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'Pediatric Gastroenterology' posts

Bellyaches in Kids (and the “Und Here” Syndrome)

Bellyaches, stomachaches, or belly pain in school-age children are a common occurrence.  At least half of the children that get referred to pediatric gastroenterologists like me come for treatment of their chronic, recurrent abdominal pain.  Parents often feel frustrated because despite multiple visits to physicians, even emergency rooms, they are left with more questions than answers all whilst their child continues to suffer.

A typical scenario is a child whose pain seems worst in the mornings after awakening and towards the evening, especially after dinner or before bedtime.  Often the child doesn’t want to eat breakfast and if forced, tells his parents he feels nauseated.   When asked where the pain is, the child most often points to the area around his belly button.

More often than not, depending on a few other factors, the diagnosis ends up being ...

Kids and lactose intolerance

Do you wonder if your child might have “lactose intolerance”?    Have you ever thought of removing dairy from your child’s diet?  If the answer to either of these questions is yes, here are a few things to remember when it comes to lactose intolerance in kids:

  • Lactose is broken down by lactase.

While lactose is the carbohydrate (sugar) found in milk, lactase is the enzyme that digests the sugar. This enzyme is found in the lining of the small intestine, breaks down lactose into simpler molecules that are easier to absorb.  When there isn’t enough lactase, the sugar isn’t properly absorbed, which leads to the symptoms of “intolerance”, which include gas, bloating, pain and diarrhea.

  • True lactose intolerance is rare in young children.

Although children as young as infants can “transiently” have less lactase in their digestive tracts (most often, this happens for a week or two after an infection), lactase production remains ...

Gluten intolerance or low FODMAPs?

Despite test results that show no evidence of their children having neither any detectable allergies to wheat nor any signs of celiac disease, many parents choose to have their children follow a gluten-free diet.  This is because of convincing stories of how gluten (a protein found in wheat and other grains) seems to cause their kids to have belly aches, nausea, bloating and a variety of other symptoms.  

For years, this was hard to explain without a scientific explanation.   Gastroenterologists like me had a hard time supporting families who wanted to follow gluten free diets, without a good “medical reason”.  Then, in 2011, researchers from Australia conducted a double-blind, randomized, placebo-controlled, rechallenge trial in nearly 3 dozen patients (none of whom had celiac disease or wheat allergy), all of whom described worsening symptoms when unknowingly ingesting small amounts of gluten.  The results of this study described a condition termed, “Non-celiac gluten intolerance”.    It was after reading this landmark study that many physicians, including myself, began to validate parents’ concerns about gluten being the culprit behind their children’s gastrointestinal (GI) problems.

But then in 2013, just as word of non-celiac gluten intolerance was gaining popularity amongst physicians like me, the exact same group of researchers from Australia published a follow-up study on a similar set of about 3 dozen patients.  The findings of this 2nd study showed that instead...

Does your child have a food allergy or food sensitivity?

“Every time my child eats, his belly hurts. I think he must have a food allergy. Can you help us?”

Countless times have I heard this from parents of children worried about foods being the cause of their child’s gastrointestinal (GI) complaints. Some families wonder whether their child should start a “gluten-free” or other type of dietary change. More often than not, families have already tried a few diets before meeting with me.

Parents considering these types of elimination diets need to be aware of a few key points:
The difference between “food allergy” and “food sensitivity”:

Helping kids with Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD): Do you know what it is?  Do you know what symptoms people suffer from? Do you know that 1.4 million Americans have IBD, and that it can affect both children and adults alike?  The gastroenterology team at Swedish takes care of both children and adults who suffer with this chronic, disease of the gastrointestinal tract

As the pediatric gastroenterology nurse who works intimately with the pediatric IBD patients at Swedish, I know all too well that many can suffer with the “ups and downs” of this sometimes debilitating disease.  Often, I tend to hear from kids when they are “down”, but my favorite time to hear from them is when they are excited about upcoming special events like the “Take Steps” walk, or Camp Oasis (a camp just for kids with IBD), both events sponsored by the CCFA.  It’s often at these events, that children first say that they start to feel “normal”. 

This year, we want to invite you to ...

What is inflammatory bowel disease (IBD)?

Inflammatory bowel disease (IBD) is a chronic (i.e. long-lasting) inflammatory condition of the gastrointestinal system.  IBD is often confused with irritable bowel syndrome (IBS) because of their similar acronyms, but the two conditions are not related.  IBD affects approximately 1.4 million Americans and is most commonly diagnosed between 15-40 years of age.
 
IBD can be categorized into ulcerative colitis and Crohn’s disease.  Though there are clear differences between the two, they are closely related and sometimes difficult to distinguish.
 
Ulcerative colitis is a condition where inflammation affects the most superficial layer of the large intestine (colon).  It typically starts at the rectum and can involve a varying amount of the colon.  In contrast, the inflammation of Crohn’s disease can affect all layers of the intestine and can involve any area of the gastrointestinal tract – from the mouth to the anus.  The type of inflammation seen in Crohn’s disease may lead to long-term complications such as strictures or fistulas (abnormal connections to other organs) that are typically not  ...

How to prepare your child for a stay at the hospital

We all know that Swedish provides top-notch pediatric services for the emergent needs of children and their families.  You may be surprised to find out that many children come to Swedish for a planned inpatient stay as well.  There can be various reasons why a child and their family might be anticipating a hospital stay.  Some examples may include having a surgical procedure that requires them to be monitored for a set period of time afterward, neurological video monitoring, or medical preparations for a procedure the following day.

Regardless of what service your child will be receiving at the hospital, there are ways in which you can better prepare them and yourself for what to expect during your stay.

At Swedish, Child Life Specialists help children and families cope with the hospital process.  Child Life Specialists are available to help educate and prepare children and families prior to surgery and/or an inpatient stay.  Some tips on how to prepare your child for an inpatient stay include .....
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