When Milad Zolnoor was a junior at Miami Killian Senior High School, he missed what his friends deemed “the best party of the year.”
Zolnoor, now 22, was an active teenager — until he got Crohn’s disease.
“I would go to parties. I liked being around friends, music. Friday night, I’d go out. Saturday night, I’d go out. Sunday, I would just do everything I needed to do because it is the last day before Monday,” said Zolnoor, of Kendall.
But once he got Crohn’s: “Friday night, I don’t feel like moving. Saturday night, I’d stay in bed. Sunday, I don’t even care,” he said. “That’s what it does to you. I would just stare blankly at the wall.”
Crohn’s is a type of inflammatory bowel disease where a disruption of the immune system causes certain proteins in the lining of the intestinal tract to be attacked, said Dr. William Muiños, pediatric gastroenterologist and associate director of the Division of Gastroenterology at Miami Children’s Hospital. Symptoms include significant weight loss, severe pain in the abdomen, diarrhea and fever.
“Socially, it’s very difficult especially being a teenager, and you have to go to the bathroom five times during math class,” Muiños said.
Crohn’s disease is one of many digestive conditions that are common in children and teenagers.
Dr. Mario Taño, pediatric gastroenterologist at Joe DiMaggio Children’s Hospital in Hollywood, separates children’s digestive problems into two groups: Functional, which are caused by poor diets, lack of activity, irregular bathroom visits or outside stimuli such as stress; and disease-related, which are caused by a disease.
The stress factor
When it comes to functional digestive conditions in children, back-to-school stress is as much of a culprit as diet or inactivity.
“We do see an upswing of pediatric abdominal pain with the weeks after starting school,” Muiños said. “These are real phenomena that are related to external stimuli in the world. When kids go to school, especially the little ones, they get some separation anxiety. They are going to meet a new teacher, and they are nervous about that.”
Irritable bowel syndrome (not to be confused with inflammatory bowel disease, which is a general term for a disease-related condition) is a functional digestive disorder that may target the upper or lower bowel. While non-peptic dyspepsia occurs in the upper bowel and results in the production of more acid, spastic colitis is in the lower bowel and results in cramps and diarrhea without any evidence of inflammation in the digestive tract, Muiños said.
A change in the child’s diet can help treat both — high-in-protein foods like egg whites and fruits are better than sugary cereals and chocolate milk.
Ignoring the urge
Constipation is often seen in younger children, who tend to avoid going to the bathroom even if they get the urge, Taño said.
“Eventually, since you are eating every day and not pooping every day, it ends up hurting when you have to go,” he said. “It turns into chronic constipation.”
Taño recommends his young patients try to go to the bathroom at least every other day.
When a young patient with cramps or irregular bowel movement first walks into Taño’s office at Joe DiMaggio, the doctor asks a series of medical-history questions.