Preventing Tummy Troubles on the Trail

Speaking with parents I frequently hear about kids with recurring abdominal pains, constipation and other belly discomforts. Many kids will refuse to exercise when they are uncomfortable and this may worsen over time. In order for kids to be healthy and happy, we need to understand a bit about the gut physiology, and need to promote healthy eating.

Certain medical problems increase the risk of recurring abdominal pains. Hypotonia (frequently associated with developmental delay), hypothyroidism, lactose intolerance, celiac, crohns, ulcerative colitis and food allergy are some of the more common causes of recurring abdominal pains. Obese or overweight children tend to get belly pains more frequently. Children who eat alot of processed foods tend to be more uncomfortable and less active than their peers who keep to a more natural diet. Children who ingest caffeine regularly tend to get more heartburn/ reflux symptoms. Children under emotional stress tend to get more frequent belly pains.

What to do? Sorry- I'm not going to give you any real easy answers. Even for experienced pediatric GI specialists, the diagnosis and management of frequently recurring abdominal pain is a bit of a challenge. Usually the answer requires some patience and some old fashioned detective work. Maybe some labwork or a trial of a more natural diet.

The suggestions that follow are very general and may not be for everyone. Consult your pediatrician if pains are sudden in onset, worsening over time, associated with blood or mucous in the stools, are associated with weight loss, fever, persistant vomiting, limp, abdominal tenderness, dehydration or decreased urine output.....

Anyway, here are the suggestions:

Start with some gentle "core" exercises such as a few sit ups and pushups. Do some stretches to improve flexibilty. Have the kids stand on one foot and then the other to improve balance. The core exercises (think yoga and pilates) are especially helpful in children with belly pains because they strengthen the abdominal wall and improve the posture. They decrease the chances of constipation. Parents or group leaders should walk with the kids around the neighborhood, starting with short trips and gradually increasing the distance. Even walking around a bit in the neighborhood will stimulate the gut and improve digestion.

Boycott high fructose corn syrup (HFCS). Foods with HFCS tend to be heavily processed and tend to contain little natural fiber.

Boycott fast food. For so many reasons.

Consider decreasing consumption of foods high in lactose. Especially in the morning, be very careful not to feed children with sensitive digestive systems foods that are particularly high in lactose. Children may do better having homemade yogurt than having fresh milk. Children may tolerate mild cheddar cheese better than mozzarella. For more specific details I would recommend the book Breaking the Vicious Cycle by Elaine Gottschall or logging onto www.scdiet.org. Elaine Gottschall was a biochemist whose daughter had ulcerative colitis. Elaine studied the process of inflammation in the gut and how diets could be used to manage gut inflammation. In her book,she discusses the benefits of homemade yogurt and discusses the proper way to make yogurt in your home. Although her book was originally intended for use with crohns disease and ulcerative colitis patients, a number of her suggestions may be helpful for children suffering with chronic abdominal pains. I may post detailed instructions for making yogurt using a seedling heat mat and canning jars, if readers are interested.

Consider using oatmeal rather than wheat based cereals. Even children who do not have celiac disease may be more comfortable digesting foods with a bit less gluten. Avoid colorful, heavily marketed kid cereal.

Consider using honey rather than sugar to sweeten the oatmeal a bit. Honey has mostly single sugars and is easier to digest than more complex sugars.

A great breakfast for kids heading onto the trail is oatmeal mixed with a natural, fully cultured yogurt , and sweetened with honey. Add some fresh fruit , and maybe some nuts or flax seeds for a well balanced meal. Oatmeal may be eaten cooked or uncooked (think granola)

For lunch on the trail, keep it simple. A gorp made from almonds and raisins has plenty of fiber and has plenty of calories for hiking. A hard boiled egg in a small cooler box with a sprinkle of salt would provide some protein. Peanut butter and a bit of jam on natural (NO HFCS) whole wheat bread might also be a good choice. Celery and carrot sticks provide a fresh crunch.

Children who are currently having GI symptoms may do best eating a ripe banana , yogurt, some white rice with a bit of salt and/or some natural usweetened applesauce (honey may be added before serving). Fully cultured natural yogurt is generally well tolerated unless the child is milk-allergic. Begin with brief easy indoor or outdoor exercises and gradually work up to longer hikes when the child feels better.

Avoid honey in infants and toddlers due to the risk of botulism.

Avoid carbonated and caffeinated beverages. Avoid beverages with added sugar such as sweetened juices and gatorade.

Encourage kids to drink plain water when they are thirsty. Teach them to carry a stainless steel water bottle in their backpack (such as Kleen Kanteen brand) to avoid chemical exposures from the water bottle.

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Comment by Suz Lipman on October 18, 2010 at 10:13am
Thank you for this, Nancy. It's great to have some suggestions about what to pack for trail lunches. It's also wonderful to have suggestions to aid kids' general physical comfort -- this could result in greater enjoyment of the time people are out in nature and fewer barriers to getting out and enjoying nature in the first place.

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