Tummy Trouble

Mummy-my-tummy-is-sore is a common refrain heard the world over. We look at some of the reasons and the cures for a sore stomach
By Donna Cobban

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It’s just before bath time and my three-month-old opens his mouth wide. Tongue quivering, he lets out an almighty scream. Nothing seems to soothe him, we rock him, we feed him and we play music. Nothing helps. It is, we conclude after cross-referencing our 75 or so baby books, a simple case of his internal plumbing needing time to adjust. In other words – he has colic.
“Give him some probiotics,” the sister at our friendly clinic tells us. Probiotics are micro-organisms that assist in maintaining the natural balance of healthy organisms, in other words the ‘good’ bacteria, in the digestive tract. For older children, it amounts to eating extra yoghurt when taking a course of antibiotics, in order to maintain that balance in the gut. For babies, it involves, in this case, a powder that looks like sherbet that I choose to dip his dummy into and pop into his mouth. Twenty-four hours later the crying seems worse. I shelve the probiotics, too afraid to try again.
A year on and I wonder if the crying was indeed louder or if I was subconsciously trying to avoid having anything other than the holy flow of breast milk passing through his system. I can’t be sure, and in order to quell my cynicism (the profit margins pharmaceutical companies make practically beg a person to be especially sceptical) I head off in search of proof. Dr Greene’s trusty website tells me of research done by the Regina Margherita Children’s Hospital in Italy. They recruited 90 breastfed babes who had been crying for more than three hours more than three days a week. Half the babies were given five drops of good-gut bacteria for 28 days, while the other half were given simethicone – a popular colic treatment that works as an anti-foaming agent in the gut. All the moms then quit cow milk and – abracadabra – 95% of the probiotic babies responded, compared to only 7% of the simethicone babies. At the end of the 28 days, the average daily crying had decreased by two hours and 26 minutes in the probiotic group and by only 52 minutes in the simethicone group. I like Dr Greene even more as he chooses not to pimp the probiotics but instead states that, while this is all very exciting, further research is needed.
Before I know it, I am going to be hearing the common refrain known to parents everywhere: “Mommy I have a sore tummy.” Unlike measles, mumps or moles, the tummy is a place of great mystery when it comes to diagnosing and treating the ‘soreness’. According to Cape Town-based doctor and homoeopath, Dr Murray Rushmere, “School-going children with recurring tummy aches not associated with diarrhoea and vomiting are usually suffering from some sort of stress.” While Dr Rushmere acknowledges that this is a huge topic in itself, he points out that “the commonest cause of stress is an excessively high scholastic expectation, not necessarily imposed by the parents, but by the over conscientious child themselves,” although he does concede that pushy parents and teachers do sometimes play a role. Stress-related tummy aches in children are usually short-lived, says Dr Rushmere, but they can recur over years. “I regard them as the childhood equivalent of irritable bowel syndrome, although the management is different,” he says.
So, in most children, where there is no clear physical cause for the tummy ache, the chances are good that it could be linked to something stressful. Perhaps a nasty new school is upsetting them, or James Junior might be hurling behind-the-teacher’s-back punches at your wee mite. Could it be a looming test or exam? I clearly remember a school Spanish test on everything single thing we had learnt that year resulting in severely knotted intestines!
But, before you reach for the headmaster’s phone number or head over to sort out James Senior, stop to think about your child’s diet. Little tummies are not yet desensitised to the rubbish we inadvertently put in them and the aching may well be a pain of protest. Eradicate junk food from your child’s diet and you may well see an improvement in recurring tummy aches. Keep rich food to a minimum and watch out for holidays where children often follow their parents’ cue and end up eating excessive amounts – that tiny tummies then battle to digest.
Constipation is another common cause for aching tummies, which, according to Dr Rushmere, can be a difficult problem to manage, and is best diagnosed with an abdominal X-ray. Another reason he cites for the constipation and tummy aches may well be the stress related to potty training. Three-year-old Robert would hold it in till his whole body ached – it belonged to him and letting it go into the toilet’s abyss was too much for him to cope with. After many visits to the toilet with various obliging adults he finally came round to the idea that his parents might be right – everyone was doing it and so he let go at last and his tummy ached no more.
Lucy Burney, a British-based author and nutritionist, believes that tummy aches can be a symptom of deficiency. “If the pain is accompanied by constipation, then suspect a lack of magnesium,” she writes. Spinach, pumpkin seeds, cashews, Brazil nuts, almonds and pine nuts, black beans, whole grains and artichokes all have high magnesium contents. You might want to look out for other signs of a magnesium deficiency, which, according to Burney, may include “restlessness, tiredness, and poor sleeping habits, grinding teeth, pins and needles and muscle cramps.”
And it doesn’t stop there. Just when you thought you had unravelled the secrets of the stomach, along comes another possibility to consider – allergies. According to Durban-based nutritional therapist Karen Horton, if stomach pains occur two to 72 hours after having eaten, a food allergy cannot be ruled out. Horton lists “general IgG [Immunoglobulin G] food allergies especially lactose or wheat/gluten intolerances as some of the common causes of stomach pain in children.” Testing kits are available to assist in the detection of allergies, and Horton recommends that in addition to this there should be an in-depth assessment with an experienced health provider. She goes on to point out that this is essential should any other members of the family have similar symptoms.
What if it isn’t a simple tummy ache? There aren’t many people, children included, who don’t double over and grimace in response to an acute stomach pain. Dr Rushmere cites a few of the more serious possibilities that could be the cause of acute stomach pain and that would necessitate immediate medical attention:
  • Gastro-enteritis (when seen with diarrhoea and vomiting)
  • Appendicitis (this would be accompanied by very severe abdominal pain, associated with complete loss of appetite and possibly a fever and vomiting)
  • Intussusception (a rare acute cause of stomach ache where the bowel telescopes in on itself, resulting in total obstruction and bloody stool)
  • Stomach ulcers
  • An abdominal pain associated with jaundice (yellow skin), which is a result of a liver disorder, either congenital or acquired (hepatitis).
Another unusual but increasingly common complaint behind acute stomach pains is kidney stones. Recently there has been a marked increase in the number of children being diagnosed with kidney stones in the United States. Dr Caleb Nelson, who heads up the Paediatric Kidney Stone Centre at the Children’s Hospital in Boston, says there are a number of possibilities for this increase. He states that, “Children are getting less physical activity, which is contributing to an increased incidence of obesity. Diet is also a factor, as many children get too much salt, eat highly processed foods and don’t drink enough water.” This may not sound surprising given that it is the United States we are talking about. He goes on to point out that not enough water in a child’s urine is also a major contributor and children living in warm climates need to be mindful of this factor. But, that said, Nelson says, “It’s too early to say that diet is the chief culprit, but it’s a leading candidate.”
More often than not, a mummy-my-tummy-is-sore cry is not going to need any medical intervention; instead it might just need a hug and some love and a bit of a rub.
10 ways to treat a simple tummy ache
1. Give them an over-the-counter medicine.
2. Ask about their bowel movements and encourage them to use the toilet as soon as they are able.
3. Have them lie on one side with their legs tucked up.
4. Have them drink a glass of water – this may help to dilute any acidity imbalance.
5. Administer some tea – a couple of slices of ginger immersed in hot water works wonders.
6. Give them a piece of unbuttered bread.
7. Put them in a warm bath and follow up with a warm hot-water bottle placed over the stomach.
8. Give them a sprig or two of parsley to chew on or sprinkle some parsley in with salads regularly.
9. Distract them – read a favourite story together or watch a good movie.
10. Spend some time together – you may well find out what the emotional issue is behind the pain.


Ilze van der Merwe-Alberts wrote 8 years 15 weeks ago

Tummy aches are very real for the little people and it is their way of saying that their little lives are challenging, hard and even scary. Give them coping skills and remind your child of their power to overcome difficulty. Remind them of previous successes and help them to feel more empowered.

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