Understanding gut health in children with tummy troubles 

Many kids suffer from stomach issues, which are often triggered by stress. Emerging research suggests that supporting their digestive health can help ease their symptoms

Vivienne McCarthy with boys Joey (left) and Sebastian (right). Picture: Larry Cummins

NEW research shows one in five children experience stomach pain, disrupted sleep and anxiety linked to gut issues.

The study, conducted by PrecisionBiotics, found constipation the most common symptom at 24%, followed by diarrhoea (21%) and bloating (20%). The research also found a strong family link — one in six parents with gut problems have children experiencing similar issues.

The study highlighted triggers, which include school-related worries, friendship challenges, tensions at home, or bullying. “Many children face these symptoms multiple times a month — some describe the pain as severe. That means in a class of 30, as many as six could be struggling with gut-related issues,” the researchers said.

Broadcaster Maia Dunphy is acutely, personally aware that gut health issues are triggered by stress.

Broadcaster Maia Dunphy is acutely, personally aware that gut health issues are triggered by stress. “I’ve become obsessed with the gut-brain axis, with gut health and its link with stress,” says the mum-of-one who was told by her GP at 16 that she had IBS.

“This was the ’90s, a time when people were obsessed with trying to be skinny. I was constantly snacking on apples and raisins. I’d get dreadful stomach pains, very debilitating attacks, like spasms in the gut. The attacks would come on quickly — my belly would begin to feel bloated and crampy, my face would get hot. I’d have to lie down — even painkillers didn’t help.

With Crohn’s and coeliac disease ruled out, Dunphy got the diagnosis of IBS. She has never forgotten her GP’s words: I don’t know anybody who has this who isn’t a worrier.

“I was a worrier. She was ahead of her time — the inextricable link between gut health and the brain is known now.”

Dunphy knows her 10-year-old son, Tom, could be susceptible. “He’s a very sensitive little boy. We’re completely cut from the same cloth, even around the things we worry about. As a child, I was always told to toughen up. For a sensitive child, that’s really hard — you internalise it, think: why can’t I?

“I never say to Tom to toughen up. We talk about why he’s worried about something, and why he may not need to worry about that. It’s about managing stress, trying to build resilience, knowing when to step in and when not to.”

Thankfully, Tom doesn’t currently have gut issues. “I don’t see any, but he does feel things deeply and talks about feeling things in his tummy,” says Dunphy. “He’s also a fussy eater.”

Vivienne McCarthy with boys Sebastian (front) and (rear) Joey. Picture: Larry Cummins

Tummy pain at school

Glanmire mother-of-two, Vivienne McCarthy’s gut problems began in her teens with the onset of her menstrual cycle. “I have heightened sensitivity coming up to my period. I battled it in my teens and 20s, which was hard — it wasn’t really spoken of then and there weren’t as many alternative foods. Over the years, I did food intolerance tests, as well as a colonoscopy and an endoscopy. They didn’t find anything. It was put down to IBS.”

While her seven-year-old, Joey, “seems to be very hardy”, McCarthy already sees gut problems in Seb, nine. “He definitely has a more sensitive tummy than Joey. I have to watch him with certain foods, particularly dairy. He can’t eat too much rubbish or sweet treats — December is a tricky month — and if we travel, he’d be a bit off.”

McCarthy, who works for Red FM, believes stress is a factor in Seb’s gut issues, particularly at flashpoints such as returning to school.

London-based specialist paediatric dietitian Bahee Van de Bor, an advocate for children’s gut health and an expert in child IBS, says parents typically see tummy problems starting when children begin school — but issues can arise even when they’re being toilet-trained.

“It’s usually tummy pain. It can happen at any time during the day or before bedtime, which can be really upsetting for everybody. One in three kids has constipation, but some have constipation with overflow diarrhoea — parents think it’s diarrhoea, but there’s underlying constipation,” says Van de Bor, adding that a gut health specialist will clarify what’s actually going on.

Impacts on affected children can be wide-ranging. The PrecisionBiotics research found children living with ongoing gut-related disorders can experience stomach pain, tiredness, irritability, tearfulness, and disrupted sleep — issues that spill into schoolwork, friendships and overall happiness.

“We know they can disrupt a child’s quality of life. Poo accidents, tummy aches and disrupted sleep can affect school attendance, learning, body confidence, and willingness to participate in sports. Some children also develop a fear of food if unsure what’s triggering their symptoms,” says Van de Bor.

While the GP might prescribe laxatives for a child with constipation, Van de Bor advises using these only as a short-term solution. “It’s more about addressing gut health via diet. Children can use probiotics while waiting to see the specialist — as long as it’s the correct strain for the issue, be it tummy pain, diarrhoea or constipation. This may help alleviate some symptoms during the wait.”

She warns, however, against false marketing, pointing out that probiotics are “a buzzword” today. “Choose a probiotic strain documented in paediatric clinical trials to ease tummy pain, soften hard stools, reduce gas and bloating and manage loose stools.”

A great starting point for parents trying to help their child is to keep a simple symptom diary for at least two weeks. “Record stool patterns, stool type and symptoms such as pain or bloating. Note whether worries, routines or certain foods might be involved.”

London-based specialist paediatric dietitian Bahee Van de Bor, an advocate for children’s gut health and an expert in child IBS.

Take ownership of symptoms

With gut issues liable to occur right through childhood, and to combat teen embarrassment around symptom-sharing, Van de Bor recommends sticking the Bristol Stool Chart to the back of the bathroom door. “Get your child to record and grade their stool themselves. Taking ownership of their symptoms makes them feel heard and validated.”

While parents might be tempted to take certain foods out of their child’s diet, she cautions against it without consulting a doctor or paediatric gut health dietitian. “Elimination diets can lead to nutritional gaps. Your child’s problem might be related to fibre intake or hydration. Maybe they’re skipping meals if they have pain.” Or they may have a busy schedule or want to be play in the playground and see eating lunch as wasting time.

She recommends looking at their food pattern and asking: Are they having regular mealtimes? Getting enough fluids, enough exercise? Having balanced meals with enough fruit and vegetables? Have they got enough time for toilet breaks? “Supporting digestive health doesn’t mean making big or restrictive changes.”

At 16, Dunphy asked her GP how she could get rid of IBS. “She said I had to learn how to manage it. It’s 30 years ago now, and I have. I realised all the fruit that didn’t suit me. I had to cut out most wine, be careful around coffee.”

After finding the right probiotic, she says, “Things changed dramatically. My attacks have reduced. I used to get them once a month. My most recent one was last year. Of course, these things don’t work for everybody — there’s no one-size-fits-all with IBS.”

McCarthy feels frustrated that she can’t have particular foods she loves. “I can’t eat lots of salad and vegetables. Too much fibre can irritate me, so I have to find balance. Stir-fries, eggs and potatoes really suit me and simple traditional type dinners – simple stews and vegetable soups.”

She has found digestive enzymes helpful, and her GP recommended Alflorex. “I’ve found it really good. I was thrilled when they brought out a version for children, that Seb has something to help him sooner than I ever did.”

McCarthy believes these kinds of gut troubles are hereditary. “My dad has had terrible gut issues all his life.”

Van de Bor says children with gut problems and tummy pain are often picky eaters. “Because they don’t know what foods are triggering the pain. Once we address the issues, the child feels better and happier. They’re more curious to eat a wider range of foods. I’ve seen it over and over. Because really these problems are fixable.”

• See: precisionbiotics.ie