Category Archives: Tummy Trouble

all things tummy: from mouth to south

Belly vs Brain: who’s in charge here?

I am intrigued by the relationship between the gut and the brain. This study that demonstrates outright behaviour changes is one example of our slowly growing understanding:
CBC News – Gut feeling: How intestinal bacteria may influence our moods

Even good old serotonin is now understood to be mostly produced by our ever-present friendly gut bacteria:
Microbes Help Produce Serotonin in Gut Medicine, nutrition and psychology are intimately intwined. Traditional means of understanding and teaching these disciplines will soon change forever.

Technology and health. I love where this is going! Constipation and GERD affect many Jamaican kids.

Is there a new tool coming to the tool-box for those children who don’t respond to diet, behavior change and current options for medication?

Magnetically applied MicroRNAs could one day help relieve constipation: Micro metal beads and magnets help deliver a biologic where it’s needed to improve constipation or rectoanal incontinence in animal models of the disorders. — ScienceDaily–+ScienceDaily%29


Fermented foods

reuben sandwich

In med school my close friend and study partner always had yogurt culture at home. I was spoilt by the creamy deliciousness of this “real” live food. NOTHING  from a store tastes the same.

In recent times as I read all I can find about gut science I see more and more articles singing the praises of fermented foods. Everything from acne to constipation has allegedly been cured by the Lactobacilli that thrive in these foods. I’ve decide to try my hand at homemade sauerkraut. I will keep you posted!

Does anyone make their own yogurt, sauerkraut, kefir, kombucha or kimchi? That’s a lot of Ks. Have you seen anything for sale in Kingston? Are there any mommies out there who found a fermented food made things better for their little ones tummy troubles? Please share your tips and discoveries.

LINK 1: Why you should eat more fermented foods

LINK 2: How to make a jar of sauerkraut for the beginner or skeptic.

Eat your veggies!

image[photo from]

The fruits-and-veggies, peas, beans, and grain you eat today might save your grandchildren from a fecal transplant.

One of the main roles of fibre is to support the “good” bacteria living in our colon. These bacteria are working to keep YOU alive. Now try explaining that to your kids, or where absolutely necessary, sneak those veggies in!

Check out THIS link for some food science.

Conversation with gut microbes

Here’s an Interesting article about how bacteria “speak” to each other. Sometimes we humans need to shut up and listen.

Small talk with big potential: Bacterial conversation counteracts antibiotic damage — ScienceDaily–+ScienceDaily%29

An app for what? Poop colour in newborns!


Parents often ask me about the significance of poop colour. I have a blog post addressing some of the major colour changes in children of all ages, see “rainbow”.

Pale stools in young infants can signify structural obstruction to the biliary tree: Biliary Atresia. This is not common in the Caribbean, but outcomes are definitely time – dependent. The best results are obtained when corrective action is taken before the infant is three months old. Mothers who suspect that their baby is having unusually pale stool should seek out a paediatric specialist to help them through the necessary blood tests and radiological scans that can determine exactly what the cause of the unusual colour might be.

Here is a link to an app dedicated to newborn poop colour. Please share your thoughts on this pre – diagnostic tool.

P.S. I am still toying with making an app dedicated to constipation. …

How do you Doo? Part 3: Get Set – position matters

WEANING: Often times during weaning the texture of baby’s stool will change . The colon and rectum must adapt to this change and expel the firmer, sometimes drier stools efficiently.  Many toddlers will undergo transient constipation with FIRM DRY stools and INFREQUENT passage of stools (less than once every 3 days) during this adjustment phase.

WITHHOLDING STOOL: Subsequently a few children, boys more than girls, may develop a tear “FISSURE” because of the hard dry stool. This will cause blood on the tissue or on the stool, and PAIN on the passage of stools and consciously or unconsciously avoiding stooling thereafter.

POTTY TRAINING: After potty training, most children are keen to sit on the toilet like a “big kid”! Many children do just fine on the toilet, but there is a large number of children who struggle to pass stool in that position… feet a dangling.

Feet a-Dangling      Dangling vs Potty Squats     Potty Squats



Squatting is the bending of the hip and knee joints simultaneously

It results in a straightening of the rectum and enhances natural relaxation of the anal sphincters.

The Perfect Squat!

The Perfect Squat!

Numerous articles have been published about the importance of the squatting position for ease of passing stools. We at Caribbean Tots to Teens do NOT support any particular brand commercial product, but we do like this video explanation of the benefits of squatting seen here.

It is important to note that you do NOT need a commercial device, toddlers can be held in the squatting position  with their backs towards the adults chest and a steadying hold just below the bended knees. They may also squat naturally when using a potty placed on the floor. Older children (up to about 20 kilograms) can stand on the toilet seat … be sure its sturdy… and squat down OR pull up a drink crate / stepping stool to allow little feet to rest comfortably with the hip and knees bent while sitting.

Does your little one need to be set in position to pass stool? Have you tried and of these techniques? Do you use a technique we haven’t mentioned here? Share with our readers, contact us! We want to know.

How do you Doo? is a series that addresses common infant and child stooling issues.

How do you doo? Part 2: A rainbow of possibilities

Many parents marvel and panic over the colour of the stool their child passes. Stool colour is DIRECTLY affected by what a child eats and the health of the intestinal tract. Once the first sticky (dark green and very gooey) meconium of the newborn is passed your child’s stools will take on a range of colours from green to gold to brown, varying with food intake, illness and antibiotics. Almost any colour in the green-gold-brown range is normal and no cause for alarm once the consistency of the stool is normal (see How do you Doo?: Part 1). Below is a picture of the acceptable colour ranges for stools of a normal BSF type 3 and 4 consistency.

Normal Variations in Colour

Normal Variations in Colour

(photo taken from

A stool that is greener in appearance indicates that the bile was released into the intestine but not “processed” but the lining bacteria. This may be because of rapid emptying (including diarrhoea, high fruit or fibre intake and laxatives) or because of a disruption to the bacterial population of the large intestine (colon) such as with antibiotic medication. As bile is processed it goes from gold to green to brown. The colour alone is NO reason to be alarmed in this situation.


Any drift from this safe ring of colour may be an indication that something is awry in the intestines. Although guilty foods can often be identified as the culprits, the safest thing to do is to GET A SAMPLE of the oddly coloured stool and make a trip to your doctor as quickly as possible. Stool may be collected and stored in a small air-tight plastic container, preferably in a cool environment. The sample should be delivered within 24 hours for best representation.


When in doubt TAKE A PICTURE also. Any information you can preserve is always helpful!! STOP and consider what to do before you flush any concerning specimen away.

Abnormal Stool Colouration

A picture is worth a thousand words, and many pictures are not for the faint of heart. Would you like to upload your pictures anonymously for help classifying what you are seeing at home? Let us know!

For children under 7 years, it is good for parents to observe the stools consistency, frequency and colour. We will continue to address these issues in this blog. Please post or email your specific questions, we would love to help unravel the mysteries you may be facing.

How do you Doo? Part 1: Consistency

Many parents are disturbed, confused and even frightened by changes in children’s stool texture. Below is a Caribbean modification of the Bristol Stool Form Chart which enables parents to describe and discuss the little ones “productions” with better understanding from the health care professionals. Types 1-2 are TOO DRY, usually due to staying in the colon for an extended period. Types 5-6 still contain a lot of the fluid from the digestive process and are TOO WET. BSF types 3-4 are ideal stool consistency.

Occasional fluctuation in consistency may occur due to change in diet. High fibre foods usually result in bulky soft to watery stools. Some fruits (eg. prunes) and other foods contain sugars /sugar alcohol such as sucralose, sorbitol and lactulose which pull fluid into the intestinal lumen and result is soft – loose stools.

Any illness associated with a fever may result in increased fluid loss (sweat/ mouth breathing) and decreased fluid intact (with loss of appetite) This is a common cause of acutely dry, hard and painful stools. Foods like RICE; APPLE SAUCE and WHITE FLOUR promote hard dry stools.  WHITE FLOUR SNACKS include: white bread, cakes, biscuits, crackers, dumplings and “cheese snacks” (such as Big Foot, Doritos, Cheese Trix etc)

Of course, a real picture is worth a thousand words, and many pictures are not for the faint of heart. Would you like to upload your pictures anonymously for help classifying what you are seeing at home?

For children under 7 years, it is good for parents to observe the stools consistency, frequency and colour. We will continue to address these issues in this blog. Please post or email your specific questions.