The GI System and Down Syndrome

How to Treat More Gastrointestinal Issues

What is reflux? What are the available treatments?

Reflux -- medically known as gastroesophageal reflux disorder (GERD) -- is a condition that results when acidic stomach contents travel backwards up the esophagus, a person's swallowing tube. All babies with and without Down syndrome have GERD; for some babies, however, the severity of symptoms warrant special attention.

Based on the current studies available, between 1 and 5 percent of people with Down syndrome have GERD and experience symptoms such as heartburn or intolerance with certain foods. In babies, reflux is typically expressed as intense back arching and crying while feeding. GERD typically results when the muscular ring at the end of the esophagus becomes relaxed, allowing the stomach contents to track backwards. Medication therapies result in significant improvements for most individuals. In certain cases, a consultation with a GI specialist and additional testing might be helpful.

If my child is constipated, what might be the causes? What are the treatment options?

Children with Down syndrome can be constipated for all of the same reasons that kids without Down syndrome become constipated: poor diet and lack of exercise, among many reasons. However, children with Down syndrome are also prone to three conditions that can result in constipation:

1. Hypothyroidism
2. Hirschsprung's disease
3. Celiac disease

Hypothyroidism results when the body's thyroid gland does not produce enough thyroid hormone; this hormone regulates many activities in the body, including the formation and processing of stool. A simple blood test can diagnose hypothyroidism, and synthetic thyroid hormone can treat the condition. Hirschsprung's disease is described above and most often diagnosed within the first year of life. Celiac disease is a condition in which the body cannot properly digest certain foods, and it's described next.

If none of the above three conditions can explain your child's constipation, you should work closely with your child's doctor to explore some laxative medications that are safe for children. In certain occasions, where the cause of constipation might be due to behavioral factors, working with a developmental-behavioral specialist could also be helpful.

What is celiac disease? Should my child be tested for it?

Celiac disease is a condition in which the body is unable to properly digest barley, rye, and wheat products. The condition can range from mild to severe, and the symptoms can also vary, including diarrhea, vomiting, constipation, and difficulty gaining weight. A simple blood test can yield an initial diagnosis, but a definitive test requires a special procedure from a GI specialist.

Up to 16 percent of individuals with Down syndrome are believed to have celiac disease. Because of this high percentage, all infants with Down syndrome between the ages of 2 and 3 should be screened for celiac disease with the simple blood test. Left untreated, celiac disease can result in malnutrition, decreased growth, and, in rare cases, intestinal cancer (lymphoma). The treatment is dietary and involves eliminating all barley, rye, and wheat from a person's diet. Working with a dietician is often helpful to families.

Is obesity a problem for people with Down syndrome? What are the treatment options?

There have not been any large-scale studies quantifying the percentage of people with Down syndrome who are either overweight or clinically obese. However, most families and clinicians would agree that weight problems are common. Sometimes there are medical reasons for the obesity, such as hypothyroidism or a lower rate of metabolism. Additionally or alternatively, people with Down syndrome frequently consume too many calories and have little to no exercise.

Building healthy eating habits while a person is young is key to preventing obesity in adolescence and adulthood. Obesity has been linked to secondary health problems such as high blood pressure, obstructive sleep apnea, and diabetes. Paying close attention to the weight of a person with Down syndrome is key to his or her lifelong health. Working closely with a nutritionist is often beneficial to families.

Originally featured on National Down Syndrome Society (NDSS.org) and reprinted with permission. Copyright ? 2012 Meredith Corporation.

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