July 20, 2020
Clinical Contributors to this Story
Jessica A. Scerbo, M.D. contributes to topics such as Pediatrics, Cancer.
Victoriya Staab, M.D. contributes to topics such as Pediatric Surgery.
Wendy Jeshion, M.D. contributes to topics such as Pediatric Gastroenterology.
The gastrointestinal (GI) tract is one of the most important pieces of real estate in the human anatomy—especially in children, whose growth and development hinge on good nutrition, and therefore on good digestion.
“Often, the most important thing in kids is their ability to grow. If they can’t digest well, they’ll be malnourished and won’t reach their full developmental potential,” says pediatric surgeon Victoriya Staab, M.D., chief of pediatric surgery at K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center.
Unfortunately, there are many chronic GI conditions that can interrupt and injure a child’s gastric health, says Wendy Jeshion, M.D., co-chief of pediatric gastroenterology at Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center.
“In my specialty—pediatric gastroenterology—we see a large spectrum of diseases and disorders that affect the digestive system,” says Dr. Jeshion, who names the following gastrointestinal (GI) conditions as being among the most common in children:
- Celiac disease: In people with celiac disease, ingesting gluten—a protein found in wheat, barley and rye—triggers an immune system response that results in damage to the small intestine, causing an array of symptoms including diarrhea, abdominal pain, short stature and weight loss.
- Inflammatory bowel disease (IBD): IBD encompasses two major digestive disorders: Crohn’s disease and ulcerative colitis. The former is a chronic inflammatory disease characterized by inflammation and irritation anywhere along the digestive tract. The latter specifically impacts the colon, which often becomes be-speckled with ulcers, or sores. Symptoms of both may include abdominal pain, rectal bleeding, weight loss and diarrhea. Although their cause is unknown, the immune system and genetics are thought to play key roles.
- Eosinophilic esophagitis (EoE): EoE is a chronic inflammatory disease of the esophagus (the tube connecting the mouth to the stomach). Although its exact cause is unknown, it’s thought to be an immune system response to food allergies wherein white blood cells accumulate in the esophagus, causing inflammation that makes swallowing difficult. Symptoms include nausea, a sensation that something is lodged in the throat, regurgitation of food and food getting stuck in the esophagus.
Oncological diseases also are a concern, says Jessica Scerbo, M.D., section chief for pediatric hematology/oncology at K. Hovnanian Children’s Hospital at Jersey Shore. Cancers within the abdomen that can present with common GI complaints, she says, include:
- Hepatoblastoma, a rare tumor that typically starts in the liver
- Neuroblastoma, which often starts in the adrenal glands
- Wilms’ tumor, a rare kidney cancer
- Lymphoma, a type of cancer that can develop in gastric lymph nodes, including those in the stomach, spleen, liver and intestines
- True GI malignancies like adenocarcinoma of the colon
Symptoms to Watch
Because many serious GI issues start out looking like innocuous tummy troubles, it’s important to know what red flags to look for. Among the most conspicuous, Dr. Jeshion says, are:
- Persistent diarrhea
- Vomiting without a cause
- Prolonged constipation
- Rectal bleeding
- Chronic abdominal pain
- Persistent difficulty swallowing
- Poor weight gain
- Sudden weight loss
- Short stature
“It’s the persistence or progression of symptoms that would be most concerning to me,” says Dr. Scerbo, adding that diarrhea for a day is normal while diarrhea for two weeks is not. “Ultimately, parents know their children best. If your gut tells you that something’s wrong, it’s best to get checked.”
What to Do if You Suspect a GI Issue
Your first line of defense should be your pediatrician. “Pediatricians are really good gatekeepers who can initiate labs and decide whether the patient should see a gastroenterologist,” Dr. Jeshion says. “I recommend going to them first.”
For less severe GI problems, nutritionists and even mental health practitioners might be helpful. “Children with anxiety often have GI symptoms, so if you have an anxious child, you might consider having them evaluated by a medical professional specializing in cognitive behavioral therapy. And for things like constipation, it might be helpful to look at their diet,” Dr. Jeshion says. “Because even serious diseases can have vague, mild symptoms, however, you should always tell your pediatrician if you suspect that something’s wrong.”
From the mild to the severe, prognoses are best when diseases are caught early. For that reason, one of the most important things parents can do is talk. “Although kids, especially teenagers, don’t like talking to Mom and Dad about belly pain and diarrhea, it’s very important to have an open conversation with your children about their digestive health,” Dr. Staab says. “When families are really comfortable having these conversations, it’s much easier to determine when a child is developing problems.”
Next Steps & Resources:
- Meet our clinical contributors: Victoriya Staab, M.D., Jessica Scerbo, M.D., and Wendy Jeshion, M.D.
- To make an appointment with Drs. Staab, Scerbo, Jeshion or a doctor near you, call 800-822-8905 or visit our website.
- Learn how we are dedicated to treating a full range of gastroenterological problems in children.
- Avoid these back-to-school bugs
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.