Decoding digestion problems

Beijing United Family Hospital's Neil Galletly answers Beijing parent's frequently asked questions on digestion

Photo: iStockphoto

Everyone faces upset tummies, much less children, when moving to a new country. To soothe some of your concerns, we asked Dr Neil Gallety, section head of Beijing United Family Hospital's Digestive Disease Center to answer some questions that our Time Out Family parents posed.

What are the common stomach problems expats face when they arrive in Beijing?

The most common problems are likely to be upset stomachs, diarrhea or vomiting. The risk can be reduced by drinking bottled or filtered water and by trying to avoid food that has been standing out for a while, wasn't cooked well, isn't fresh or could have been washed in contaminated water. It is difficult to avoid the risk completely and having a supply of anti-diarrhea medicine and oral re-hydration salts at home can be helpful.

What is the most common food in Beijing that causes digestive issues from your clinical experience?

Street food – although delicious – can be a cause of ‘food poisoning’ and gastroenteritis. Spicy foods such as Sichuan hotpot can cause temporary abdominal discomfort or diarrhea – and can worsen symptoms from gastritis, ulcer or reflux disease.

What should one eat while recovering from a food poisoning?

‘Food poisoning’ or gastroenteritis causes inflammation in the gut, which can cause profuse diarrhea and vomiting. This can result in dehydration so the most important thing to do while recovering is to rest and to drink plenty of fluids to keep well hydrated. Oral rehydration salts can help. With regards to food, avoid spicy, oily and greasy food until the symptoms of food poisoning have fully resolved. Bland ‘white’ foods such as rice (or rice porridge), steamed fish and chicken are best for a few days

Does boiling Beijing tap water make it safe?

No. Boiling tap water will help kill any bacteria and other microbes that might be present but will not remove chemicals or other contaminants that might be in the water. I would recommend using bottled water or filtered water for drinking, cooking and cleaning your teeth.

Does drinking warm water after a meal really help with digestion?

Probably the main benefit of drinking warm water with a meal is that it can help make us feel full and stop us from overeating. It may also help promote emptying of the stomach after a meal.

How many hours before bed should kids stop eating for optimum digestion?

Leaving at least two hours between eating and lying down to sleep can help reduce night-time acid reflux in both children and adults.

What is the order of courses (soup first? Or fruit?) one should consume in a meal?

There are probably no real differences to digestion based on the order of the food consumed – it all mixes together in the stomach!

My child has sour bad breath – is there something wrong with her digestion?

Although people often think that bad breath is caused by digestive problems, it is much more frequently caused by dental and gum problems or by ENT problems such as sinusitis. Only five percent of cases of bad breath are due to digestive issues such as acid reflux, gastritis or helicobacter pylori infection of the stomach lining.

My child constantly has constipation. What are the foods you recommend she eats?

Constipation is a common problem and can cause unpleasant abdominal discomfort and bloating. Simple dietary ways to improve constipation including ensuring good hydration with water or juices and making sure there is plenty of fiber in the diet from vegetables and fruit. Dried fruits such as dried apricots and prunes are a particularly good dietary treatment as the sugar (sorbitol) in dried fruit has gentle laxative properties. If the constipation does not improve with simple dietary changes it would be sensible to consult with your doctor.

How do I know if my child is lactose intolerant?

Lactose intolerance occurs when the body does not make enough of the enzyme lactase, which digests lactose (the sugar found in milk and dairy products). As a result, lactose is not absorbed but is instead fermented by bacteria in the intestines. This fermentation can produce bloating, crampy abdominal pain and diarrhea. If your child develops gassy symptoms, bloating, discomfort or loose stool whenever they drink milk, or eat cheese or ice cream, it is likely they have a degree of lactose intolerance. Lactose intolerance becomes more common as we get older, but can also occur in children. It is not dangerous but can produce unpleasant symptoms. A reduction in dairy product intake or use of lactase enzyme supplements will reduce the symptoms. Yogurt is relatively low in lactose and so can often be tolerated by people with lactose intolerance.

Norovirus is a worry amongst parents now. How do we tell it apart from stomach flu?

'Stomach flu' is another term for viral gastroenteritis – i.e. inflammation of the gastrointestinal tract by a virus infection. Symptoms may include diarrhea, vomiting and abdominal pain. Fever, lack of energy and dehydration may also occur. Norovirus is one of several viruses that can cause this gastroenteritis. It often causes a rapid onset of symptoms that lasts from one to seven days. All forms of viral gastroenteritis are highly infectious and so good hand hygiene and frequent hand-washing with soap and water is important to try to limit the spread of the virus. It spreads easily in schools and nurseries – keep infected children at home for at least 24 hours after their symptoms have fully settled.

How often should children be dewormed?

I would not recommend routine deworming unless a child (or adult) has symptoms and clinical evidence of a chronic worm infestation. There is little evidence that routine deworming of children is of benefit, and any benefit that exists is likely to be limited to populations in poor rural areas with a high incidence of worm infestation.

What are free radicals and why do people keep recommending it for the stomach?

I’m not sure I understand this question! Not one of my patients has ever asked about it! But free radicals are molecules containing unstable atoms that can damage the body and may contribute to cancer, ageing and other disease processes – so it’s unlikely that it is recommended for the stomach!

Do probiotics really help in having a healthy gut?

Probiotics are live strains of bacteria and other microorganisms that we consume either in food and drinks (e.g. live yogurts, kimchi, kefir, sauerkraut) or as supplements. They can be taken to maintain or improve general health or as ‘medicine’ to help treat and recover from specific diseases. Probiotics are thought to help supplement the microbiota – the community of billions of bacteria living in your gut – which plays a vital important role in maintaining a healthy metabolism and immune system. It is probably not necessary to take probiotics continuously – a 30-day course is usually sufficient. Probiotics may be particularly helpful in helping the gut and the microbiota to recover from a bout of gastroenteritis or after a course of antibiotics.

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