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

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
  • 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

Originally published in ParentsCanada magazine, July 2013.

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