With carbohydrates and sugars two of the big triggers for food reactions in children that can impact their bowels; Easter is the perfect time to remind parents of the causes and symptoms.
Carbohydrates from wheat products and complex sugars can be triggers for diarrhoea in children. In most cases this is because their small bowel doesn’t have enough of the digestive enzymes that break these large molecules into simple sugars that can then be absorbed into the blood stream.
Instead, the carbohydrates and complex sugars travel to the colon where they come into contact with the normal bacteria present.
This starts a fermentation process and the production of gas, along with water secretions into the bowel, causing acidic diarrhoea.
Sugars such as fructose (from fruit) and lactose (from milk), non-soluble sugars in sugar-free products like gum, and wheat products can all trigger diarrhoea in children.
Often, simply addressing the amount of chocolates, sweets, soft drink and cordial, fruit and sweet drinks a child consumes can stop diarrhoea.
A child’s small bowel simply doesn’t have the capacity to absorb too much fruit sugar, and children should be encouraged to eat no more than two pieces of whole fruit a day, and avoid drinking fruit juice.
Lactose intolerance often manifests in later childhood, when the body’s genetic switch turns off production of the lactose-digesting enzyme.
It’s interesting to realise that lactose intolerance is the way nature intended, with all animals, including humans, programmed to stop producing the enzyme that breaks down lactose as their need for their mother’s milk stops. Any adults who can digest lactose carry genetic mutations that prevent this natural process from occurring.
Symptoms of lactose intolerance are triggered by lactose-containing dairy products, such as milk, cream and ice cream, and they can include abdominal cramps, wind and diarrhoea one to two hours after a meal.
If your child is found to be lactose intolerant, foods with lactose should be substituted with calcium-rich foods with no or low lactose, such as lactose-free milk, soy milk, acidophilus yogurt and block cheese. Even though yoghurt and cheese are made from milk, the bacteria in the cheese and yoghurt cultures consume the lactose during production.
Children with suspected carbohydrate or sugar intolerances can be assessed by non-invasive stool (poo) testing and breath testing.
Wheat, too, can cause symptoms, ranging from poor absorption of the wheat starches (carbohydrates) in the small bowel and their subsequent fermentation in the colon (triggering symptoms in irritable bowel syndrome), to significant gut damage triggered by wheat in coeliac disease.
Any child (or adult) who has gastrointestinal symptoms after consuming wheat products should see their doctor for assessment. At a minimum, they require blood testing to assess for possible coeliac disease.
If your child is affected by diarrhoea, excessive wind or constipation a good first port of call is the National Continence Helpline (1800 33 00 66), which is staffed by continence nurses, including paediatric continence nurses, 8am to 8pm EST weekdays.
This article was prepared with the assistance of Brisbane Royal Children’s Hospital paediatric gastroenterologist Dr Francis Connor.