Bad Digestion in Children: A Pediatric GI Perspective on Poop, Puke and Pain Problems

"Doctor, you are the fifth pediatrician in three months who told me that my son has a virus. What are the chances he catches the same virus and wakes up with a stomachache and vomiting every three weeks, and no one else at home has been sick? Are you sure that he doesn't have something else?"

Digestive problems are a big deal in pediatrics. Anyone who deals with children and teens know that they are highly prone to bellyaches, nausea, vomiting, constipation, or various combinations of the above, and they seem to occur at the worst possible times, say, the night before a final exam, while getting ready for school, or during the middle of a long road trip. What perhaps adds to the frustration is that when they are brought to medical providers for examination, all findings, whether from physical assessment, laboratory tests, or X-rays, would often turn out to be normal. What is going on? Is the child faking the symptoms? Are we dealing with a "psychosomatic" condition? Is the doctor missing something? Are there more tests that need to be run? Will the problem happen again?

If this was your experience with a child, chances are that it might not have been the first occurrence, and that there may be additional trips to the doctor's office, urgent care clinic, or emergency room for the same things, not too far in the future. Everyone gets frustrated - the child, the parents and caretakers, the teachers, and even the medical care providers, who would rather not look and feel incompetent for not being able to "fix" the problem the first time.

Thankfully, medical providers are generally quite competent at recognizing a truly sick child or teenager, so if they don't seem to be able to identify any serious condition in the pediatric patient with bad digestion, chances are that they haven't missed anything of that sort. The majority of these frustrating digestive complaints turn out to be due to what are now known as "functional" digestive disorders, or DBGI's (disorders of brain-gut interaction). These are conditions that cause a lot of distress, but nothing is technically "broken" physically. Symptoms appear to be due to normal kinds of activities, e.g., the stomach churning, the rectum filling up with stool after a meal, etc., except that those who experience pain seem to be a lot more sensitive to these activities than most others, and that there appear to be situations where the problems tend to get worse.

This book aims to explain the nature of such conditions, and to provide more focused look at the most common ones, which include functional constipation, functional abdominal pain, irritable bowel syndrome, functional nausea, functional dyspepsia, abdominal migraine/cyclic vomiting syndrome, etc. Common remedies, both medication therapy and complementary/alternative approaches, are discussed as appropriate. The book concludes with a few highly memorable patients (their names and some personal details have been altered to maintain confidentiality, of course) for illustrative purposes.

Those who read through this book will find functional digestive disorders in children demystified, and be armed with what it takes to tame the symptoms in these conditions. Hopefully, this book will also restore one's confidence in our pediatric medical providers. Yes, we (usually) know what we are doing...we just sometimes have a hard time explaining certain things....