Digestive System (for Parents)
the general population. Functional GI disorders are disorders of gut–brain interaction. Rumination syndrome - effortless regurgitation of recently swallowed food Childhood functional disorders: children and adolescents. Children with feeding problems or alternative feeding practices had lower energy . are more likely to develop gastrointestinal and eating disorders. on its relation with gross motor function level in children with CP [41,42,43,44,45,46,47] . Contributory factors include abnormal bowel mobility, prolonged. Slow transit constipation (STC), formerly known as neuronal intestinal dysplasia Many children with STC have emotional and behavioural problems, including: Join a support group such as the Paediatric Continence Association of Australia. . Most cases of constipation are treated by eating a diet high in fibre, drinking.
Energy intake of children decreased with poorer gross motor function. Open in a separate window 2. Micronutrient Deficiencies The above-described inadequate dietary intakes, besides from putting children at risk of calorie—protein malnutrition and reduced linear growth, may also lead to micronutrient deficiencies. Micronutrients are important for many metabolic pathways; specific or generalized micronutrient deficiencies may cause symptoms, which are difficult to distinguish from the general neurologic impairment of NI children.
Low micronutrient levels may indeed affect cognition, behavior, social interaction, developmental outcomes and hence quality of life. A Norwegian study conducted by Hillesund et al. Micronutrient intake was assessed with a four-day food diary and micronutrient status with laboratory analysis of micronutrient concentrations was performed.
The 16 supplemented children had higher mean intakes of most vitamins and minerals, but insufficient intakes of folates, iron, magnesium and vitamin D was still observed in some patients. With regards to laboratory analysis, the children who received multi-vitamin supplements presented with higher concentrations of thiamine and cobalamin compared to those who did not receive supplements. Of all children, Overall, the study found low dietary intakes and biochemical deficiency of several micronutrients in children with CP, especially in those not receiving nutritional supplements.
More recently, a study conducted by Kalra et al. The serum levels of iron Levels of zinc were lower though difference was not statistically significant. The present study confirms that biochemical deficiency of micronutrients is common in children with CP, indicating that dietary intakes of vitamins and minerals are often too low to balance needs in this population.
Furthermore, also children who are exclusively tube fed, may develop nutrient deficiencies, because enteral formulas provide adequate amounts of micronutrients only when volumes consumed meet their age-related daily recommended intakes for energy.
Many NI children require lower energy intakes posing them at risk for low micronutrient intake [ 17 ]. Iron deficiency anemia is a frequent complication in NI children due to low iron intake. Selenium deficiency is another issue that can be encountered in NI children who receive long-term enteral nutrition, as some types of medical nutrition products do not contain adequate doses of selenium. Selenium is an essential trace element and a component of selenoproteins. A study conducted by Etani et al.
Carnitine deficiency is relatively common in children with epilepsy. Carnitine is a water-soluble quaternary amine with important intracellular functions, but is only biologically active in the l-isoform. Recently, Fukuda et al.
Slow transit constipation - Better Health Channel
Altered Energy Requirements Alterations in energy requirements ERs frequently occur in NI children and are an important determinant of nutritional status. ERs for children with severe neurodisabilities such as CP are different from those recommended for neurologically normal children due to the influence of many factors altering their resting energy expenditure REE. First, because ambulatory status and characteristics of motor impairment type, distribution and severity influence movement patterns choreoathetosis, dystonia and muscle tone hypertonia, hypotoniaREE has been reported to be significantly lower in most children with CP when compared to neurologically normal children.
Conversely, it has been hypothesized that children with athetosis have similar or even increased ERs compared to recommendations for neurologically normal children, because of increased involuntary movements at rest. When considering functional ability, nonambulatory children have significantly lower REE levels than do children with greater function.
An accurate estimate of ERs is important for nutritional intervention, but it is often difficult to obtain in NI children. Currently, equations specific for CP children are available. The first equation was developed by Krick et al. One requires prediction of basal metabolic rate with the commonly used Schofield equation [ 26 ], and the other equations use a multiple of total body water measurements. From these baseline calculations, each equation then estimates the total energy expenditure with corrections for physical activity levels, gross motor function level GMFCS and a general correction for the existence of CP.
In a study conducted by Walker et al. The study showed that ERs decreased as ambulatory status declined and more limbs were involved.
The greatest predictor of ERs was fat-free mass, then ambulatory status [ 27 ]. Gastrointestinal Disorders Affecting Nutrient Intake The most frequent gastrointestinal disorders that impact on feeding dynamics and significantly affect dietary intakes in NI children are dysphagia and gastroesophageal reflux [ 282930 ].
The appropriate control of the digestive system depends on the healthy functioning and integrity of the neural system.
Patients with structural abnormalities of the central and peripheral nervous systems are more likely to develop gastrointestinal and eating disorders. Dysphagia Dysphagia, occurs as a result of impairment of one of the phases involved in the swallowing process: The foregut, from mouth to duodenum, is the part of gastrointestinal tract most severely affected in children with CP, because of its great density of extrinsic innervations, which are damaged by the initial injury to the central nervous system.
Dysphagia is common in children who acquire brain damage in early in life [ 1331 ], for example in children with CP, but may also occur in children with brain injury acquired later in life [ 3233 ] e. Oropharyngeal dysphagia OPDwhich includes impairment of both the oral and pharyngeal phases, is one of the major factors involved in etiopathogenesis of poor feeding and reduced dietary intakes in NI children.
In fact, OPD is responsible for inefficient feeding process due to excessive food spillage, which is not available for energy and nutrient needs. It causes children to eat more slowly than other members of the household, taking up to 2—12 times longer to swallow pureed food and up to 16 times longer to chew and swallow solids compared to healthy children.
As a result, regular family or school mealtimes may be insufficient for these children, leading to underfeeding and total dependency on a caretaker.
It is believed that OPD is highly prevalent in individuals with CP; however, the true prevalence is difficult to define due to the lack of well-conducted population based studies. Variability in prevalence could be due to methodology limitations parent reports, use of non-validated methods, and case-definition of OPDand inclusion of individuals with a broad range of gross motor impairment and different ages.
One of the first studies assessing oral motor skills in children with CP was conducted by Reilly et al. The Authors evaluated oral motor skills by means of a video recording in 49 children with CP aged 12—72 months in community. The severity of OPD was directly correlated to severity of functional motor impairment, with moderate-to-severe OPD occurring mainly in children with tetraplegia. Early feeding histories of these children revealed that in a significant proportion of children, feeding problems occurred within the first 12 months of life, preceding the diagnosis of CP in many cases, confirming the hypothesis that feeding behavior is a sensitive indicator of central nervous system integrity in neonates [ 40 ].
During the subsequent years, several studies have focused on OPD and specifically on its relation with gross motor function level in children with CP [ 41424344454647 ]. Recently, Benfer et al. With regards to pharyngeal phase impairment, in the study conducted by Benfer et al.
The gallbladder stores bile, which is released when food containing fat enters the digestive tract, stimulating the secretion of cholecystokinin CCK. The bile emulsifies fats and neutralizes acids in partly digested food. After being stored in the gallbladder, the bile becomes more concentrated than when it left the liver, increasing its potency and intensifying its effect on fats.
Anus[ edit ] The human anus is situated between the buttocks, posterior to the perineum. It has two anal sphincters, one internal, the other external. These hold the anus closed until defecation occurs. One sphincter consists of smooth muscle and its action is involuntary; the other consists of striated muscle and its action is voluntary.
In many animals, the anus is surrounded by anal sacs. Role of the anus is when the rectum is full, the increase in intra-rectal pressure forces the walls of the anal canal apart allowing the fecal matter to enter the canal. The rectum shortens as material is forced into the anal canal and peristaltic waves propel the feces out of the rectum.
The internal and external sphincters of the anus allow the feces to be passed by muscles pulling the anus up over the exiting feces. Conditions Affecting the Esophagus[ edit ] There are two different types of conditions that may affect the esophagus.
The first type is called congenital: The second type is called non-congenital: Some examples of these are: Tracheoesophageal fistula and esophageal atresia Both of these conditions are congenital.
In Tracheoesophageal fistula there is a connection between the esophagus and the wind pipe trachea where there shouldn't be one.
In Esophageal atresia the esophagus of a newborn does not connect to the stomach but comes to a dead end right before the stomach. Both conditions require corrective surgery and are usually detected right after the baby is born.
In some cases, it can be detected before the baby is born. Esophagitis Esophagitis is inflammation of the esophagus and is a non-congenital condition. Esophagitis can be caused by certain medications or by infections. It can also be caused by gastroesophageal reflux disease gerda condition where the esophageal sphincter allows the acidic contents of the stomach to move back up into the esophagus.
Gastroesophageal reflux disease can be treated with medications, but it can also be corrected by changing what you eat. Conditions Affecting the Stomach and Intestines[ edit ] Everybody has experienced constipation or diarrhea in their lifetime. With constipation, the contents of the large intestines don't move along fast enough and waste material stays in the large intestines so long that almost all water is extracted out of the waste and it becomes hard.
With diarrhea you get the exact opposite reaction: Common flora bacteria assists in the prevention of many serious problems. Here are some more examples of common stomach and intestinal disorders: An exemplary case of acute appendicitis in a year-old boy. The organ is enlarged and sausage-like botuliform. This longitudinal section shows the angry red inflamed mucosa with its irregular luminal surface. Diagnosed and removed early in the course of the disease, this appendix does not show late complications, like transmural necrosis, perforation, and abscess formation.
Appendicitis Appendicitis is the inflammation of the appendix, the finger-like pouch that extends from the cecum. The most common symptoms are abdominal pain, loss of appetite, fever, and vomiting.
Children and teenagers are the most common victims of appendicitis, which must be corrected by surgery. While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly due to peritonitis and shock. Celiac Disease Celiac disease is a disorder in which a person's digestive system is damaged by the response of the immune system to a protein called gluten, which is found in rye, wheat, and barley, and also in foods like breakfast cereal and pizza crust.
People who have celiac disease experience abdominal pain, diarrhea, bloating, exhaustion, and depression when they eat foods with gluten in them. They also have difficulty digesting their food. Celiac disease runs in families and becomes active after some sort of stress, like viral infections or surgery. The symptoms can be managed by following a gluten free diet.
Doctors can diagnose this condition by taking a full medical history or with a blood test. Diverticulitis Benign gastric ulcer Diverticulitis is a common disease of the bowel, in particular the large intestine.
Diverticulitis develops from diverticulosis, which involves the formation of pouches diverticula on the outside of the colon. Diverticulitis results if one of these diverticula becomes inflamed. In complicated diverticulitis, bacteria may subsequently infect the outside of the colon if an inflamed diverticula bursts open.
If the infection spreads to the lining of the abdominal cavity peritoneumthis can cause a potentially fatal peritonitis. Sometimes inflamed diverticula can cause narrowing of the bowel, leading to an obstruction.
Also, the affected part of the colon could adhere to the bladder or other organ in the pelvic cavity, causing a fistula, or abnormal communication between the colon and an adjacent organ. Gastritis and Peptic ulcers Usually the stomach and the duodenum are resistant to irritation because of the strong acids produced by the stomach.
But sometimes a bacteria called Helicobacter pylori or the chronic use of drugs or certain medications, weakens the mucous layer that coats the stomach and the duodenum, allowing acid to get through the sensitive lining beneath.
This can cause irritation and inflammation of the lining of the stomach, which is called gastritis, or cause peptic ulcers, which are holes or sores that form in the lining of the stomach and duodenum and cause pain and bleeding. Medications are the best way to treat this condition. Gastrointestinal Infections Gastrointestinal infections can be caused by bacteria such as Campylobacter, Salmonella, E. They can also be caused by viruses or by intestinal parasites like amebiasis and Giardiasis.
The most common symptoms of gastrointestinal infections are abdominal pain and cramps, diarrhea, and vomiting. These conditions usually go away on their own and don't need medical attention.
Inflammatory Bowel Disease Inflammatory bowel disease is the chronic inflammation of the intestines, which usually affects older children, teens and adults. Ulcerative colitis usually affects just the rectum and large intestine, while Crohn's disease can affect the whole gastrointestinal tract from mouth to anus along with some other parts of the body.
Patients with these diseases also suffer from extraintestinal symptoms including joint pain and red eye, which can signal a flare of the disease. These diseases are treated with medications and if necessary, Intravenous or IV feeding, or in the more serious cases, surgery to remove the damaged areas of the intestines. Polyp A polyp is an abnormal growth of tissue tumor projecting from a mucous membrane. If it is attached to the surface by a narrow elongated stalk it is said to be pedunculated.
If no stalk is present it is said to be sessile. Polyps are commonly found in the colon, stomach, nose, urinary bladder and uterus. They may also occur elsewhere in the body where mucous membranes exist like the cervix and small intestine. Disorders of the Pancreas, Liver, and Gallbladder[ edit ] Disorders of the pancreas, liver, and gallbladder affect the ability to produce enzymes and acids that aid in digestion.
Cystic Fibrosis Cystic fibrosis is a chronic, inherited illness where the production of abnormally thick mucous blocks the duct or passageways in the pancreas and prevents the digestive fluids from entering the intestines, making it difficult for the person with the disorder to digest protein and fats, which cause important nutrients to pass through without being digested. People with this disorder take supplements and digestive enzymes to help manage their digestive problems.
Hepatitis Hepatitis is a viral condition that inflames a person's liver which can cause it to lose its ability to function. Viral hepatitis, like hepatitis A, B, and C, is extremely contagious. Hepatitis A, which is a mild form of hepatitis, can be treated at home, but more serious cases that involve liver damage, might require hospitalization. Cholecystitis Acute or chronic inflammation if the gallbladder causes abdominal pain.
The actual inflammation is due to secondary infection with bacteria of an obstructed gallbladder, with the obstruction caused by the gallstones. Gallbladder conditions are very rare in kids and teenagers but can occur when the kid or teenager has sickle cell anemia or in kids being treated with long term medications. Cholestasis Cholestasis is the blockage in the supply of bile into the digestive tract. It can be "intrahepatic" the obstruction is in the liver or "extrahepatic" outside the liver.
It can lead to jaundice, and is identified by the presence of elevated bilirubin level that is mainly conjugated. Biliary colic This is when a gallstone blocks either the common bile duct or the duct leading into it from the gallbladder.
This condition causes severe pain in the right upper abdomen and sometimes through to the upper back. It is described by many doctors as the most severe pain in existence, between childbirth and a heart attack. Other symptoms are nausea, vomiting, diarrhea, bleeding caused by continual vomiting, and dehydration caused by the nausea and diarrhea.
Another more serious complication is total blockage of the bile duct which leads to jaundice, which if it is not corrected naturally or by surgical procedure can be fatal, as it causes liver damage.
The only long term solution is the removal of the gallbladder. Gastrointestinal Dysfunctions[ edit ] As we age, the amount of digestive enzymes produced by the body drops way down. This leads to decreased and slower digestion, slower absorption of nutrients and increased accumulation of fecal mater in the intestinal tract. Undigested food material and metabolic waste can also build up due to slow elimination, starting a series of health problems.
When digestion slows, it turns the intestines into a toxic environment. Helpful organisms cannot live in toxic environments. When the beneficial organisms die they are replaced by harmful organisms, such as yeasts and parasites, the most common being Candida albicans. This leads to changes in the intestinal wall which produce leaky gut syndrome, which allows many toxic chemicals to be introduced into the bloodstream.
As a result, the entire toxic load of the body is increased, causing a bigger burden on the liver, kidneys and other body organs. When this happens the organs that are normally used for eliminating waste and supplying nutrients to the GI tract become a large dump for waste. This problem can be made worse by the use of prescriptions and over-the-counter medications, antibiotics, and a diet that is too low in fiber or contains 'junk food'.
Most people never think about their GI tract. We are concerned about what the outside of our bodies look like, but we completely ignore the inside. Because our bodies a very resilient, deterioration of the digestive system can go on for years with no symptoms or side-effects.
When symptoms finally do appear they are usually very non-specific, and include: Over the years these symptoms become more serious, including: Poor digestion, poor absorption, and bacterial imbalance can be traced to many chronic conditions. Every organ in the body receives nutrients from the GI tract; if the GI tract is malfunctioning then the whole body suffers. It is possible to return good health to your GI tract by improving digestion, consuming the right amount of fiber, and cutting out junk food and refined sugars.
You can improve the function of the intestines by taking fiber supplements and vitamins especially B12 and vitamin K. Some doctors suggest herbal or vitamin enemas to cleanse and relieve constipation and to help stimulate peristaltic movement which will help to move the bowels.
Irritable Bowel Syndrome Irritable Bowel Syndrome IBS is a disorder with symptoms that are most commonly bloating, abdominal pain, cramping, constipation, and diarrhea. IBS causes a lot of pain and discomfort. It does not cause permanent damage to the intestines and does not lead to serious diseases such as cancer.
Most of the people affected with IBS can control their symptoms with stress management, diet, and prescription medication. For others IBS can be debilitating, they may be unable to go to work, travel, attend social events or leave home for even short periods of time. About 20 percent of the adult population has some symptoms of IBS, making it one of the most common intestinal disorders diagnosed by physicians. It is more common in men than women and in about 50 percent of people affected it starts at about age Researchers have not found out what exactly causes IBS.
One idea is that people with IBS have a large intestine colon that is sensitive to certain foods and stress. The immune system may also be involved. It has also been reported that serotonin is linked with normal GI functioning. People with IBS have diminished receptor activity, causing abnormal levels of serotonin in the GI tract.
Because of this, IBS patients experience problems with bowel movement, motility, and the sensation having more sensitive pain receptors in their GI tract. Many IBS patients suffer from depression and anxiety which can make symptoms worse. There is no cure for IBS, but medications are an important part of relieving symptoms.
Fiber supplements or laxatives are helpful for constipation. Anti diarrhoeals such as Imodium can help with diarrhea. An antispasmodic is commonly prescribed for colon muscle spasms.
Antidepressants and pain medication are also commonly prescribed. These types of cancers begin in the connective tissue like fat, muscles, nerves, cartilage, etc. GIST originates in the stroma cells. Stroma cells are strung along the GI tract and are part of the system that helps the body to know when to move food through the digestive system. Over half of GISTs occur in the stomach. Most cases occur in people between the ages of forty and eighty, but they can also occur in a person of any age.
All GISTs of any size or location have the ability to spread. In the early stages, GIST is hard to diagnose because early-stage symptoms cannot be recognized. In the later stages a person can have vague abdominal pain, vomiting, abdominal bleeding that shows up in stool or vomit, low blood counts causing anemia, and having an early feeling of being full, causing a decrease in appetite. GIST is now recognized as an aggressive cancer that is able to spread to other parts of the body.
People who have been diagnosed with GIST should get treatment as soon as possible. Food Allergies Food allergies occur when the immune system thinks that a certain protein in any kind of food is a foreign substance and will try to fight against it.
Only about eight percent of children and two percent of adults actually have a food allergy. A person can be allergic to any kind of food, but the most common food allergies are to nuts, cow's milk, eggs, soy, fish, and shellfish. Most people who have a food allergy are allergic to fewer than four different foods.
The most common signs of food allergies are hives, swelling, itchy skin, itchiness, tingling or swelling in the mouth, coughing, trouble breathing, diarrhea, and vomiting. The two most common chronic illness that are associated with food allergies are eczema and asthma. Food allergies can be fatal if they cause the reaction called anaphylaxis. This reaction makes it hard for the person to breathe.
This can be treated by an epinephrine injection. When this happens, contents from the stomach, called reflux, leak back into the esophagus and the stomach. When the stomach refluxes, stomach acid touches the lining of the esophagus and causes it to have a burning feeling in the throat or the chest.
This is what heartburn is. When you taste the fluid in the back of your throat, it is called acid indigestion. It is common for a person to get occasional heartburn, but when it occurs more than twice a week it can be considered to be GERD. GERD can occur in people of all ages including infants. Some symptoms of GERD include having a pain in your chest, hoarseness, having trouble swallowing, or having the feeling of food being stuck in your throat.
The main symptoms are having persistent heartburn and acid regurgitation. GERD can also cause bad breath and a dry cough. No one knows why people get GERD. Some things that could contribute to GERD are alcohol use, pregnancy, being overweight and smoking. Certain foods might also contribute like citrus fruits, caffeine, spicy, fatty, and dried foods, and also mint flavorings. Over-the-counter antacids or medications that help stop acid production and help the muscles empty the stomach are commonly used to treat GERD.
Constipation Not everyone is on the same schedule for having a bowel movement. Depending on the person, a "normal" schedule can range anywhere from three times a day to three times a week. If you start having bowel movements less than your own personal schedule, then you might be getting the signs of constipation. Constipation is when you have trouble having bowel movements. The stool is very hard, making it difficult to pass and causing a person to strain.
You may even feel like you have to have a bowel movement even after you have already had one. When you digest food, the waste products go through your intestines by the muscles contracting. When in the large intestine, most of the water and salt from the waste products are reabsorbed because they are needed by the body for our everyday functions.
You can become constipated if too much water is absorbed, or if waste products move too slowly. Not getting enough fluids, a low fiber diet, age, not being physically active, depression, stress and pregnancy can all contribute to constipation. Medications and narcotics can also cause a person to get constipated. Chronic constipation may be a symptom of a liver problem such as a urea cycle disorder.
The best way for a person to treat constipation is to make sure that they are getting enough fluids as well as fiber in their diet. By doing this, the bulk of their stool is increased and made softer, so that it can move through the intestines more easily. Being more active and increasing daily exercise also helps keep bowel movements regulated. Hemorrhoids Hemorrhoids also known as haemorrhoids, emerods, or piles are varicosities or swelling and inflammation of veins in the rectum and anus.
Two of the most common types of hemorrhoids are external and internal hemorrhoids. External hemorrhoids are those that occur outside of the anal verge the distal end of the anal canal. They are sometimes painful, and can be accompanied by swelling and irritation. Itching, although often thought to be a symptom from external hemorrhoids, is more commonly due to skin irritation.
If the vein ruptures and a blood clot develops, the hemorrhoid becomes a thrombosed hemorrhoid. Internal hemorrhoids are those that occur inside the rectum. As this area lacks pain sensory receptor receptors, internal hemorrhoids are usually not painful and most people are not aware that they have them. Internal hemorrhoids, however, may bleed when irritated. Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: Prolapsed hemorrhoids are internal hemorrhoids that are so distended that they are pushed outside of the anus.
If the anal sphincter muscle goes into spasm and traps a prolapsed hemorrhoid outside of the anal opening, the supply of blood is cut off, and the hemorrhoid becomes a strangulated hemorrhoid. Bleeding in the Gastrointestinal tract[ edit ] Bleeding in the gastrointestinal tract doesn't always mean you have a disease, it's usually a symptom of a digestive problem.
The cause of the bleeding may not be that serious, it could be something that can be cured or controlled such as hemorrhoids. However, locating the source of the bleeding is very important. The gastrointestinal tract contains many important organs like the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus.
Bleeding can come from one or more of these area from a small ulcer in the stomach, or a large surface like the inflammation of the colon. Sometimes a person doesn't even know they are bleeding.
When this happens, it is called hidden, or occult bleeding. Simple tests can detect hidden blood in the stool. What Causes Bleeding in the Digestive Tract Esophageal bleeding may be caused by Mallory-Weiss syndrome which is a tear in the esophagus. Mallory-Weiss syndrome is usually caused by excessive vomiting or may be caused by childbirth, a hiatal hernia, or increased pressure in the abdomen caused by coughing.
Various medications can cause stomach ulcers or inflammations.
Medications containing aspirin or alcohol, and various other medications mainly those used for arthritis are some examples of these. Benign tumors or cancer of the stomach may also cause bleeding. These disorders don't usually produce massive bleeding. The most common source of bleeding usually occurs from ulcers in the duodenum.
Researchers believe that these ulcers are caused by excessive stomach acid and a bacteria called Helicobacter Pylori. In the lower digestive tract, the most common source of bleeding is in the large intestine, and the rectum. Hemorrhoids are the most common cause of bleeding in the digestive tract. Hemorrhoids are enlarged veins in the anal area which produces bright red blood that you see in the toilet or on the toilet paper. How do you Recognize Bleeding in the Digestive Tract The signs of bleeding in the digestive tract vary depending on the site and severity of the bleeding.
If the blood is coming from the rectum, it would be bright red blood. If it was coming from higher up in the colon or from the small intestine, the blood would be darker. When the blood is coming from the stomach, esophagus, or the duodenum, the stool would be black and tarry. If the bleeding is hidden, or occult, a person may not notice changes in the stool color.
If extensive bleeding occurs, a person may feel dizzy, faint, weak, short of breath, have diarrhea or cramp abdominal pain.