore, medical attention should be sought to ensure appropriate management.

This is particularly so if your child vomits very forcefully (projectile vomiting), if the vomitus contains blood or bile, the vomiting is accompanied by severe diarrhoea, or the vomiting is associated with irritability and altered consciousness.

Dehydration is also an important concern when there is vomiting, so watch out for its signs.

Keeping it healthy

To ensure that your child’s GI system is healthy and continues to function normally, here are some things to note:

  • Diet

    A healthy and balanced diet is important for your child’s optimal growth and development, which contributes to their overall health.

  • Hygiene

    Good hygiene practices (e.g. proper handwashing before and after eating, and after going to the toilet) is important to prevent infections that can cause GI problems.

    Prioritise hygiene when preparing food at home or when buying outside food.

  • Good daily rhythm

    Maintaining a good daily rhythm with adequate sleep, regular mealtimes and heathy exercise will go a long way to ensuring a healthy gut.

  • Psychosocial well-being

    Pay attention to your child’s mental health by maintaining good and warm communication within the family.

    A healthy GI system ensures that your child won’t have to experience pain and discomfort caused by these GI issues.

    Always seek medical advice early if there is any concern about your child’s symptoms.

Professor Datuk Dr Christopher Boey Chiong Meng is a consultant paediatric gastroenterologist and hepatologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Child health , pain , diarrhoea , constipation , vomiting

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