Help. Is this a flare?

[Momof3boys]

Hi,
My son is 7 and was bumped up to 25mg methetrexate 3 weeks ago from 15mg, added 325 mg ferrous sulfate at the same time, continues on folic acid, Prevacid, and multivitamin.
I think he had the stomach flu earlier this week as he was exposed. Home sick Monday, Tuesday, and Wednesday feeling nautious, vomiting, no diarrhea, tummy pain. He felt better Wednesday night until bed and then thought he might vomit and had watery diarrhea X1. The GI doc gave us zofran when we bumped the methetrexate so I gave him some when he was sick. Yesterday he went to school even though he wasn't eating much as all and his stomach hurt. No fever....although he has had low grade at least once a week for months. He had diarrhea at school several times he said and once right in his second grade classroom. His teacher is amazing and handled it well. Last night he had diarrhea twice more and is is light brown/tan and foamy. We have a scope scheduled for the end of October to check on how he is doing. Do you think this is just the stomach flu still or should I call GI?He is needing zofran daily due to nausea and tummy pain. I hate watching my kid go through this we have been playing with meds since February when he was diagnosed. Thanks for your guidance in advanced. Sincerely, Concerned Mom

 

[Charlotte.]

Hi Momof3boys,
I'm sorry your son does not feel well at the moment. I've had a bit similar symptoms a while ago (which you can see in past threats if you like; and most of the symptoms returned) and I was not sure whether my GI was right that it was just the stomach flu or a flare-up but now it's pretty clear that it's a flare-up (well, of course, my GI thinks, there was the flu prior to that but it was just the beginning of the flare-up which I now know for sure). It can be really hard to distinguish and of course, the flu can take up to a few weeks but so can a Crohn's flare-up and - as you probably know yourself - even much longer.
I would now try to focus on treating the symptoms until the scope is done. Maybe there is also a chance to draw some bloodwork before and to test calprotectin? I would call your son's GI as well, if possible.
Did your son try ensure in the past? It can be really helpful and there have been studies that it's also effective if it is not used exclusively but only additionally. It helps things settle down and did help me with diarrhoea, nausea and cramps after a week I would say.
What about vegetable mash such as potato mash, it helps my Crohn's symptoms, maybe you should give it a try for a day and see if symptoms improve and slowly go back to normal food? Or Moro's carrot soup which helps with stomach flu (studies have shown its effectivity)?
Has your son had stomach symptoms such as nausea before and has he had gastritis issues?

 

[Momof3boys]

Thank you for listening and your suggestions. I think it's so complicated. He has autism too....high functioning but autism. He can't unfortunately have ensure....he's allergic to the corn ingredients in it. He has never eaten soup, well not since he was 2. Sensory issues and it is a HUGE fight to get him to eat new foods. We did a feeding clinic for over a year to increase the foods he eats.
When he feels ill he gets defensive, aggressive, and anxious. Yesterday we had a blood draw the third time this month and it was awful. He has been so tough with other draws but with all the GI symptoms this week he just lost it. He tried to run away, was screaming, crying and terrified. I felt awful. We were at children's hospital and they really were trying but it took 1 hour, 3 nurses, and 2 pokes to get his blood. 2 weeks ago when his blood was drawn it took less than 5 minutes and not a tear. That is how I know he is miserable. He's not himself.
I am going to call GI on Monday if he still has symptoms. I do think his Crohn's is a prime factor in this. I'm just praying this will all be better soon. Thank you again.

 

[Momof3boys]

And yes he frequently has gastritis symptoms.