It’s not unusual for children, especially those of adolescent age, to report stomach aches and pains. It can be quite difficult to distinguish between a simple virus and a more serious abdominal condition or disorder in children since the signs and symptoms can be quite similar.
GI conditions are very common globally, occurring in nearly 60 million Americans alone. Pediatric gastrointestinal issues and digestive disorders are similarly common, and abdominal pain is present in nearly 15% of all children who have these conditions.
Like all medical conditions, GI conditions range in both type and severity, and the evaluation and management of gastrointestinal illness in children is somewhat more complicated.
In what follows, we’ll be discussing some specific pediatric gastrointestinal conditions. Particularly, we’ll discuss several of the most common types of GI conditions and available treatments before concluding with a view of the long-term outlook for those who suffer from GI conditions, mild or severe.
Characteristics of Gastrointestinal Conditions
Pediatric gastrointestinal conditions are conditions associated with the digestive system, inclusive of the stomach, esophagus, intestines, and rectum.
Many GI symptoms are well-known, including vomiting, diarrhea, and abdominal pain, yet since these symptoms are fairly universal, certain GI conditions can be difficult to diagnose. Some general risk factors that can cause GI symptoms in children include poor diet, stress, and some genetic factors.
There are two broad types of GI conditions: functional and structural. Within these two types are several conditions and disorders, some of which we’ll discuss below.
Types of Pediatric Gastrointestinal Conditions
The following are some different types of gastrointestinal conditions found in children:
• Gastroesophageal Reflux
• Hirschsprung’s Disease
• Short Bowel Syndrome
Gastroesophageal reflux is a condition involving the reflux of stomach acid into the esophagus. This process normally occurs in infants and through the normal growth process and will improve and resolve usually by about 18 months of age. The reason this occurs in infants is that the sphincter between the end of the esophagus and the beginning of the stomach has not fully developed.
If the infant has issues with feeding, irritability, and weight gain, the condition needs further evaluation to determine if there is another underlying condition such as food allergy or pyloric stenosis.
Treatment for this condition will involve methods to decrease acid production, avoiding potential allergens, and surgical treatment, such as in the case of pyloric stenosis.
Hirschsprung’s disease is a condition in which nerve cells do not form in the part of the large intestine just above the rectum. It is mostly understood as a genetic issue. Babies with this condition are unable to have a bowel movement. They usually have some abdominal swelling and also may have some vomiting. The diagnosis is determined definitively by a rectal biopsy which will show a lack of neural ganglions.
Treatment of this condition will require a surgical pull-through procedure in which the end of the large intestine that has no nerve tissue is removed, and then the new end with functioning neural tissue is reattached to the rectal region. Individuals with this condition will often have some issues with either intermittent constipation or sometimes fecal incontinence. Yet, overall quality of life has been improved in most patients. Regular follow-up with a gastrointestinal specialist will be the standard practice.
Short Bowel Syndrome
Pediatric short bowel syndrome is a condition that occurs after the surgical removal of part of the intestine in an infant or child. Some of the conditions requiring surgical excision of the intestines are necrotizing enterocolitis, gastroschisis, or mid-gut volvulus. After these surgeries, the child is often left with a much smaller length of intestine than usual. This presents a problem with achieving adequate nutrition, and the use of parenteral nutrition sources will be necessary. The decreased amount of absorptive ability of the intestine as well as the alteration of the gut biome is a tremendous obstacle to manage in these children.
Treatment at the beginning of this condition will include parenteral nutrition intravenously. Also, children will need to be closely monitored to make sure they have adequate hydration and electrolyte balance. The reason is that this condition can cause large losses of volume due to intestinal malabsorption. Subsequently, enteral nutrition by feeding tube will be the standard treatment.
Many of the symptoms of certain GI conditions can be managed in a timely manner once diagnosed. Further, if the condition isn’t caused by genetic inheritance, many GI conditions are preventable with the proper lifestyle interventions.
In some cases, GI conditions can be managed well and sometimes outgrown by the child with the condition. Yet, in some conditions, such as short bowel syndrome, lifelong management will be needed.
As a parent caring for a child, it’s important to promote a healthy lifestyle with adequate nutrition and a healthy bowel regimen. This will include healthy foods with fiber, as well as excellent hydration throughout the day.