The six most common causes of tummy trouble in toddlers
The following are just a sample of tummy trouble sources; many more are rare but possible. If your toddler suddenly becomes ill, has pain in his stomach that doesn't seem to go away or is getting worse, and you're at all concerned, call your doctor. It's always better to err on the side of overcaution than undertreatment.
1. Gastroenteritis or "stomach flu"
Is your child vomiting and suffering from diarrhea? If so, he could have gastroenteritis, more commonly known as "stomach flu." Doctors use this term to describe any inflammation of the stomach and intestines caused by a viral or bacterial infection. Viruses are the most common culprits, including the virulent rotavirus that causes such severe vomiting and diarrhea that many children end up in the hospital for IV rehydration.
Because gastroenteritis is usually caused by a virus, the illness can't be treated with antibiotics. But that doesn't mean you can sit back and wait for the ailment to run its course. Gastroenteritis causes vomiting, diarrhea, and loss of appetite, which can quickly lead to dehydration. You must make sure your child is getting enough fluids for the two to three days that the illness lasts. "You want to rest the gut and give small sips of clear liquid," says Carol Steltenkamp,a pediatrician at the University of Kentucky Children's Hospital in Lexington. Since a stomach with gastroenteritis doesn't tolerate milk products well, ask your doctor about other fluids you can give, such as water, juice, or a rehydrating electrolyte solution such as Pedialyte. Popsicles and Jell-O also seem to go down — and stay down — well with most sick toddlers. Don't force your child to drink too much plain water since a child with diarrhea or vomiting who drinks too much water can get what's called "water intoxication," which can lead to seizures.
You'll know your toddler is getting enough fluids if he continues to product wet diapers (or urinates on the toilet regularly), his lips and skin appear moist, and he sheds tears when he cries. If he isn't doing these things, get him to your pediatrician immediately. If the office is closed, go to an emergency room. Don't be surprised if the doctor suggests admitting your child to the hospital for a day or two of intravenous fluids. It's the quickest and safest way to treat serious dehydration.
As your child begins to recover from gastroenteritis, stick with the so-called BRAT diet. BRAT stands for bananas, rice, applesauce, and toast. Don't feel bound to these foods specifically — most bland foods such as unsalted crackers, noodles and oatmeal work well too. These foods won't upset your toddler's stomach, and are binding so they slow down loose stools.
2. Milk intolerance
True milk allergy and its cousin lactose intolerance are somewhat rare in toddlers (fewer than one in 10 is allergic or sensitive to milk). Your child is at higher risk if someone else in your immediate family has trouble digesting milk products (there is a genetic link). Tummy troubles related to milk can become full blown as a child switches from formula or breast milk to whole cow's milk and begins eating other dairy products such as yogurt and cheese. Symptoms of both milk allergy and lactose intolerance include vomiting, diarrhea, stomach pain, and rashes.
To pinpoint dairy products as the cause, a doctor will recommend that you keep all dairy away from your child for a few days, and then slowly reintroduce it. If your toddler's stomach troubles start up again, you've caught your villain red-handed.
For kids with a milk allergy (meaning they are allergic to milk protein), soy milk may be the answer, but it's not for everyone: Five to 10 percent of kids who are allergic to milk are also allergic to soy. In that case, you'll need to talk to your pediatrician about how to make sure your child gets enough calcium from other foods.
Children with lactose intolerance lack the enzyme lactase, which is needed to digest dairy. Luckily for these kids, they can continue to have dairy as long as they take a synthetic form of lactase, which you can find in an over-the-counter supplement. You can also buy lactose-free milk products.
3. Changes in diet
The most common stomach problem in toddlers — who are continuing to add more and more foods to their diet — is constipation. Constipation is defined as not having a bowel movement for two or three days and then passing small hard stool. If this is the case for your toddler, sit tight. After a few weeks his digestive system will adjust to the changes in his diet and he'll start having regular bowel movements again. You can help jumpstart the process by making sure your toddler is getting enough fiber and fluids throughout the day. (On the days when he seems particularly constipated, avoid bananas, rice, apples or applesauce, and toast. These foods are binding and inhibit bowel movements.) In addition, exercise can help get the bowels moving, so encourage your little one to run around.
4. Upper respiratory illness
Believe it or not, the common cold and even the flu can give a toddler a tummy ache. That's because much of the mucus produced during an upper respiratory illness drips down the throat. When your child swallows it, it can irritate his stomach. If your child complains of stomach pain during a cold, call the doctor. Your doctor may prescribe medicine to dry up the mucus, which will cut down on the irritation. Some children will vomit as a way to clear the mucus out of their system. It's not pretty, but it usually does the trick and the pain goes away.
Sometimes a more serious yet seemingly innocuous respiratory illness can give a child a stomachache (along with a sore throat, fever, and headache). This conglomeration of symptoms can mean strep throat. Call your doctor immediately if you suspect that your toddler's stomachache may be related to strep infection. This illness is caused by streptococcus bacteria and needs antibiotic treatment.
5. Abdominal pain and vomiting
Don't take a wait-and-see approach if your child is vomiting, lethargic, seemingly fine one minute and then writhing in pain the next, or passing blood from the rectum. Call your doctor immediately. These symptoms may signal an intestinal blockage called intussusception, which is fairly common in children 6 months to 3 years old. "Our emergency room sees about one case a week," says Hardy. Doctors treat intussusception by barium or air enema, or, if that doesn't work, surgery.
These symptoms may also indicate appendicitis. The classic symptoms are abdominal pain, fever, and vomiting. But if children's acetaminophen doesn't reduce his fever and if he can't keep anything down, including water, he may have appendicitis, especially if the stomach pain worsens over a few hours and seems to be located in the lower right quadrant of his abdomen.
6. Lead poisoning
For families living in urban areas or in homes built before the 1970s, lead poisoning continues to be a real threat. Since toddlers love to put things in their mouth, they are at risk of ingesting lead from contaminated paint chips, which taste sweet and may be lying on the floor or windowsill if paint is peeling. One of the few outward signs of lead poisoning in children is a stomachache. Other signs of lead poisoning include lethargy, poor appetite, crankiness, and constipation.
If your doctor suspects lead poisoning, he will order a blood test. In addition, he may schedule an X-ray of your child's abdomen; it will show whether there are lead flecks in his system.
Luckily, you can get medicines that bind to the lead in a child's system and help flush it from the bloodstream. You can treat a child with a mild case of lead poisoning at home with an oral medication. However, a child with a more serious case may have to be hospitalized and given an aggressive treatment of intravenous medicine.
2007-03-07 15:06:06
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answer #1
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answered by RadTech - BAS RT(R)(ARRT) 7
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