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Tid★Bits Magazine Spring 2013

Tuesday, May 14, 2013

In this issue:

  • Common Digestive Issues in Children: GERD & IBS
  • New Perioperative Unit
  • 5 Steps for 5K Training
  • Special Report: Sports & Energy Drinks
  • Garden-Themed Activities & Snacks

Common Digestive Issues in Children: GERD & IBS

Doctors and nurses at Children's Hospital of Richmond at VCU (CHoR) receive many questions from concerned parents about children's digestive issues. The following is an overview of two common conditions that affect many children and adults.

Gastroesophageal Reflux Disease (GERD)

It is not uncommon to sometimes experience an uncomfortable feeling in your chest after eating certain foods or a big meal, but if this discomfort happens often it may be due to GERD. Gastroesophageal reflux occurs when the contents of the stomach flow back into the esophagus (tube that connects stomach to throat) causing a burning feeling. When this reflux occurs often, or severely, it is considered a disease.

Symptoms & Causes People with GERD typically experience daily symptoms. In children, the main symptom is a burning feeling in the chest, neck or throat areas (heartburn) that worsens after a meal. Children with severe symptoms may complain of stomach, chest or belly pain and may vomit after eating. Infants with GERD spit up frequently, arch their bodies and cry during and after feedings, and may refuse to eat.

GERD can result from digestive system abnormalities, milk allergies, or other serious conditions such as heart, brain or nervous system disorders. GERD is common in infants because of their immature digestive systems and the repetitive, large feedings they need for growth.

Treatment Eating smaller, more frequent meals can help minimize reflux. Keeping a child in an upright position during and after meals may also help. In addition, if your child experiences reflux at night, your pediatrician may recommend extending the time between dinner and bedtime or raising the head of your child's bed. Your pediatrician may also prescribe stomach medicine or suggest thickening formula or breast milk.

Children should also try to avoid foods and liquids that cause symptoms to occur more frequently. Items that tend to trigger GERD symptoms include: caffeine, fatty and fried foods, spicy foods, and peppermint. Keeping a food journal can help you figure out what foods trigger reflux in your child. Overall diet adjustments may be necessary for those with allergies.

When to contact a doctor A doctor's visit is highly recommended if an infant or child has signifi cant symptoms of reflux or regurgitation (when swallowed food flows out of the mouth). These symptoms include: arching of the body and excessive crying (colic); poor appetite or weight gain; forceful vomiting; choking or turning blue during meals/feedings; and repeated chest infections. Many infants and children outgrow GERD, but it can be a continuing problem into adulthood. Proper treatment and mealtime/schedule changes can provide much-needed relief and help avoid complications.

Irritable Bowel Syndrome (IBS)

IBS results from abnormalities in functioning of the lower part of the digestive tract (colon/bowels). The major symptom of IBS is abdominal cramps with alternating diarrhea and constipation (difficult, infrequent bowel movements).

Symptoms & Causes The abdominal pain associated with IBS is usually short-lived and occurs mainly around the navel/ belly area. IBS pain may not occur every day and is not typically related to a meal or accompanied by nausea or vomiting. Children with IBS do not typically lose weight or experience a decrease in appetite. Symptoms can be made worse by stress.

In the United States, the major cause of IBS is not enough fiber in the diet. Obesity, not enough exercise, and a family history of IBS increase the likelihood of developing the condition.

Treatment To help avoid – and treat – symptoms of IBS, a child should have "their age" plus 5 grams of fiber every day. Avoiding high fat, highly refined (fast) foods; increasing intake of salad, fruit and vegetables; weight loss; and daily exercise also help.

When to contact a doctor Parents should try the above steps before consulting a doctor. An IBS diagnosis is made by taking a thorough medical history, examining the patient, and excluding other, more serious, diseases. IBS treatment often involves diet and lifestyle changes in addition to medication.

Dr. Martin Graham, Division of Gastroenterology and Nutrition

CHoR's Gastroenterology and Nutrition team includes doctors, nurses, nurse practitioners and dietitians who are dedicated to treating common problems like GERD and IBS as well as less common, more serious gastrointestinal diseases and disorders.

Read more of this issue!

TidBits Spring 2013

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