Gastrointestinal conditions affect the gut or digestive system. The digestive system breaks down food into nutrients that are used to provide us with energy and keep us healthy. As food moves through the digestive system it is digested and absorbed into the body. The main organs that make up the digestive system are the mouth, oesophagus (gullet), stomach, small intestine, large intestine (colon), rectum and anus. The liver, pancreas and gall bladder also play important roles in digestion.
Whilst it is common for all infants and children to experience one or a few gastrointestinal symptoms every now and again, often it is not a cause for concern and will resolve on its’ own, sometimes with a short course of medicine or changes in diet, lifestyle or fluid intake.
However, occasionally undiagnosed gastrointestinal conditions can get in the way of day-to-day functioning and can affect child growth and development and long term health. There are many conditions affecting the digestive system; however the most common conditions that are seen by Paediatric Dietitians are Coeliac disease, Irritable Bowel Syndrome (IBS), and Inflammatory Bowel Disease (IBD) which includes Crohn’s Disease and Ulcerative Colitis.
Signs and symptoms of a gastrointestinal condition
Gastrointestinal conditions can be very complex and as a result are often difficult to diagnose. Many of the signs and symptoms associated with gastrointestinal conditions can be mild and often pass quickly, especially in children. It is important to speak to your GP, Health Visitor, School Nurse, Paediatrician or other health care professional if you are concerned that your child is experiencing symptoms that prolonged or are unusual for them, such as;
– Stomach pain
– Nausea
– Diarrhoea
– Vomiting
– Constipation
– Bloating and cramps
– Blood in stools
– Poor appetite
– Trouble swallowing
– Weight loss or poor growth
– Nutritional deficiencies
Further investigations such as blood tests, stool samples, scopes and cameras may need to be completed in order to diagnose gastrointestinal conditions.
Coeliac disease
Coeliac disease is an illness in which the body’s immune system attacks its’ own gut tissue in response to eating gluten (a protein found in wheat, barley and rye grains). This damages the lining of the small intestine and means that the body cannot absorb nutrients from food properly. Coeliac disease is classified as an autoimmune disease, not an allergy or food intolerance. Coeliac disease affects 1 in 100 people, however it is more likely when a first degree family member also has the condition.
Currently the only treatment is a lifelong gluten free diet, and if this is adhered to properly there are unlikely to be any long term health consequences associated with Coeliac disease.
Paediatric Dietitians are involved with education about gluten and diet and helping children and families plan a balanced gluten free diet. We can assess diet and advise on key nutrients that are important for those with Coeliac disease as well as provide advice for preventing cross contamination, label reading and eating out.
Coeliac disease – useful links and webinars
For further information on Coeliac disease visit: Coeliac UK
For those with diagnosed Coeliac disease, the following webinars (also available on Coeliac UK) may be useful:
What is Coeliac Disease? (7 minutes)
The Gluten Free Diet (7 minutes)
Reading Food Labels (7 minutes)
Cooking and Eating Out (5 minutes)
Irritable Bowel Syndrome (IBS)
IBS is a long term condition that affects the large intestine (colon). It is an incredibly complex condition that is often difficult to diagnose as the gut appears normal, but does not work as it should. IBS results in abdominal pain, changes in bowel habits (such as diarrhoea or constipation), bloating, and excessive wind amongst many other gut symptoms. The exact cause of IBS is not known. There is an increased risk of IBS for children who have parents who both have IBS. Your child’s healthcare professional will complete a detailed history and perform some investigations to determine if IBS is likely.
Paediatric Dietitians can support children with confirmed IBS. There are a range of dietary and lifestyle factors that can manage IBS and reduce severity of symptoms. Many children will have certain foods or drinks that are known to aggravate IBS and we can work with you to try to determine these triggers and how to maintain a healthy diet.
Inflammatory Bowel Disease (IBD)
IBD is a name for a range of different gut conditions which cause the digestive system to become inflamed (swollen, painful). The most common types of IBD are Crohn’s Disease and Ulcerative Colitis. They cause symptoms such as diarrhoea, abdominal pain and a fever. IBD is usually diagnosed from the age of 15 and older. There is currently no cure for IBD and treatment includes medication, lifestyle changes, special diets and occasionally surgery.
Paediatric Dietitians can work with families to help manage IBD through special diets. Sometimes specialised diets such as a full liquid diet can be helpful, however there are also times when cases are mild and no special diet is required. It is best to discuss this with your specialist health care professional further prior to referral to a Paediatric Dietitian.
