India's children are facing a silent gut health crisis, warns paediatric gastroenterologist

Children's gut health may be affected by changing food habits, increased screen time and reduced outdoor activity, with recurring digestive complaints often going unnoticed by parents. Dr Ekansh Agarwal, Consultant Paediatric Gastroenterologist, Hepatologist and Endoscopist at Girish Nursing Home and Endoscopy Centre in Bareilly, Uttar Pradesh, highlights the importance of gut health during childhood and the everyday habits that may influence it.

According to Dr Agarwal, the gut does much more than digest food. The microorganisms living in the digestive system help break down food, absorb nutrients and keep harmful organisms at bay. Maintaining a healthy balance of these microbes is particularly important during childhood, when the body is growing and developing.

Changes in children's daily routines may put their gut health under pressure. Dr Agarwal points to frequent consumption of packaged foods and sugary snacks, excessive screen time, reduced physical activity and fewer opportunities for outdoor play as factors that may affect the balance of gut microbes.

Frequent or unnecessary use of medicines, including antibiotics, may also influence this balance. When everyday habits do not support a varied diet and an active lifestyle, the gut environment may become less resilient.

Gut-related problems do not always appear as severe stomach pain. According to Dr Agarwal, children may experience recurring abdominal discomfort, feeling full too quickly, changes in bowel habits or a reduced appetite.

Other concerns, such as persistent tiredness, frequent illness, difficulty concentrating or



unexpected changes in mood, may also deserve attention when they occur alongside digestive symptoms.

These signs can have several possible causes, so they should not automatically be attributed to gut health alone. However, recurring or persistent symptoms should not be dismissed, and parents should consult a healthcare professional when they are concerned.

A healthy gut microbiome plays a role in digestion, nutrient absorption and immune function. Dr Agarwal notes that an imbalance in the gut may be associated with inflammation and changes in the body's immune response.

He also highlights possible links between gut health, allergies and metabolism. These relationships are complex, and digestive symptoms alone do not establish that a child has a microbiome imbalance. Recognising persistent problems early can help families seek appropriate medical advice rather than allowing symptoms to continue unchecked.

A varied diet containing fibre-rich foods is one of the everyday steps that may support gut health. Dr Agarwal recommends foods such as oats, apples and broccoli as sources of fibre that can help nourish beneficial gut bacteria.

Yoghurt and fermented foods such as sauerkraut may also provide beneficial microbes, depending on how they are prepared. Parents can focus on offering a balanced variety of foods while limiting packaged snacks that are high in sugar and salt.

Antibiotics should be used only when medically indicated and as advised by a healthcare professional. They are important medicines when needed, but unnecessary use can affect the gut microbiome.