Thursday, April 1, 2010

Guest post from Dr. Joe Klassen

Digestive Health for Kids


There is a very longstanding wisdom that says good health starts in the gut. There can be no doubt that a healthy digestive tract is a fundamental issue for our children. Although concerned parents try to ensure that our kids get nutritious foods on their plate, it is also important that the food they eat is properly digested, absorbed and that undesired things are eliminated. It also bears study to ensure that we are not reacting to what we take in.

Digestive issues are often poorly understood as there is a huge variability among individuals and also variations over even short periods of time in any individual. With kids this can be even more complicated as they may be unable to properly articulate how and what they feel. The transient nature of the symptoms frustrates the child, caregiver and health professional alike. While I want to make the discussion as simple as possible, I still need to mention that any serious health issues need to be managed under the care of a professional, and that underlying serious issues are ruled out.

It is not uncommon for healthy children to have a tummy-ache on occasion. When it happens frequently and starts to limit our child’s play or schooling, then we have to get concerned. One of the frustrations many parents have is that with vague symptoms and nothing immediately dangerous, they are placated and told to go home and come back if there is any change. After many visits, there is a loss of confidence that “small” issues get any attention from a busy health care system. Given the nature of audience that reads this type of publication, I am going to skip the lectures on junk food, additives, colourings and high fat content as a contributor.

For anyone with some digestive complaints, a few simple tips can often improve the severity and frequency of complaints. Let’s start with a few simple tips that can help anybody. Chew your food well. This is almost a cliché of sorts in natural health, but it bears repeating especially with children who may gulp down their food to get to their next game or show. Remember not to dilute the digestive power of the stomach by having too much water with a meal. Have water throughout the day, but limit it in the half hour before and during meals to a small glass of water, letting the stomach produce it’s acid to dissolve the food. This improves ability to kill microorganisms on the food as well as to improve the stimulation of the rest of the process by having an increases-acid product moving out of the stomach to the small intestine. Being distracted while eating is a common impediment to a child’s good digestion. Try not to eat in front of the tv or standing while doing some other task. Although it is not always possible in our busy world, making an effort to have a group dinner at the family table is a boon to digestion. It is also a positive activity for the family, and some guidance from the parent’s on healthy discussions can ensure that we stay involved in each other’s lives. Offering thanks for our meal also serves as a bit of a stalling tactic to start the digestive process by anticipation. It also serves to start some very healthy habits in our kids. We go around the table after the meal is set, and everyone takes their turn sharing three things for which they are grateful today, and it really helps us see into each other, as well as start to salivate for our meal.

Gas and bloating are common complaints and are often due to overeating and rushing through a meal. When it is more persistent we should examine if there is a pattern of certain foods that sets this off. Many of us are becoming more reactive to foods such as dairy, wheat, corn, soy, eggs and citrus. The reason why this is occurring goes beyond our space here, but put simply, these foods contain some hard-to-digest proteins, are omnipresent in our diet, and are extremely concentrated in our food. Simply reducing or eliminating these foods for a period of time can offer a rest period and time to heal the gut. The judicious use of digestive enzymes or apple cider vinegar to improve digestion can help to minimize the impact of these or other reactive foods. Poor gut microflora can also contribute to discomfort in digestion. Gas-producing bacteria or yeasts can feed on the contents of our digestive tract and produce the gas that causes distension and discomfort.

Health gut flora is a whole topic of importance for our kids. The use of antibiotics without probiotic support, as well as the use of cleaning products and aggressive hygiene (eg chlorine in our water) in our community can wipeout the gut flora. Use of a probiotic on an occasional basis is adequate for most to establish a healthy flora. I don’t recommend using these constantly as we should give time for one’s bowel to establish its own balance (there are instances where this may not be so).

IBS is a condition that afflicts a larger number of people every year. It is diagnosed as a collection of symptoms after workup for other serious ailments have been ruled out. The common symptoms are abdominal pain, cramps, bloating, diarrhea and constipation. There are no specific tests to identify this “diagnosis of exclusion. From a naturopathic perspective, it is important to understand why there is such an irritation in the digestive system. We’ll start by looking at the quality of physical digestion; is the food being broken down to its basic components? If the food is incompletely digested, then it may cause much irritation farther down the tract, or it may serve as the food source for fermentive microflora. This leads to much gas, bloating and discomfort. The poorly digested food may also then be identified by the immune system, causing inflammation and irritation of the tissue and also more systemically (this is one relationship of foods to ADHD and other conditions). The irritated digestive tract may experience pain, cramps, and an excess or lack of motility corresponding to irregular and uncomfortable bowel movements.

More serious digestive issues include celiac disease, which is a significant immune response to the gluten contained in wheat and some other grains. Our body reacts to this protein and the anti-body/antigen complex leads to an immune attack on the lining of the digestive tract. This in turn can lead to a myriad of symptoms in the GI tract, and also to issues related to poor absorption of nutrients as in anaemia, fatigue and depression. This condition is becoming more prevalent and yet conventional medicine lacks an effective management of the issue beyond avoidance of gluten-containing foods. We see there can also be a similar reaction to other foods and one must ensure that our children are not encountering reactive foods in their diet. An excellent way to find out if there is a reaction to certain foods is to do a food allergy blood test. This blood test will show if there is an immune reaction to foods based on the presence of antibodies in the blood. This IgG test is for the delayed-onset allergies as found in celiac and other food allergies. I need to point out that it is not a test for the IgE antibodies that moderate histamine in the more obvious “hayfever” or “beesting” allergy presentation. The blood sample can be taken in your practitioners office, and is processed by a recognized laboratory. Fortunately for children, the basic panel of 96 foods can be sampled from a fingerstick and a few blood drops so we don’t have to endure a needle venipuncture and the trauma to kids (and myself) that comes with it.

Remember that much of our gut’s reaction to foods is at the root of many digestive complaints and if we can improve the quality of digestion, gut flora balance and reduce reactivity to foods, we can dramatically improve our health. When it comes to our children, it is important that we choose to select foods carefully and to observe their reaction. Many other conditions are a result of the inflammatory response from the gut, such as asthma, ADHD, eczema, depression and hormone issues. Food additives, preservatives and colourings are a whole new dimension to this issue that can be covered in future issues. As we develop a better understanding of our relationship with our food intake, we can reduce the increase in many of these childhood health concerns.

-Dr. Joe Klassen, ND practices at Fish Creek Naturopathic Medicine in Calgary, AB. He has a focus on digestive health, hormones, allergies and childhood issues. He chooses to include food and digestion as an integral approach to all health issues and includes these recommendations in his treatment guidelines.

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