Children’s abdominal complaints have many potential causes, most of which are not dangerous, but some (such as appendicitis) can be life threatening. For this reason, all belly problems should be monitored closely and treated with care. To help parents determine the best course of action when their child has abdominal upset, I’ve summarized the most common causes of stomach and intestinal concerns in children and adolescents, as well as their treatments. At the end I’ll review some “red flags” that should trigger parents to seek medical attention.
Heartburn (Reflux Disease)
Heartburn symptoms are fairly common in children and adolescents, with as many as 3 to 5 percent of all adolescents experiencing reflux disease. Chest and upper abdominal discomfort occurs when acidic stomach contents slide upwards into the esophagus, causing irritation and a burning sensation. Reflux is caused by decreased strength of the valve (esophageal sphincter) that closes the esophagus off from the stomach or from obesity (which increases stomach pressure). Diet can also play a role in triggering episodes of heartburn.
Treatments for Reflux Disease
If your child is prone to reflux symptoms, there are several things you can do to reduce the frequency of their problems before resorting to medication. For example, if certain foods seem to trigger heartburn (such as acidic or fatty foods), then avoiding those consistently is a good first step. Be aware that the position of the body can greatly influence the likelihood of regurgitation. Encourage your child not to eat before bedtime or lie down after a large meal. Elevating the head of your child’s bed can also decrease the flow of stomach contents into the esophagus. If your child is overweight or obese, losing weight may resolve his or her reflux problems.
If these lifestyle interventions do not control your child’s heartburn, there are three kinds of over-the-counter (OTC) medications that may be helpful. They each treat heartburn in a different way, so be sure to find the one(s) that works best. In some cases, relief may be achieved by using more than one medicine at a time. Always make sure that you read the Drug Facts label carefully before offering any medicine to your child or teen.
Constipation is a very common problem, and accounts for 3 to 5 percent of all pediatrician visits. Although people often think of constipation as synonymous with hard stool, the medical definition of constipation is more specific and must include two or more of the following symptoms (occurring at least once a week for two months) in a child older than four years of age:
Constipation may be caused by a low fiber diet, painful defecation (causing the child to avoid passing stool), food intolerances, medications and bowel dysfunction (related to different diseases).
Lifestyle treatments that may be helpful in remedying constipation include: regular exercise, increased fluid consumption, higher fiber diet, discontinuing cow’s milk and behavior modification (such as toilet breaks at regular intervals).
OTC Treatments that are commonly used to treat constipation include: Stool softeners, laxatives (four types), enemas, and suppositories.
Red Flag Review
Although most cases of heartburn, constipation, and diarrhea are not dangerous, it is important to be on the lookout for more concerning signs and symptoms that could require immediate medical attention. These include:
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