Indigestion in Older Children

What are the different ways in which indigestion shows itself in children?

First, in acute disturbances which last for a few days only; and, secondly, in chronic disturbances which may continue for weeks or months.

Which of the two forms of indigestion is more likely to impair seriously the health of the child?

Chronic indigestion; for since the cause is not recognized it often goes on for months and even years unchecked.

What are the symptoms of acute indigestion?

These are familiar and easily recognized. They are vomiting, pain, undigested movements from the bowels, often fever and considerable prostration.

Such attacks are usually traceable to their proper cause, the removal of which is followed by prompt recovery.

What are the common causes of acute indigestion?

This is frequently due to overeating, to indulgence in some special article of improper food, or to eating heartily when overtired. Acute indigestion often marks the beginning of some acute general illness.

How should acute indigestion be managed?

One should bear in mind that for the time being the digestive organs have stopped work altogether. The important thing, therefore, is to clear out from the intestines all undigested food by some active cathartic, such as castor oil. The stomach has usually emptied itself by vomiting. All food should be stopped for from twelve to thirty-six hours, according to the severity of the attack, only water being given.

At the end of this time is it safe to begin with the former diet?

No; for such a procedure is almost certain to cause another attack of indigestion. At first only broth, thin gruel, very greatly diluted milk, or whey should be given. The diet may be very slowly but gradually increased as the child's appetite and digestion improve, but in most cases a week or ten days should elapse before the full diet is resumed.

What are the symptoms of chronic indigestion?

These, although familiar, are not so easily distinguished and are very often attributed to the wrong cause. There are usually general symptoms such as indisposition, disturbed sleep, grinding of the teeth, fretfulness, languor, loss of weight and anæmia. There are besides local symptoms: flatulence, abdominal pain, abdominal distention, constipation, or looseness of the bowels with mucus in the stools, foul breath, coated tongue, loss of appetite, or an abnormal capricious appetite. Such symptoms are often wrongly ascribed to intestinal worms.

What are the common causes of chronic indigestion?

This is generally the result of a bad system of feeding, either the prolonged use of improper food or of improper methods of feeding.

Examples of bad methods of feeding are, coaxing or forcing to eat, rapid eating with insufficient mastication eating between meals, allowing a child to have his own way in selecting his food, as when he lives largely upon a single article of diet. Things to be considered under the head of improper food are, indulgence in sweets, desserts, etc., the use of imperfectly cooked foods, especially cereals and vegetables, and of raw or stale fruits.

Is it not true that a diet or a special article of food which does not make a child ill is proof that such a diet or such a food is proper for a child?

By no means; with many people the only guide In feeding children is that the article in question did not make the children sick, therefore it is allowable. This is a very bad principle. A better one is to adopt such a diet as will nourish the child's body with the least possible tax upon his digestive organs; in other words, to exclude articles which experience has shown to be injurious to most children.

How should chronic indigestion be managed?

This is a much more difficult matter than the treatment of acute indigestion, for, as it is usually the result of the prolonged use of improper food or of an improper method of feeding, a cure can be accomplished only by a discovery and removal of the cause.

Is chronic indigestion curable?

In the vast majority of cases it is so, but only by faithfully observing for a long period the rules for simple feeding laid down elsewhere. One of the greatest' difficulties in the way of recovery is that parents and nurses are unwilling to follow a restricted diet long enough to secure a complete cure, or to change radically their methods of feeding, but expect the child to recover by simply taking medicine.

For how long a period is it necessary to continue very careful feeding?

In any case it must be done for several months; with most children for two or three years; with some, throughout childhood, for with them the slightest deviation from established rules is sure to provoke a relapse.

Is not medicine useful?

It is undoubtedly of assistance for the relief of some symptoms, but the essential thing is proper feeding, without which nothing permanent can be accomplished.