Celiac disease affects approximately 1% of children worldwide. It is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. When children with celiac disease consume gluten, their immune system attacks the small intestine, leading to damage and impaired nutrient absorption. Symptoms can vary widely and include abdominal pain, diarrhea, constipation, bloating, and poor growth. Celiac disease is often underdiagnosed as symptoms overlap with other conditions. Genetic predisposition plays a significant role, with a higher prevalence in children with a family history or certain genetic markers (HLA-DQ2 or HLA-DQ8). Diagnosis involves blood tests for specific antibodies and confirmation with an intestinal biopsy. Managing celiac disease requires a strict gluten-free diet, which helps alleviate symptoms and promote intestinal healing. Children with Celiac Disease should continue to follow regularly, at least every 6 months, with their Pediatric Gastroenterologist and a Dietician who is well versed with gluten free diet.

Inflammatory Bowel Disease (IBD), which includes Crohn's disease and ulcerative colitis, affects approximately 0.2-0.3% of children in the U.S. and is increasingly diagnosed in younger age groups, even in India. IBD is characterized by chronic inflammation of the gastrointestinal tract, causing symptoms like abdominal pain, diarrhea, fatigue, blood in stools, anemia refractory to oral iron supplementation, frequent episodes of diarrhea and weight loss. The exact cause remains unknown, but it involves a combination of genetic susceptibility, immune system dysregulation, and environmental factors. Children with a family history of IBD are at a higher risk. Diagnosis involves blood tests, stool studies, imaging, and endoscopic evaluation. Treatment includes anti-inflammatory medications, immunosuppressants, and sometimes biologic therapies. Nutritional support is also essential to ensure proper growth and development.

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder that affects 5-15% of children globally. It presents with recurrent abdominal pain associated with changes in stool consistency or frequency. Stress, dietary factors, and gut-brain interaction disturbances contribute to IBS. Although IBS does not cause structural damage, it significantly impacts a child's quality of life. Diagnosis is clinical, based on symptom patterns, and ruling out other conditions. Management focuses on dietary modifications, stress reduction, and sometimes medications for symptom relief.

Constipation affects about 5-30% of children, making it one of the most common pediatric gastrointestinal complaints. It is characterized by infrequent, hard, or painful stools. Causes include low dietary fiber, inadequate fluid intake, withholding stool, or underlying medical conditions. Functional constipation, which has no identifiable organic cause, is most prevalent. Diagnosis is based on history and physical examination, with additional tests if an organic cause is suspected. Management includes increasing dietary fiber, ensuring adequate hydration, using stool softeners, correct positioning while defecation, alleviating fear of passing stool (much more common in younger children) and establishing regular toilet routines.

Chronic diarrhea, defined as loose stools lasting more than four weeks, affects 3-5% of children globally. Causes range from infections and food intolerances to malabsorption disorders like celiac disease or Inflammatory Bowel Disease. A thorough history, including dietary habits and exposure to infections, is crucial for diagnosis. Stool tests, blood work, and imaging may be needed. Management depends on the underlying cause and often includes dietary adjustments, rehydration, and treating specific infections or inflammation.

Acute pancreatitis is rare in children, with an estimated incidence of 3-13 cases per 100,000 annually. It involves inflammation of the pancreas, causing sudden, severe abdominal pain, nausea, and vomiting. Causes include infections, medications, trauma, and genetic predisposition. Diagnosis is based on clinical symptoms, elevated pancreatic enzyme levels, and imaging studies. Management focuses on supportive care, including pain relief, hydration, and addressing the underlying cause.

Jaundice, characterized by yellowing of the skin and eyes, is common in newborns but less frequent in older children. It occurs when there is excess bilirubin in the blood, often due to liver dysfunction, infections, or hemolysis. The incidence varies widely, with up to 60% of newborns developing jaundice. In older children, causes may include hepatitis, biliary atresia, or genetic conditions. Early diagnosis is critical as some of these diseases can progress very rapidly often requiring liver transplants as well. Diagnosis involves blood tests and imaging. Management depends on the cause and may include phototherapy, medications, or surgery.

Gallstones, though uncommon, affect 2% of children and are increasingly recognized due to rising obesity rates. They form when bile components, such as cholesterol, crystallize. Risk factors include obesity, rapid weight loss, certain medications, and genetic predisposition. Symptoms include abdominal pain, nausea, and vomiting, often triggered by fatty meals. Many a times, a child might be diagnosed with Gall stones as an incidental finding on an USG done for some other purpose. Diagnosis involves ultrasound imaging. Treatment ranges from dietary modifications to some medical treatment options to surgical removal of the gallbladder (cholecystectomy) in symptomatic cases.

Children with Autism Spectrum Disorder (ASD) often experience co-occurring medical conditions, particularly gastrointestinal and feeding challenges. Research indicates that 40-80% of children with ASD have gastrointestinal issues such as constipation, diarrhea, or abdominal pain. These conditions may be due to altered gut microbiota, sensory sensitivities, or restrictive diets common in children with ASD. In most children with ASD, it is a combination of all these conditions. Additionally, up to 50% of children with ASD may have feeding problems, including selective eating or aversions to certain textures. Sleep disturbances, which affect 50-80% of children with ASD, can exacerbate these issues. It is critical for children with ASD to have a healthy gut as poor gut health leads to worsening of their behaviors, sleep patterns and participation in different kinds of therapies. Management requires a multidisciplinary approach, including dietary adjustments, behavioral therapy, and medical interventions tailored to the child's specific needs.

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are also prone to certain co-occurring conditions. Approximately 25-40% of children with ADHD have sleep disorders, such as difficulty falling or staying asleep, which can worsen attention and behavioral symptoms. Additionally, 10-30% experience gastrointestinal complaints like constipation or abdominal pain, possibly related to dietary habits or medication side effects. Emotional and behavioral challenges, including anxiety and mood disorders, affect up to 50% of children with ADHD. These co-occurring conditions often require integrated care approaches, addressing both ADHD symptoms and associated medical or emotional issues through medication, therapy, and lifestyle changes