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Digestive Issues: How to Help with Diet

Digestive issues are extremely common among kids and adults in our country. So common, in fact, that we often don’t give these issues much thought and accept these feelings as being sort of normal. As a registered dietitian, I can tell you that digestive issues are your body’s way of telling you that some changes need to be made to feel better.

Here are common digestive problems, along with causes and dietary cures:

Acid Reflux

Causes:  Overeating, making the stomach too full and as a result, the stomach contents push up into the esophagus. Reflux can also be caused by food sensitivities or allergies, especially in infants.
Diet Cures:  Eat smaller meals at regular intervals each day (3 meals and 2 snacks). Your stomach is about the size of your two hands cupped together (with two more hands on top to make a sphere), so try eating about this much at meals. Eliminate fried foods. Eat plenty of fruits, vegetables, whole grains and lean meats. Eliminate trigger foods such as caffeine, dairy, and other high fat foods (such as sausage pizza or “loaded” nachos). In infants, rule out food sensitivity or food allergy; common culprits related to reflux in infants are cow’s milk protein (dairy), soy, eggs, and wheat.

General Indigestion

Causes:  Overeating, poor quality of diet, chronic constipation, inflamed enterocytes (cells that line the gastrointestinal tract).
Diet Cures:  Eat smaller meals at regular intervals (see above). Reduce processed foods and focus on whole foods such as legumes, fruits, vegetables, whole grains and lean meats. Drink plenty of water (2+ liters/day). Vary your grain intake (often we eat some form of wheat at all meals and snacks throughout the day). Consume probiotics through quality food sources such as organic yogurt, fermented vegetables (sauerkraut, kimchi, etc), and kefir.

Chronic Constipation

Causes:  A diet that is high in refined carbs, low in fiber, and inadequate in fluids. Constipation worsens with inadequate physical activity and long sedentary periods. Kids may be constipated if they consume too much dairy.
Diet Cures:  Eat fresh fruit at least twice per day and vegetables at least 2-3 times per day. Replace refined grains with whole grains. Other foods high in fiber include legumes, nuts and seeds. Drink 2+ liters of water per day. Limit dairy to 12-24 oz per day. Engage in physical activity throughout the day; even walking and doing house chores are helpful.

Frequent Loose Stools

Causes:  Excessive intake of sugary beverages, including juice, as well as excessive intake of “diet sugars”. Can also be caused by food sensitivity/food allergy. Another cause may be imbalanced gut flora, which can occur after taking antibiotics or with prolonged poor quality of diet.
Diet Cures:  Eliminate sugary beverages and replace with water or milk (given dairy is tolerated). Limit diet beverages to 8 oz per day or less. Trial an elimination diet of common food allergens for two weeks to see if symptoms improve (dairy, wheat, soy, eggs, nuts, fish, shellfish). Consume quality probiotic food sources (see above), as well as soluble fiber which is found in foods such as bananas, oatmeal, applesauce, dried peas as in pea soup, carrots, cucumbers.

Stomach Pain, with Gas and Bloating

Causes:  Food intolerance, sensitivity or allergy. Also these symptoms occur with general overeating of unhealthy food choices.
Diet Cures:  Trial elimination of common culprits for two weeks, including lactose (in dairy), wheat, legumes including beans and nuts, eggs, and soy. Eliminate sugary beverages as well. If symptoms do not improve, investigate fructose intolerance by working with a registered dietitian. Eat smaller meals and regular intervals throughout the day reflecting the Healthy Plate Model.

If you didn’t see your digestive issues listed above, or for more specific questions, leave a comment in the section below. For more guidance on helping your family overcome digestive issues, make an appointment with a registered dietitian at North Shore Pediatric Therapy.

What is GERD and how does it affect babies’ eating habits?

Gastroesophageal reflux disease, or GERD, is a fairly common condition in infants. To be clear, almost all babies will have typical infant reflux, or Acid Reflux Baby“spitting up” to some degree, because their gastroesophageal sphincter muscles are still developing. More severe infant reflux will be painful, causing fussiness and sometimes interfering with successful feeding and weight gain.

Signs that an infant has more serious reflux issues are:

  • Frequent spit ups, with crying and fussiness before, during and after spitting up
  • Back arching during feeds
  • Eyes watering during feeds
  • Face turning red, along with grimacing and signs of pain during and after feeds and/or spit-up episodes
  • Frequent hiccups
  • Fussiness when lying down that improves when upright
  • Baby refusing breast or bottle feeds
  • Infant not meeting weight gain or growth goals at pediatrician visits

Most of the above symptoms are a direct response to the burning pain the baby feels when acidic stomach contents are refluxing up into the esophagus. In severe cases of reflux, the infant begins to develop a strong negative association of pain with breast or bottle-feeding. The infant will begin to refuse feeds in order to avoid this pain. This response becomes a learned habit, and over time, results in lower intake, slower weight gain, and dehydration in extreme cases. A baby who is refusing feeds can cause alarm for parents, who then might try forcing feeds in desperation, which can be distressing to the infant and cause further negative association with feeding. Parents should be aware of these signs of GERD and contact the pediatrician right away.

Diagnosis and Treatment of GERD:

Reflux is more common in premature infants since their gastrointestinal tracts are immature compared to term infants. It can also be a symptom of food allergies, in which case the infant may be allergic to the milk proteins in formula, or proteins from foods passing through mother’s breastmilk. In any case, a pediatrician can discern symptoms and diagnose GERD. Treatment protocols for infant GERD usually include a medication, such as ranitidine (also known as Zantac) or lansoprazole (also known as Prevacid). In some cases, the infant needs a special formula or mom may need to eliminate food allergens from her diet. A registered dietitian can help moms navigate special diet needs related to GERD, as well as ensure proper growth and transition to solids if these areas have been affected. Also, the pediatrician can educate parents on “reflux precautions”, which include feeding the baby at a more upright angle, not lying baby flat on their back after feeds, burping baby well, etc.

Sometimes the painful association of GERD creates long-term feeding issues with infants and kids. In these cases, children will continue to have “oral aversion” to eating. Signs of oral aversion stemming from reflux include difficulty transitioning to solids, very picky eating, refusal to put objects in their mouths in general, etc. If your child has signs of feeding difficulties, or if his or her growth has been impacted by GERD, contact North Shore Pediatric Therapy. A multi-disciplinary team including registered dietitians and speech therapists can work with your child to ensure adequate nutrition, growth, and development related to feeding skills.

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