Kids Gastro Care - Paediatric Gastroenterology Service

31/03/2025

Wow! This was an interesting short read all about poo from the BBC website.
It is always worth checking on your child's poo (and your own poo) once in a while as you can get some understanding of your child's gut health.

Once again the microbiome seems to have a role here as well. More and more research points to the interaction and impact of our gut microbiome on gut function and in the long term also on the body's cardiovascular and neurological systems.

Don't miss out on an easy opportunity to check over your child's gut health...Remember to have a good look before they flush!

It may sound bizarre to some, but take a picture of it if you see something a bit odd. Your friendly neighbourhood GP or paediatric gastroenterologist (Spiderman fan!) will probably want to have a look at what it is you've seen too, make sure you have some decent lighting and zoom in, just please don't drop your phone!!

I discussed some of this in more detail in a Much Ado About Poo blog post a few years back.
https://www.kidsgastrocare.co.uk/poo-in-children-a-simple-guide-for-parents-to-normal-and-abnormal-poo-patterns-in-kids

The ideal poo is a 'type 3' or 'type 4' – cracked or smooth sausage – delivered once per day.

07/03/2025

It was so good to have a refresher on this alternative way to do an upper GI endoscopy or gastroscopy (camera test).
And it was great to catch up with my Adult Gastroenterology colleagues from the Royal Free that lead the way with this.

03/11/2024

This is a fantastic step in the right direction by TFL!

Time and again I have heard this concern from patients and families in my paediatric gastroenterology clinics.

I hear how they are so stressed at the thought of travelling because of a lack of access to toilets on their journey.

It doesn't matter if it is Irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or some other bowel or bladder issue.

Just knowing you can reach a toilet more easily whilst travelling to and from school, college or work, could help transform some peoples lives.

Billie Nicholls, who has ulcerative colitis, says some people don't have the luxury of waiting.

01/03/2024

Returning to the gastro groove again after a long pause to recover from surgery for a sports-related injury.

So it means a lot to receive lovely feedback like this from a family seen in a recent Kids Gastro Care paediatric gastroenterology clinic in Elstree.

31/08/2022

Have you sought advice from an independent practitioner about your child's diet out of a concern it may be having an impact on their health.

Or have you been recommended to see someone about your child's nutritional status or to help you to introduce some dietary changes?

Food and the gut are of course inextricably linked.

Reviewing the diet of a child can be an important aspect of a paediatric gastroenterology assessment.

Making a change to a child's diet can be therapeutic in some situations. For example going Gluten free after a confirmed diagnosis of Coeliac disease by a paediatric gastroenterologist.

Doing this safely and with the support of the correct personnel is essential especially in children so as to avoid unnecesary exclusions from their diet at a time when they are needed for healthy growth.

Here is a great article from the British Dietetic Association that offers a clear explanation about the differences between a dietitian, nutritionist, nutritional therapist and other diet experts.

It is always good to know more about those you're seeking advice from.

Are dietitians and nutritionists the same thing? And if not, what is the difference between a dietitian, a nutritionist and a nutritional therapists?

14/08/2022

Great to see an updated guideline on Eosinophilic oesophagitis (EoE) published this month in Gut journal, one of the leading publications in the field of gastroenterology. EoE is a condition that affects people of all ages. The way it presents itself in (younger) children can be vague and vary with age including feeding issues and refractory reflux. In older children and adults, it is a common cause of food getting stuck in the gullet. Once a secure diagnosis has been made with endoscopy and biopsies, therapy is based on dietary changes or medication use.

Background Eosinophilic oesophagitis (EoE) is an increasingly common cause of dysphagia in both children and adults, as well as one of the most prevalent oesophageal diseases with a significant impact on physical health and quality of life. We have provided a single comprehensive guideline for both....

27/07/2022

What a brilliant initiative from Guts UK. A fantastic charity that aims to promote our digestive health by funding research into our entire gastrointestinal system including the pancreas.
A Poo-torial !

Helps to understand more about poo and what its colour and consistency mean.

Definitely worth a read..help break down the taboo around poo.

There's a taboo surrounding toilet habits, but your poo is an indication of your health. Checking your poo includes being aware of the colour and consistency, but also how frequently you empty the bowels. Be sure to check all three tabs. Please donate today, so we can continue creating empowering to...

01/04/2020

Hello all,

In these unprecedented times of isolation and social distancing, we're all having to get used to a new 'normal'. Travelling in to the hospital these days is a surreal experience, with almost empty roads, and non-stop driving rather than the usual stop-start-stop. Even in peak 'rush hour' times, the journey is just a fraction of what it usually is.

I can't reiterate enough how important it is to follow the official advice to stay at home.

To help with this, my Kids Gastro Care clinics are now using remote video consultations instead of direct face to face clinic room visits. It's part of the way we're all adapting to this situation.

Don't hesitate to be in touch for a no obligation preliminary discussion with me, if you think I can help your child with their tummy troubles. If it's possible to assess things remotely, I'll try my best to help.

In the meantime, please stay at home and keep well!

Dr Dan Crespi

https://youtu.be/MU0KCsVvnIw

Hello! This is a brief introductory video about the Kids Gastro Care clinics with Dr Daniel Crespi. I am a paediatric gastroenterologist, very used to seeing...

26/02/2020

Poo accidents in children...is an issue I frequently see in my Kids Gastro Care clinics. Also called soiling, encopresis and faecal incontinence, it is not often the first thing that families talk about when I meet them in clinic.

Being a 'poo doctor' I have become very used to talking about all aspects of bowel function and poo every day - just ask my kids!
This isn't always the case for many others. There is still a great deal of stigma attached to poo problems in children and adults of all ages.

Poo accidents can be a tremendous source of upset, embarrassment as well as social awkwardness, isolation and shame. They can leave parents frustrated at times as it is difficult to understand how their child can not seem to control their bowel motions. Sometimes children are told that they're being lazy and it can be easy to blame the child for the situation.

I have seen children who needed upward of 6 changes of underwear and clothes a day because of poo accidents. Schools often send children home when these accidents occur. What should be fun childhood social activities such as swimming and sleep overs are limited or even stopped all together for fear of the dreaded accident happening.

In the majority of children with poo accidents, the most common reason for this to occur is constipation. There is often a significant build up of poo within the large intestine (colon) or 'poo factory' as I call it. This is known as faecal impaction. Often the build up occurs in the very last section of the colon called the re**um - a sort of holding area for poo before it is passed out of the body. The impacted faeces sits in the colon and builds up gradually over time becoming more and more firm. Newer poo can sometimes slide past this mass of older poo, and slip out unannounced, as an accident. Sometimes this can be mistaken for diarrhoea.

The re**um becomes more and more stretched over time. The usually sensitive re**um, loses its ability to sense being filled up with new poo as it has been stretched beyond its usual dimensions. Accidents can occur at any time, often seemingly without the child even noticing. To add to an already difficult situation, and because of the close location of the stretched re**um to the bladder, wee accidents can also become a part of the problem.

Often this situation isn't recognised for what it is until late in the journey. A crucial early step is understanding what has happened and explaining how it has developed, using a non-judgemental, no blame approach. This combined with the right type of laxative treatment then aims to clear out - or disimpact - the old mass of poo that's been sitting there probably for some time.

Occasionally, a special type of x ray of the tummy, a so called shape study (colonic transit study) may be used to help clarify the situation and visually demonstrate the build up of poo. The picture shows an accumulation of shapes in the pelvis, in the last part of the colon with a stretched re**um. Other parts of the colon are also loaded with poo. The sensation of needing to go is weakened by this stretch of the re**um and accidents occur regularly.

The good news is that often dramatic improvements can be made when the situation is recognised and then managed appropriately with disimpaction. I have seen children go from having multiple accidents each day to none overnight, with a simple intervention using laxatives to clear out the impacted re**um.

I really feel it's time to break down these taboos around poo and get this issue more widely recognised and then treated properly. Talking about poo with a fun down to earth approach is a start. It is only poo after all...

If you think your child may be experiencing issues similar to those I have mentioned in this post, please do have a look at the Kids Gastro Care website for more information about constipation in children.

The ERIC website, run by ERIC -the Childrens Bowel and bladder charity- is a fantastic resource for families affected by these issues. Please do help support their amazing work if you can by making a donation.

If you'd like to discuss things in more detail in an appointment with me, then please don't hesitate to be in touch by giving us a call.

https://www.kidsgastrocare.co.uk/constipation-in-children

05/02/2020

Every so often, an image on the screen during a paediatric endoscopy, makes me stop and admire the wonders of the human body.
Being grateful for things we take for granted is not always that easy, sometimes we need a reminder, and this image did that for me.
https://www.kidsgastrocare.co.uk/the-view-from-the-inside-paediatric-endoscopy-and-a-moment-to-reflect

14/01/2020

Toilet training in young children. Studies show it happens at an older age and that parents have less and less time to help their children to achieve this milestone. Increasing the pressure to be out of nappies by start of regular attendance at school probably doesn't help. Interesting article. https://www.tes.com/magazine/article/toilet-training-what-schools-need-know

Given that parents are now potty training later, should schools introduce ‘must be toilet trained’ policies? Absolutely not, researchers tell Chris Parr. School staff, they say, should be trained in the issues around toilet training so they can help and work with families

12/01/2020

I came across this on Twitter this week...sums up one of my kids to a tee!