Sign up with Facebook- Health A to Z
- Healthy Living
Bowel Disorders
Bowel Disorders
Conditions affecting the small and large intestines.
Children are subject to a wide variety of bowel disorders, including obstructions and infections, as well as malabsorptive, inflammatory, and functional disorders. Causes range from genetic abnormalities to environmental factors such as diet, stress, and exposure to viruses and bacteria. The fully formed gastrointestinal tract is 12-15 ft (4-5 m) long at birth, but all of its components do not function maturely for several months. Intestinal problems resulting from birth defects are generally the first to be discovered, often manifesting themselves soon after birth.
Intestinal obstructions are a major type of bowel disorder. If left untreated, they cause malnutrition and other health problems. Some may lead to intestinal ruptures and result in peritonitis, a potentially life-threatening infection of the abdominal cavity. In pyloric stenosis, a common bowel obstruction, the muscle that surrounds the opening between the stomach and the duodenum (part of the small intestine) thickens and becomes stiff, blocking the passage of food to the intestines. The most characteristic symptom is abnormally forceful vomiting (known as projectile vomiting), usually following meals. The vomiting causes weakness, malnutrition, constipation, and dehydration. Treatment consists of surgery to widen the obstructed passageway. Pyloric stenosis is relatively common, occurring in approximately one out of every 250 births and four times more often in boys than girls.
In atresia, another type of bowel obstruction, a portion of either the small or large intestine fails to open properly, impairing normal digestion. This condition is surgically corrected by removing the affected portion of the bowel. Hirschsprung's disease occurs when some of the nerve cells that regulate normal bowel activity are missing, causing a portion of the intestines to contract. This condition is also corrected by surgery. Yet another type of obstruction is intussusception, in which part of the small intestine folds onto itself, in an action that resembles the folding up of a telescope, with one section sliding over another. Intussusception, which occurs most often between the ages of 3-36 months, cuts off circulation in the intestine and can cause an infant to go into shock. It is often associated with an infection, injury, or other problem. It can sometimes be corrected with a special enema, although surgery may be necessary. Intestinal obstruction may also be caused by an inguinal hernia, which occurs when a weakness or opening in the abdominal wall allows part of the intestine to protrude into the groin.
Malabsorptive conditions are disorders in which food cannot pass properly from the small intestine to the rest of the body through the lymphatic or circulatory system. They may be caused by the absence of particular enzymes or by a variety of hereditary or acquired diseases. The most common malabsorptive conditions affecting infants and children in the United States are cystic fibrosis and celiac sprue disease. Cystic fibrosis, which also causes breathing difficulties and dehydration, hampers normal digestion by preventing the pancreas from functioning normally. Treatment includes replacement of missing pancreatic enzymes with a synthetic substitute and dietary measures to ensure adequate nutrition.
In celiac disease, the small intestine is damaged when the protein gluten (an ingredient of wheat, rye, and other grains) is consumed, preventing proper absorption of essential nutrients. Symptoms of this disorder—which usually appears between the ages of 8-24 months but can begin as late as adolescence—vary but usually include growth retardation, loss of appetite, and irritability. Other possible symptoms include abdominal bloating, diarrhea, constipation, vomiting, and excessive bruising. The primary treatment is adherence to a gluten-free diet supplemented, at least initially, by vitamins and minerals to correct the deficiencies caused by the disease. Other causes of malabsorption in children include lactose intolerance,
Inflammations of the bowel constitute another category of intestinal disorders. These disorders, collectively known as inflammatory bowel disease (IBD), include ulcerative colitis, Crohn's disease, and bacterial infections. Symptoms include abdominal pain, nausea, and loose stools or diarrhea, which may contain mucus, pus, or blood. As with other conditions that disturb normal intestinal functioning, inflammation of the bowel eventually results in malnutrition and impaired growth and development. In addition, blood loss from the bowel may result in anemia. In ulcerative colitis, the mucosal lining of the colon (large intestine) becomes inflamed.
With Crohn's disease, any part of the gastrointestinal tract can be affected, resulting in an inflammation that attacks the intestinal lining and extends deeply into the intestinal wall. The area most commonly affected is the lowest portion of the small intestine (called the terminal ileum), producing chronic abdominal pain. When Crohn's disease affects the colon, it causes diarrhea and severe cramping.
Another cause of intestinal inflammation is the bacterial infection shigellosis, or dysentery, which commonly strikes children between the ages of one and nine. The shigella bacteria are spread by contamination of food, excrement, and hands, and are also carried by flies. As in other forms of inflammatory bowel disease, the lining of the intestine becomes inflamed, causing diarrhea. In serious cases, dehydration may become severe, requiring immediate medical attention. Inflammatory bowel disease caused by infection is treated by administering antibiotics and restoring lost bodily fluids. In ulcerative colitis and Crohn's disease, which have no known treatable cause, anti-inflammatory medications, such as sulfasalazine and corticosteroids, are commonly prescribed. Severe cases may require hospitalization and intravenous feeding.
A bowel disorder experienced by many children is acute viral gastroenteritis, also called stomach or intestinal flu. The disorder is an intestinal infection caused by a virus which penetrates the intestine and damages its lining, interfering with digestion. Unlike bacterial infections, the first symptom of viral infection in the intestine is usually vomiting, which is then followed by diarrhea after one or two days. Other symptoms include appetite loss, abdominal cramps, and, in some cases, fever. Within three to five days, the infection generally runs its course. The primary treatment of gastroenteritis is administration of fluids to prevent dehydration. Breastfed babies with intestinal viruses can continue to nurse; bottle-fed babies should be switched to an oral rehydration product or other clear liquid until they recover. Infants may temporarily develop lactose intolerance for up to several weeks following an intestinal virus. Viruses are transmitted by food and water, and by direct contact, especially in crowded environments such as schools, day-care centers, and hospitals.
In addition to viral and bacterial infections, bowel disorders also result from infection by parasites or worms. The three most common types are pinworms, roundworms, and hookworms. While people of all ages can be infected by parasites, young children are especially susceptible because of their greater exposure to dirt from playing outdoors, often barefoot, and their tendency to put fingers or other objects in their mouths. After entering the body via the mouth or skin, worms live and/or mature in the intestines and lay their eggs there. Symptoms of parasite infestation can include abdominal pain and distension, nausea, cramps, diarrhea, and loss of appetite. Worms are commonly treated with antihelminthic drugs. For roundworm or hookworm, only the affected person needs treatment; for pinworm, the victim's whole family should be treated.
Irritable bowel syndrome (IBS), a disorder commonly associated with adults, also occurs in children and adolescents. IBS, often called recurrent abdominal pain (RAP), is distinguished from most other bowel problems by the fact that it is caused by an irregularity in digestive functioning, rather than an abnormality in the structure of the bowel itself. Usually in response to stress, the muscles of the colon contract irregularly, interfering with the normal passage of food through the intestine. It may either travel too slowly, causing constipation, or too quickly, causing diarrhea. Persons with IBS often experience both these symptoms regularly, as well as abdominal pain, gas, and bloating.
An estimated 2.5 million children in the United States suffer from irritable bowel syndrome. Symptoms most often begin around the age of 10, although they can start as early as five years of age. The disorder tends to run in families; about 75% of children with IBS have at least one parent or sibling with gastrointestinal problems. Symptoms often disappear in early adolescence and return in the later teen years. Irritable bowel syndrome is a chronic condition that can be managed but not cured. Treatment consists of adding fiber to the diet, both through foods and fiber supplements, and taking measures to reduce and manage stress.
Bowel Disorders News
