When Kids Have Diarrhea

Just like constipation, diarrhea is also a common problem in children of all ages, a CHOC Children’s gastroenterologist says.

“There are many different causes from lactose intolerance to celiac disease to structural abnormalities to food allergies to inflammatory issues,” Dr. Mitchell Katz says. Infections are a common cause but so can dietary factors affect stooling. A common scenario is “toddler’s diarrhea” where an otherwise healthy toddler has persistent diarrhea due to excessive consumption of juice.

Diarrhea may go away by itself or it can last for days. Dr. Katz says it’s time for a parent or caregiver to seek help from a doctor if:

  • The child cannot drink enough in order to maintain hydration
  • There is blood in the child’s stool
  • The child has other symptoms of an illness that can’t be explained
  • The child appears ill
  • The child has significant weight loss
  • The child has a high fever
  • The child has persistent abdominal pain or his abdomen is distended

“The best way to treat diarrhea is to treat the child for the underlying illness that may be associated and to keep the child hydrated”, Dr. Katz says. If the child has a bacterial infection that is causing diarrhea, the infection may need to be treated, and antibiotics may be prescribed, he adds.

Keeping the child hydrated is critical, Dr. Katz says. When a child has diarrhea, with or without vomiting, large amounts of fluid can be lost from the body. Excessive fluid loss can lead to dehydration, and when the body loses too much water, it can body functions.

The best fluid to give the child is an electrolyte solution with a small amount of sugar in it, such as a product called Pedialyte or Enfalyte, says Dr. Katz. Also, avoid giving the child milk for at least two or three days may be advisable in certain circumstances.

More posts about gastrointestinal issues:

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Childhood Obesity: Your Options

boy with donut appleCOMING TO TERMS WITH OBESITY
“Looks can be deceiving. It can be hard for parents to tell if their child is obese,” says Dr. Vaquero Solans. “Parents who are overweight or obese might not ask about their
children’s weight. It is the duty of the physician to talk about that. Ask your pediatrician about your child’s weight. We use specific body-mass index charts for children. BMI differs for each age and gender, because they are growing. Ask your pediatrician for an assessment.”

PREVENTING AND TREATING OBESITY
“Prevention really starts during pregnancy. Mom should have a healthy weight gain while pregnant and keep as active as she can considering her condition,” says Dr. Vaquero Solans. She also pointed out that childhood obesity is not a problem that can be solved by
medication. “Changes in lifestyle are the best. It’s a combination of healthier diet and promoting physical activity. Nutrition counseling by the pediatrician, a specialist or a dietitian will help.”

GET MOVING
Exercise helps keep kids fit and should be a part of every child’s daily routine, says Dr. Vaquero Solans, who encourages parents to set a good example. She offered these tips to
make exercise a lifestyle habit for kids that starts in infancy:

  • Start with the baby. Place him on his tummy so he will be encouraged to move around more.
  • Older children should have at least one hour a day of exercise. “This does not need to be all at once. It can be short bursts of activity of something intense 15 minutes at a time four times a day.”
  • Don’t let children age three or older sit in a stroller. They are old enough to walk.
  • Take the kids to the playground or on a walk regularly.
  • Involve the kids in sports or activities like dance when possible.

FAST FACTS

  • Number of children and adolescents in the U.S. who were overweight or obese in 2012: 1 in 3+
  • Percentage of children ages 6-11 in the U.S. who were obese in 1980: 7 %
  • Percentage of children ages 6-11 in the U.S. who were obese in 2012: Almost 18

View the full feature on Kids and Obesity

Dr. Solans
Dr. Cecilia Vaquero Solans
CHOC Pediatric
Gastroenterologist

PHYSICIAN FOCUS: DR. CECILIA VAQUERO SOLANS

Dr. Vaquero Solans completed her pediatric residency training at the Hospital General de Ni–os in Buenos Aires, Argentina. She also was a fellow in pediatric nutrition at North Shore University Hospital, Cornell University Medical College in New York, and completed a
fellowship in pediatric gastroenterology and nutrition at the Montefiore Medical Center, Albert Einstein College of Medicine in New York. She is interested in all pediatric digestive diseases with a special emphasis in nutrition, growth and obesity.

Dr. Vaquero Solans’ philosophy of care: “I like to provide excellent care to all my
patients in a comprehensive vision of body and mind, considering the individual patient and the family. I have a great interest in the care of the underserved groups and children with autism, other special needs and the Spanish-speaking population is very dear to me.”

EDUCATION:
Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina

BOARD CERTIFICATIONS:
Pediatrics Pediatric Gastroenterology and Nutrition

More about Dr. Cecilia Vaquero Solans

This article was featured in the Orange County Register on June 30, 2014, and was written by Amy Bentley.

Fight Obesity with the Right Food

Fight_Obesity_Right_FoodsObesity in children is a major health concern in the United States: Almost 18 percent of children ages 6 to 11 are obese, a significant increase from the 7 percent of kids that age who were obese in 1980. However, an improved diet can go a long way toward overcoming the problem, a CHOC Children’s pediatric gastroenterologist says.

One of the best ways for parents to help children prevent obesity is to improve their diet, says Dr. Cecilia Vaquero Solans. She suggests that parents and families follow a simple “five-to-one” plan when it comes to food, beverage, exercise and lifestyle choices for their kids:

  • Serve five fruits or vegetables per day.
  • Drink four glasses of water per day.
  • Have three meals per day. (Breakfast is the most important.)
  • Spend two hours or less watching television and playing on electronics, combined.
  • Have one hour of exercise of a day.
  • Sweet beverages like soda and juice? Zero.

Sugary desserts and candy should be rare, Dr. Vaquero Solans says.

“Dessert should be mostly fruit, nuts, yogurt and high-fiber snacks,” she says.Fight_Obesity_Right_Foods_2

Children also don’t need juice, Dr. Vaquero Solans says, noting its high sugar content. Instead, children should drink milk or water.

Here are some more healthy eating tips for parents from Dr. Vaquero Solans:

  • Model good eating habits for children. To keep your kids from eating unhealthy foods, don’t buy them or keep them at home.
  • Eat meals at home whenever possible, but when eating out, make the salad a central part of the meal. These days, even fast food restaurants have at least one or two salads as a healthier alternative.
  • When going out for entertainment, go after the meal and don’t make the fast food meal the center of the day.
  • Snacks in between meals are good for kids, as long as they are healthy. Try a piece of fruit, yogurt or a cereal bar, which can help prevent overeating at mealtime.
  • If mom or dad are busy at work and have little time to cook, prepare some meals over the weekend and freeze them. This helps to avoid buying take-out.

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Kids and Stomachaches

stomach_ache_boyFACT OR FICTION?

“No matter what the cause of the stomachache, the pain is real,” says Dr. Mitchell Katz. So what causes tummy  trouble?  It can be as specific as an ulcer, a dietary issue, pneumonia or a sinus infection. “Stomachaches are extraordinarily common. Although always a concern, the majority of kids with abdominal pain do not require urgent intervention,” says Dr. Katz.

INSPECTOR GASTRO

To decide how serious the pain is and whether it’s organic (like an ulcer or appendicitis) or non-organic (like stress), parents need to pay attention to the location. “If the pain is under the belly button there is a greater likelihood that the pain is nonorganic than if it is further away from the belly button,” says Dr. Katz.

Other common causes of  abdominal issues:

  • GI tract infection
  • Acid reflux
  • Constipation

MEDS OR MEDICAL ATTENTION?

Parents have to take a step back and judge the severity of the pain when deciding to give their child medications for stomach issues, says Dr. Katz. “If they think the issues are due to something as simple as a few missed bowel movements, there’s no harm in a stool softener. If significant pain is present, it’s always better to call your primary care provider to talk about the condition,” says Dr. Katz.

WHEN WILL THE ACHE GO AWAY?

“The vast majority of stomachaches can be diagnosed and dealt with after an appropriate history and physical examination,” says Dr. Katz. If these red flags are present, call your doctor:

  • Blood in stool
  • Change in appetite, body weight
  • Pain that interrupts sleep
  • Diarrhea
  • Vomiting
  • Fever

FAST FACTS

  • The age range in which most cases of appendicitis occur: 10-30 Years Old
  • The number of hours that heartburn can last: 2 Hours
  • The number of Americans that develop at least one ulcer during their lifetime: 25 Million

View the full feature on Kids and Stomachaches

Dr. Mitchell Katz Pediatric Gastroenterologist
Dr. Mitchell Katz
Pediatric Gastroenterologist

PHYSICIAN FOCUS: DR. MITCHELL KATZ

Dr. Katz is currently director of CHOC’s multidisciplinary feeding team, pediatric GI lab services, and the division of pediatric gastroenterology and nutrition. He was a fellow in pediatric gastroenterology and nutrition at the University of California, San Francisco and is a five-time recipient of the Orange County Medical Association’s Physician of Excellence award.

Dr. Katz’s philosophy of care: “Listening carefully to the child and the parent. Explore where the child and the family are in life and understand the interrelation between health and emotional well-being.”

EDUCATION:
State University of New York at Downstate Medical School

BOARD CERTIFICATIONS:
Pediatrics and Pediatric Gastroenterology

More about Dr. Katz

This article was featured in the Orange County Register on October 27, 2013 and was written by Shaleek Wilson.

Dr. Mitchell Katz Talks about Stomach Pain in Children

CHOC Pediatric Gastroenterologist Dr. Mitchell Katz talks with CHOC Radio host Bryan Mundia about the symptoms of stomach aches and pains in children. Dr. Katz says that all pain is real and parents are the key in understanding why their child might be in pain. Dr. Katz also discusses the red flags that may be indicators of potentially more serious gastrointestinal issues.

Dr. Katz is currently director of CHOC’s Multidisciplinary Feeding Program and pediatric GI lab services. He was a fellow in pediatric gastroenterology and nutrition at the University of California, San Francisco and is a five-time recipient of the Orange County Medical Association’s Physician of Excellence award.

Enjoy the show.

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