How many watery bm is too many ?

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my little penguin

my little penguin

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Back story lots of abdominal pain
Ds was placed on EEN Monday
Told to try to decrease miralax
Had been having 2-3 watery bm last weekend

Loose bm Monday cut to 1/4 capful
Still loose Tuesday stopped miralax
Wed no bm
Thursday a few pebbles - gave 1/2 capful miralax
Friday no bm gave 1 cap Friday
Started augmentin ear infection
Today 1 cap this am
So far 7 extremely watery bm
Only three doses of abx
And two caps of miralax never ever give him that much watery bm
Maybe one loose stool but not this :ack:

So how many watery bm are you permitted a day before you have to call on call Gi. ?
:shifty:
I thought it was more than 10 - not sure ? ???
Not dehydrated drinking formula all day plus water but lips are cracked and bleeding from his cold/sicca syndrome

Hate this !
 
I think our GI nurse said after 10 watery bms in one day to call. C has never hone stay had this problem but this was after his surgery so may not apply to non surgery issues.
 
We call if it's 10-15 - depends on how she looks. But I generally only call if it lasts two days.

That said, M has a feeding tube, so we can run pedialyte through that and so I worry less about her being dehydrated.

M has had that kind of reaction to antibiotics but in that case, I waited a couple days to make sure it was the abx and not something else. We had to switch to a different antibiotic and that worked (I can't remember which antibiotic it was that caused the problem).
 
Grace had something similar. They said dehydration even though she had plenty from formula and water.
She ended up in the hospital that time but she's never had watery diarrhea.
They said her body was taking water from other areas in her body and using it areas that needed it more.
I'm still not sure how that works but that's what they said.
 
E gets diarrhea with antibiotics if she doesn't take Florastor. But if your son's started before the antibiotics, it sounds like something else is going on (but the antibiotics probably are contributing too). Hope it clear up soon--you guys deserve a break.
 
Augmentin is a huge culprit for diarrhea. I agree with 10 being the number.
You might also want to call the pediatrician and see if they can give a different antibiotic. One that is not known to hurt the stomach as much.
The problem with augmentin is the second part which is called clavulonillate (may be misspelled) makes the first part which is amoxicillin stay in your system longer so it can work better but it is very rough on the stomach. None of my kids can tolerate it.
Maybe ask for a cephalosporin instead, like Cefzil.
 
Thanks Kim
We are on ER watch now
He had 13 bm yesterday and 3 so far today
Talked to his Gi this morning
Can't switch abx
Last year ear infection tried omincef first then added zpack on top of that
Ended up with mastoiditis ( same ear )
Iv drugs and later augmentin were used to clear it
Gi is trying to balance things now but we are to keep giving abx unless he ends up admitted
 
Oh no. I hope they find an answer quickly. Poor DS. Done you know what testing they are doing? Sending hugs your way!
 
Bloodwork stool studies and urine
Waiting for stool studies they think infection
So bowel rest until we get results back
 
How are things today?

A had 3 stomach bugs in a 6 week period. It was horrible. This seems to be a bad year for that.
 
Just waiting for his Gi to call with a plan
Currently using pedialyte /formula combo but not where he should be at all
 
He was on bowel rest today ( clears only )
Right now he has no nutrition source

The key will be Friday if he tolerates formula or if the diarrhea starts again
So have to wait to see
 
Not really
Two days of flagyl and he is only able to drink 1000 calories
He is suppose to consume 2000 calories

He has a few days to increase formula at home but not many
 
Mre is complete and now we wait for results

Found out ensure clear therapuetic nutrition is an option when the kiddo is on clears only
Not a complete nutrition but better than Popsicles for days

Ds actually likes the apple flavor and this is a kid who hates any juice especially apple juice
 
Small amount of inflammation found in terminal ileum
Going to watch as inpatient over the weekend and more than likely scope on Monday
 
Oh ...
And FC was 79 on April 18th for a ref range of normal up to 160

So apparently that test is useless for him
Sed rate - 9 ( up to 20 normal )

Just very annoyed the testing didn't pick it up at all
 
my little penguin said:
Oh ...
And FC was 79 on April 18th for a ref range of normal up to 160

So apparently that test is useless for him
Sed rate - 9 ( up to 20 normal )

Just very annoyed the testing didn't pick it up at all
Click to expand...

Was CRP and other blood tests such as Hb and ferritin done?
 
Crp 0.04 which is below the normal range 0.08 -0.76
Hgb was 13.3 bottom of normal is 13.5 so not really low
Ferritin was done in March I think at 18 -normal 10-....
Ferrying has been dropping but he stopped iron supplements last April and his ferritin has been dropping since
But he has inflammation from arthritis as well
All other labs were perfect
His labs are always perfect

10 plus watery D a day is not his norm at all
Which is why they are doing lots of other tests
 
my little penguin said:
Crp 0.04 which is below the normal range 0.08 -0.76
Hgb was 13.3 bottom of normal is 13.5 so not really low
Ferritin was done in March I think at 18 -normal 10-....
Ferrying has been dropping but he stopped iron supplements last April and his ferritin has been dropping since
But he has inflammation from arthritis as well
All other labs were perfect
His labs are always perfect

10 plus watery D a day is not his norm at all
Which is why they are doing lots of other tests
Click to expand...

I understand you. I believe and hope that the scope would provide answers. I send my best wishes to him.
 
Hope the scopes help you figure out what's going on. Any thoughts of doing something like TPN to get some nutrition in while you wait for results?
 
Offically scopes /pill cam scheduled for Monday

He was permitted to switch to peptamen Jr from clear ensure
Since both were causing lots of abdominal pain and he likes the taste of peptamen Jr better
 
Scope in the am
Talk of possible tpn if scope looks visually good
Anyone do tpn ?
What do I need to know?

Asked Gi to trail elemental formula first though
 
O did tpn. You know the drill and can google with the best of them. Infection risk is the big concern. Second is some organs shutting down but they monitor those carefully. Refeeding syndrome anyone? When o went septic some wondered if the infection was from her line but in the end it was her blown apart intestine that caused the sepsis and organ shut down. Well maybe the mal nutrition shut down the organs. Who knows. I forget but I think it was 15-20% of people who get infection from tpn iv die from it. But I tend to think it depends on what you had that required the tpn to begin with.

If his nutritional status will support it, I might trial formula also. Trust yourself. You are a smart cookie!
 
M developed Refeeding syndrome (but with elemental tube feeds, not TPN). They will monitor very carefully for it - blood work done three times a day while we were in the hospital. They generally monitor for around 5 days, but because she developed it, we ended up staying in the hospital for 10.

She was given IV phosphate and potassium to counter the drops in her electrolytes and was eventually put on a oral phosphate/potassium supplement (and stayed on it for several months).

They told us that they monitor for Refeeding syndrome with MANY kids but very very few actually develop it.

No experience with TPN here.
 
MLP,
Sorry to hear all that has been going on. Haven't been online in a few days.
Caitlyn had TPN only for short time. I really hope they the scopes and pill cam give some answers. Good luck with it all tomorrow!
 
Scopes complete
Visually good
Switching to elemental formula
Waiting for pill cam and biopsy results
 
MLP, I'm sorry, I've missed this entire thread! I'm so, so sorry you've been dealing with all this! I hope he's able to tolerate the formula. Will be thinking of you and sending lots of hugs...:ghug: :ghug: I wish I could do more! :hug:
 
Everything was clear -pill cam and scopes
So crohns is good
Elemental formula seems to improve things
Still some minor issues but watery bm seemed to have stopped mostly

At least he is out of the hospital after a week and half
 
So glad to hear that the scopes were clear and that you're back home. I hope that the new formula continues to help.
 
Glad he's home and improving! :D (But, frustrating that tests couldn't pinpoint a cause. :()
 
my little penguin said:
Everything was clear -pill cam and scopes
So crohns is good
Elemental formula seems to improve things
Still some minor issues but watery bm seemed to have stopped mostly

At least he is out of the hospital after a week and half
Click to expand...

MLP, I am very happy for him. I am sure he would go back to school soon. The very best.
 
Having lots of trouble drinking the elemental formula orally ...
And still having watery D
So no solids at all
 
Really sorry to hear that your guy is still having diarrhea and having to drink elemental formula. That stinks. Hope things improve soon!
 
Dme sent a new flavor /kind elemental which ds can actually drink today
:dance::dance:
He just started it this afternoon

One less thing to worry about. :)
This kind is suppose to constipate kids
So maybe. Just maybe things will be normal in that department
Have to watch and wait
 
That's what I was wondering too. Also stool tests can miss infectious agents- sometimes you need multiple samples.
 
He was admitted for 2 and 1/2 weeks
Placed on antibiotics (flagyl ) just in case the infection didn't show in stool tests and multiple c diff /stool tests all negative
Never improved symptoms
Watery D stopped on clear fluid
Only to return when any proteins ( ensure clear or peptamen Jr ) were added back in
Given it only returned with protein introduction and his severe food allergies
They tried elemental formula ( neocate Jr)
The one with prebiotics ( fiber ) increased abdominal pain and one watery bm a day
Just switched to plain neocate Jr without fiber and no more diarrhea - actually no bm which hasn't happened in almost three weeks .

We follow up with Gi in a few weeks
But Gi was hinting at severe protein intolerance .
The amount of solid foods he has been able to tolerate has decreased significantly over the past year and proteins even more so .

No signs of infection or crohns
 
Kim
They did test for csid since they were scoping anyways
The results are not back yet .

Has severe constipation at this point
 
Poor guy (and you!) :( I'm so sorry you're still not seeing improvement in how he's feeling. :ghug:
 
Really?
How much miralax does he take daily?hasnt He been on miralax a long time? Why would this just happen suddenly?
 
So ds had 9 bm on sat and 22 on Sunday
Gi wanted him in for an emergency appt today

Very good Gi appt

ds is complicated so lots of theories Including malabsorption due to pancreas insufficiency

equals lots of tests and more bloodwork

keeping ds on a short leash -Gi's goal is to try to keep him out of the hospital while we figure it out if possible

so continue no foods and try to get all the testing done

At least Gi agrees something is wrong and didn't say "IBS"
 
Glad to hear that your GI is serious about finding the cause of this. Good luck with the testing--hope you figure it out.
 
MLP!
I am also glad to hear he is taking this serious. I didn't think miralax was causing this. Keep us,posted
 
Good. I felt my blood pressure rise when I heard "Miralax". Thoughts and prayers for your DS and learning a solid cause so you can start the work of healing.
 

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