SALT LAKE CITY — Many of the gastrointesinal issues that bother children can be headed off by good handwashing and by thoroughly cooking certain foods, including meats and eggs.
But there are other stomach issues that are more complicated to prevent and harder to handle.
Pediatric stomach trouble, from the simple virus to food poisoning, appendicitis or a bowel obstruction, is the topic of the Deseret News/Intermountain Healthcare Hotline on Saturday from 10 a.m. to noon. Dr. Nicole Langston, pediatrician, and Dr. David Hasleton, emergency room physician, both at Riverton Hospital, will answer phoned-in questions on the topic. The toll-free number is 1-800-925-8177.
Abdominal pain, vomiting and diarrhea are all fairly nonspecific symptoms that can have various causes, the doctors say. And figuring out what's going on may be as simple as analyzing a stool sample. "More and more research shows how closely the brain is connected to the gastrointestinal tract," said Langston, who notes that stress can be responsible for stomach problems. For children, a problem in school may manifest at home as stomachache or nausea. It's best to pay close attention to the symptoms and the timing, she said. If pain persists, have a parent or child or both keep a diary of when the pain occurs and what it's like. "Often, seeing a pattern saves us from unnecessary testing and surgery."
Patterns can reveal that certain foods are to blame, for example, such as an allergy to milk. Or it can indicate something not related to food or even the abdomen at all.
If vomiting is accompanied by high fever or clumsiness or a headache, it can be more worrisome. Without a fever, it's not likely to be a urinary tract infection. Figuring out the variables is what leads to a correct diagnosis.
Parents often count as constipated a child who is not constipated, the doctors agree. It's about the stool, not the frequency. And infrequent bowel movements are often a behavioral, rather than physical issue. There are many reasons young children become "fecal withholders," Langston said. But it can be problematic because it causes all kinds of pain, school absence and other issues, making it less a medical issue than a social one.
Appendicitis presents itself like other gastrointestinal problems, with pain, cramping and nausea. There's usually not a high fever, although there may be a low-grade one. One differentiator is it does not accompany watery diarrhea.
As for food-borne bacterial infections such as E.coli, listeria and salmonella, some are treated with antibiotics and others not. In many cases, a bacterial infection can run its course. With cryptosporidium, for instance, treatment is indicated for those who are very young or old and immunocompromised. For others, it is allowed to run its course, Hasleton said.
"If the child is ill enough to be fairly dehydrated, we get more aggressive and treat with antibiotics so the illness can resolve."
It's also important to have basic good eating habits and adequate sleep to build up the immune system, Hasleton said.
Hotline information
The Deseret News/Intermountain Healthcare Hotline focuses on kids' varied stomach woes today. From 10 a.m. to noon, Dr. Nicole Langston and Dr. Dave Hasleton will answer calls. In the Salt Lake area, call 801-236-6061. From elsewhere, the toll-free number is 800-925-8177, only operational during hotline hours.
e-mail: lois@desnews.com