Children’s digestive health is foundational to their overall growth, cognitive development, immunity, and dayto-day comfort. Digestive issues in children—ranging from functional constipation and reflux to diarrhoea and food intolerances—can disrupt their ability to learn, play, and thrive. With the new school term underway, it’s an opportune time for pharmacy teams to play a proactive role in supporting young tummies and reassuring parents who may be concerned about their child’s gastrointestinal wellbeing.
Pharmacists are a cornerstone of community-based healthcare, and their expertise places them in a unique position to promote, support, and manage digestive health in children. As trusted professionals with direct access to the public, pharmacists can bridge the gap between concerned caregivers and more specialist services when needed.
Community pharmacists are often the first healthcare professional consulted when a parent is worried about their child’s digestive symptoms. Whether it’s a baby with colic, a toddler who’s constipated, or a school-aged child with frequent tummy aches or reflux, pharmacists can assess the situation, provide clinical advice, and help families determine the best course of action.
Importantly, pharmacists are trained to recognise red-flag symptoms that warrant urgent referral to a GP or paediatric specialist. Signs such as persistent vomiting, weight loss, blood in stools, severe abdominal pain, or failure to thrive should never be overlooked. Pharmacists’ ability to triage these cases accurately protects children’s health while easing the burden on GP practices.
By providing timely advice and identifying serious cases early, pharmacists help ensure that children receive the appropriate care as efficiently as possible.
Managing Parental Anxiety and Misinformation
Digestive issues in children are often distressing for parents, particularly if the symptoms are chronic or interfere with school attendance, sleep, or eating. In the digital age, many parents turn to the internet for answers— sometimes encountering unverified or misleading information.
This is where the pharmacist’s role as an educator and trusted advisor becomes vital. Pharmacy teams can provide parents with reliable, evidence-based information, helping to dispel common myths and clarify confusion surrounding digestive conditions, medications, and nutritional management. For example:
• Myth: All tummy pain in children is caused by food intolerances.
• Fact: Functional abdominal pain is far more common, especially during times of stress like returning to school.
Pharmacists can also guide parents through treatment plans prescribed by a GP or consultant, explaining how medications work, when they should be taken, and what side effects to watch for. This is especially important in chronic conditions such as gastroesophageal reflux disease (GORD), food allergies, coeliac disease, or irritable bowel syndrome (IBS).
Common Digestive Conditions Seen in Children – A Pharmacist’s Overview
1. Functional Constipation
This is one of the most common issues seen in children, particularly during school terms when routines change and toilet avoidance becomes common.
Pharmacist’s role:
• Encourage good hydration and dietary fibre intake.
• Support families with the correct use of laxatives.
• Advise on toilet routines and behaviour modification techniques.
• Refer when constipation is chronic or associated with other red flags (e.g., weight loss, blood in stool, failure to respond to OTC treatment).
2. Infant Colic
Often self-limiting, colic is distressing but not dangerous. However, it can cause significant anxiety in parents.
Pharmacist’s role:
• Offer reassurance and advice on feeding techniques.
• Discuss options such as simethicone drops or hydrolysed formulas if appropriate.
• Ensure red flag symptoms are ruled out (e.g., persistent vomiting, poor weight gain).
3. Reflux (GORD)
Gastro-oesophageal reflux is common in infants and can persist in older children.
Pharmacist’s role:
• Explain differences between physiological reflux and GORD.
• Recommend nonpharmacological strategies like upright feeding and burping.
• Advise on appropriate use of alginates or acid-suppressing therapy under medical supervision.
4. Diarrhoea and Gastroenteritis
Acute diarrhoea can spread rapidly in school environments.
Pharmacist’s role:
• Educate on the importance of hydration and use of oral rehydration solutions.
• Counsel on infection control (hand hygiene, exclusion from school).
• Recommend zinc supplementation where appropriate.
• Refer if symptoms persist or signs of dehydration are present.
Gastroenteritis, often referred to as the “stomach bug,” is a common, usually self-limiting illness in children. Caused by viral, bacterial, or (less commonly) parasitic infections, it typically presents with diarrhoea, vomiting, abdominal cramps, fever, and malaise. Norovirus and rotavirus are the most common viral culprits, particularly in childcare and school settings, where outbreaks can spread rapidly due to close contact and shared surfaces.
Pharmacist’s Role:
As first-line healthcare providers, pharmacists can guide parents through the safe and effective management of gastroenteritis at home. The mainstay of treatment is oral rehydration therapy (ORT) to prevent or correct dehydration, especially in younger children who are at greater risk of fluid loss.
Key advice includes:
• Encourage small, frequent sips of oral rehydration solutions (ORS), which contain balanced electrolytes and glucose to aid absorption.
• Continue breastfeeding or formula feeding in infants.
• Avoid sugary drinks and undiluted fruit juices, which can worsen diarrhoea.
• Watch for signs of dehydration: dry lips, sunken eyes, reduced urine output, and lethargy.
Pharmacists should refer urgently if any red flag signs are observed, including:
• Persistent vomiting or inability to keep fluids down.
• Blood or mucus in stool.
• High fever or listlessness.
• Symptoms lasting longer than 3–5 days.
• Signs of moderate or severe dehydration.
Some parents may request antidiarrhoeal medicines, but these are generally not recommended in children under 12 years.
Pharmacy teams should explain why supportive care is preferable and reinforce the natural course of viral gastroenteritis.
Hygiene Advice
Prevention is just as important. Pharmacy teams should take every opportunity to promote:
• Regular handwashing with soap and water.
• Disinfecting toys, surfaces, and toilets during outbreaks.
• Exclusion from crèche or school for at least 48 hours after the last episode of vomiting or diarrhoea.
Vaccination against rotavirus, introduced in Ireland in 2016, has significantly reduced the burden of gastroenteritis in infants. Pharmacists can support awareness and adherence to vaccination schedules as part of public health education.
5. Food Allergies and Intolerances
Lactose intolerance and food allergies (e.g., to milk, eggs, nuts) may present with GI symptoms.
Pharmacist’s role:
• Help parents identify potential triggers through symptom diaries.
• Support safe food elimination under medical or dietetic supervision.
• Advise on nutritional supplements if required.
Promoting Treatment Adherence and Long-Term Management
Adherence to prescribed treatment regimens in children can be a challenge. Taste preferences, fear of side effects, or misunderstandings about the need for long-term use can lead to poor compliance. According to ElRachidi et al. (2017), pharmacists are instrumental in supporting adherence in paediatric patients.
By taking time to talk through treatment plans with both children and their parents or guardians, pharmacy teams can reinforce the importance of consistency and address concerns in a non- judgmental way. This collaborative, supportive approach can prevent treatment failure and promote better long-term outcomes.
In addition, follow-ups at the pharmacy can act as informal check-ins—particularly valuable for families managing chronic digestive conditions.
Appropriate Use of OTC Medicines in Children
Pharmacists and their teams are well-placed to guide families in choosing safe and ageappropriate over-the-counter (OTC) medications for digestive symptoms such as:
• Constipation: Treatments may include lactulose, macrogols, or glycerin suppositories depending on the child’s age, symptom severity, and duration.
• Diarrhoea: Oral rehydration therapy is often first-line, with careful monitoring for signs of dehydration.
• Acid reflux and indigestion: Antacids or alginate-based products may be considered, but should always be weighed against the child’s age, frequency of symptoms, and medical history.
Pharmacists also play a critical role in ensuring that correct, weightbased dosing is used—especially in infants and toddlers where even minor overdoses or underdoses can have significant consequences (Conn, 2021). They can review other medications the child is taking to avoid harmful interactions or duplications (Ireland, 2016).
Probiotics – A Supportive Option for Gut Recovery
Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit to the host. In paediatrics, they are often used to support digestive health, restore gut flora after illness, and manage certain gastrointestinal conditions.
Other Potential Uses in Children
Beyond gastroenteritis, probiotics are being explored in a range of paediatric digestive issues:
• Antibiotic-associated diarrhoea: Probiotics may help maintain gut flora balance and reduce disruption.
• Infant colic: Some studies show promise for certain strains in reducing crying time.
• Irritable bowel symptoms: Though data are mixed, some children may benefit from strain-specific products under medical guidance.
Product Selection and Safety Considerations
Pharmacists should ensure probiotic products are:
• Strain-specific and supported by clinical evidence.
• Suitable for the child’s age group.
• Stored correctly (refrigerated if required).
• Free from allergens if the child has food sensitivities.
Education and Public Engagement Initiatives
As accessible healthcare professionals, pharmacists can play a key role in public health campaigns, particularly at the start of the school year when many digestive issues are exacerbated by changes in routine.
In-store events, school talks, and collaborations with local GP practices or dietitians can amplify awareness. Topics might include:
• “Back to School Bowel Health” week
• “Healthy Lunchbox Tips for Happy Tummies”
• “Understanding Probiotics for Children”
Educational materials and targeted campaigns using leaflets, digital screens, and social media can further support outreach.
Written by Dearbhla Walsh, Pharmacist
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