Digestive Disorders Health Article

Digestive Disorders

Disorders that affect one or more of the organs and glands that make up the digestive system.

The digestive system consists of organs—the mouth, esophagus, stomach, and small and large intestines—and glands—salivary glands, liver, gall bladder, and pancreas. The glands secrete digestive juices containing enzymes that chemically break down food into smaller, more absorbable molecules. In addition to providing the body with the nutrients and energy it needs to function, the digestive system also separates and disposes of waste products ingested with the food.

Congenital defects

Malformation of any one of the digestive organs can disrupt digestive functions. Surgery is required to correct most of these conditions. The intake of food can be disrupted by orofacial clefts, commonly known as cleft lip or palate. This condition is usually corrected by surgery within the first three months following birth, and may be corrected within the first days after birth. Infants with cleft lip or palate may have difficulty feeding because they are unable to suck efficiently enough to nurse or bottle feed. Special bottles that direct the flow of formula to the back of the mouth are used in these cases.

Another congenital disorder, an abnormal closure in an opening of one of the digestive system organs called atresia, requires surgery as soon as possible after birth to allow normal function of the digestive system. Abnormal closures may also affect the intestines. An imperforate anus is completely closed off, and surgery to create an opening is required immediately after birth.

Abnormal narrowing of a digestive system passageway, stenosis, typically affects the stomach or intestines. In pyloric stenosis, the pyloric sphincter between the stomach and small intestine is too small to allow food to pass through it. A symptom of pyloric stenosis is projectile vomiting following every feeding, usually within 15 to 30 minutes. Most infants with pyloric stenosis begin to exhibit projectile vomiting sometime between two weeks and four months. The vomiting may develop gradually while the parents and pediatrician try various strategies for relieving a newborn's "spitting up." Pyloric stenosis may occur as often as one in every 250 births, and is most common in male, white, first-born babies. Like most narrowing or closures of digestive system organs, pyloric stenosis is serious and must be corrected with surgery. Similarly, in anal stenosis, the anus is too small to allow the passage of fecal material.

Infants with chronic vomiting may also have a condition that results when the esophogeal sphincter, the valve between the esophagus and stomach, allows the stomach contents to flow back into the esophagus. This problem, usually outgrown within the first year, can be alleviated by burping the infant frequently and by leaving the infant in an upright or semi-upright position for at least 30 minutes following a feeding. For bottlefed babies, thickening the formula with baby cereal may help.

Digestive disorders in toddler, preschool, and school years

After the first few months of life, the most common causes of digestive disorders are infections caused by a virus or, less commonly, bacteria or parasites. An intestinal infection, referred to as gastroenteritis, is spread by unsanitary water or food supplies. A pediatrician should be consulted when a young child experiencing abdominal pain exhibits any of these warning signs: vomits blood or greenish bile; exhibits strenuous or repeated vomiting, or vomiting that lasts more than 24 hours; complains of harsh abdominal pain or has a swollen abdomen; exhibits symptoms of dehydration, such as decreased or lack of urination; is unable to take fluids; or seizure.

When an infant or young child is vomiting, it is important to keep his head turned to the side or face down over a basin or towel to minimize the possibility that the vomitus (material being vomited) be inhaled into the lungs. A key concern whenever a young child is vomiting and unable to keep anything in her stomach is dehydration. About one to two hours after the last vomiting episode, offer the child a few sips of cool water. Follow this every half hour with a few sips of water or other clear liquid such as sugar water or gelatin water (one-half to one teaspoon of sugar or flavored gelatin in about four ounces of water). There are also commercial electrolyte solutions that your pediatrician may prescribe to counteract the potential for dehydration during a bout with vomiting. Gradually return the child to a normal diet over the next 24 hours, while continuing to encourage his intake of fluids. If your child is unable to keep fluids down, and continues to vomit for more than 24 hours, notify your pediatrician. He may order diagnostic blood, urine, and other tests. In rare instances, a hospital stay may be required.

After age five, emotional upset—either distress or excitement—sometimes triggers abdominal pain and even vomiting. If your child exhibits recurring abdominal pain and vomiting accompanied by change in behavior, emotional triggers for the digestive problems should be considered. Your pediatrician, your child's teacher, or a child psychologist can help diagnose the root of the emotional upset.