By Sarah Herndon, November 2018

For two long years, Annette Shilling listened to countless advice from her pediatrician, other parents and even a psychologist on how to make her young daughter have regular, pain-free bowel movements.

It was a trip to the emergency room that seemed to kick off two-year-old Katie Shilling’s bout with intestinal troubles. She could not even stand upright, she was so constipated. After an enema and an x-ray that showed no signs of blockage, Katie was released with recommendations from the hospital physicians of a diet high in fruit and a daily dose of MiraLAX.

But three months later, when it came time to potty train, Katie refused. She was barely able to sit on the toilet comfortably. “She physically could not control her bowels because she had withheld so much,” Annette says. The psychologist they were seeing labeled it as anxiety and said that Katie was choosing to withhold her movements. No one seemed to be able to help, and with kindergarten looming in the background, Annette worried that Katie would not be accepted into a school because of her accidents. “When you have a four-year-old that is not potty trained, everyone will make you feel like a failure,” says the Uptown mom.

Finally, in “a tearful moment” in their pediatrician’s office, Katie was sent to see a pediatric GI specialist at Ochsner. The specialist immediately diagnosed Katie with clinical constipation and put her on a laxative. The muscles in her intestines were so stretched that they no longer contracted to allow Katie to have a proper bowel movement. Within six weeks, the blockage had been passed and Katie was fully potty trained. “Nobody but a GI [doctor] brought any of that up and it took two visits. Two years erased by two visits,” Annette says.

Sooner Rather Than Later

Dr. April Ulmer, a pediatric gastroenterologist with Kids and Tummies, sees many kids with varying degrees of tummy pain, and parents always ask her if they waited too long to have their child seen. While that is not typically the case, Dr. Ulmer does offer parents some guidance in knowing when their child should be brought in to a pediatric GI doctor.

“If you notice that there is a complaint that starts to increase in frequency or starts to increase in severity, then it is definitely time to get that child seen,” says Dr. Ulmer, whose practice is located in Gulfport, Mississippi. Another instance when a parent should seek medical advice is if their child starts to withdraw from playtime, sports and even eating, she says. Weight loss and a lack of proper growth for their age is a huge red flag. “Not growing rapidly enough is just as serious as losing in a young child,” Dr. Ulmer says. “They should not go an extended amount of time and not  gain a pound or grow an inch.”

Dr. Ulmer treats everything from acid reflux to liver conditions to gut allergies, such as celiac disease (an autoimmune disease caused by gluten). She has been seeing more children with allergies who seem to be getting younger and whose symptoms are becoming more severe. Dr. Ulmer attributes this to the foods that they are eating, often filled with harmful fillers, preservatives, and colorings. “The gut affects us in ways that we are only recently coming to understand,” she says. Dr. Ulmer adds that it’s important to offer kids foods that support the good bacteria in their guts versus those that promote the pro-inflammatory bad bacteria.

Stay On Top Of It

Simply put, the best way for a parent to be proactive and get ahead of the more serious GI issues is to listen to their child and be their advocate. “If you’re not happy with the way you feel, you go to the doctor that you think might have the answers, but with kids, you rely on somebody remembering to tell you that you might want to try this,” she says. In hindsight, Annette wishes that she had spoken up sooner and pushed to see a specialist. “Parents need to listen to their own gut, no pun intended,” Dr. Ulmer says. “If mama is worried, I am worried.”

Dr. Ulmer is with Kids and Tummies, 
401 Cowan Road, Suite B Gulfport, MS,
228.222.4072, kidsandtummies.com