Brief Answer:

Iron deficiency and gastritis.

Detailed Answer:

Hi!

I have gone very carefully through your query. Your child's problem seems to be due to gastritis.

Make sure that she has a sizeable breakfast before leaving for school.

An overnight long gap between meals would essentially lead to accumulation of stomach acids (which are meant to help in digestion but the food simply does not come).

The excess acids thereby collect and irritate the stomach walls which leads to throwing up. Iron pills are known to precipitate gastritis.

Our gastrointestinal tract has a forward propulsive movement (peristalsis) that moves the food material forward as it is digested, absorbed and finally expelled as feces.

If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe and on the other hand the bowel habits would not be proper. This would make her nauseous, tired. The tiredness on the other hand is more due to iron deficiency.

In order to provide relief, you need to ask for the following:
1. Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.

2. Give Lanzol Junior tablet (Lansoprazole)/Nexium (Esomeprazole) once daily before breakfast.

3. Give plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like Isabgol/Psyllium husk or Senna. I would insist you to increase the dietary fiber intake.

4. Regular playing or exercise for at 1 hour a day to keep the bowel movements proper.

5. Give curd or yogurt on daily basis. It contains beneficial bacteria and should help.

6. Give her Iron rich foods.

Good sources of Iron include:
1. Liver.
2. Meat, fish and tofu.
3. Iron-fortified breakfast cereals or bread.
4. Eggs.
5. Pulses and beans.
6. Nuts and seeds.
7. Dried fruit - such as dried apricots, prunes and raisins.
8. Wholegrains - such as brown rice.


Hope that helps.

Regards,
Dr. Diptanshu Das, Pediatrician

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