When should you worry about your preschooler's stomach issues?

By Lisa Bendall on June 14, 2013
It’s common for small kids to have stomachaches, diarrhea, constipation or nausea. But it’s also worrisome. “Young kids have a limited ability to tell you what’s going on,” says Dr. Glen Ward, a pediatrician in White Rock, B.C. You may not know if your child is suffering from something temporary, like a virus or a bad banana, or has a chronic or more serious problem, like celiac disease. These questions will help you sort out when you need medical guidance and when the illness is likely to run its course.

When did symptoms begin?

Has your normally healthy child had a few days of uncomfortable symptoms, or been plagued by problems for months? That’ll be your first clue, says Dr. Ward. “If it’s an unwell child with longstanding symptoms, that is most likely to be a more serious illness.”

What’s going around?

Has a sickness been spreading through the daycare? Statistically speaking, most preschoolers with abdominal symptoms turn out to have a temporary viral illness.

Are there other complaints?

Besides a sore stomach, your child may have vomiting, a fever, runny stool or constipation. Of course, any time you’re concerned about your child’s symptoms, call your doctor. But certain red flags mean that medical help is needed quickly. If your child is showing signs of dehydration, if there’s blood in the stool, or is inconsolable with pain, seek help. “It has a lot to do with severity,” says Dr. Ward. It’s also worth a trip to the doctor’s office if symptoms don’t subside after a couple weeks.

What’s going on in life?

Stressful events, such as starting a new daycare, can lead to abdominal symptoms. Toilet training is also often linked to tummy problems, because kids may start holding back their bowel movements.

Have you been travelling in another country? Camping by the lake? Parasites can cause gas, nausea, vomiting and diarrhea. Some parasitic infections will disappear on their own, but others will need treatment. Again, call the doctor if the symptoms don’t clear up in two weeks.

A food intolerance can lead to tummy upset (see sidebar), but so can certain eating habits. Too much milk may cause constipation, and excessive juice can trigger diarrhea. A kid who gets constipated may tend to graze because she can’t stomach a full meal, but snacks may be low in fibre, making problems worse. Even gassy foods like cabbage or beans can cause tummy pain.

What the doc will do

Expect your child’s healthcare professional to ask a lot of questions. You may be asked in detail about the consistency of your child’s bowel movements, because the history and physical exam will influence what tests, if any, are done. These might include stool and urine samples. Blood tests, abdominal X-rays and ultrasounds are only occasionally used. “It’s important that the child isn’t exposed to unnecessary procedures,” says Dr. Ward. “By the same token, the evaluation has to be thorough.”

When foods fail

  • Sore guts? A food insensitivity or allergy could be the culprit. Intolerances to gluten or lactose are not rare in children. But before you start cutting out wheat, milk or other nutritious foods from your kid’s diet, it’s critical to have a discussion and appropriate testing with a healthcare provider. “We see people making assumptions, then limiting their child’s diets for a very long time,” says pediatrician Dr. Glen Ward.
  • Sherry Torkos, a pharmacist and health author in Fort Erie, Ont., agrees about talking to a doc. “You really need to not stab in the dark.” Plus, she says, if you don’t know what’s going on but start treating symptoms like diarrhea with drugstore products, you may mask something that truly needs medical attention.
  • You definitely don’t need a doctor’s OK to jettison the junk from your kid’s diet, says Sherry. “If the child’s eating a lot of junk foods or too much sugar, that can be really hard on digestion.” And you may also want to give probiotics a try, since an imbalance in the gut’s friendly bacteria could be the culprit. “There may be a simple solution to your child’s tummy troubles.”

Originally published in ParentsCanada magazine, July 2013.

By Lisa Bendall| June 14, 2013

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