I need help as to where to go please! Infant with Blood loss since 3 Months Old

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I am just kind of starting at the begining...to make is all make sense. I started seeing blood in Emersynes diaper when she was 3 months old. Visible blood. It has continued on and off for 10 months (visibly with what I could see). The Ped brushed it off as being due to the antibiotics I was on at the time, but I took her into see a GI doctor because I didn't feel like that was normal, antibiotics or not.

He decided it was "food allergy" and told me to go off several foods. Visible blood went away, I slowly started eating normal, no blood, she was doing great. I had her stool tested and it came back clean, meaning no blood.

She got an ear infection, went on antibiotics and BAM, large amounts of blood again. Saw th GI doctor and again, he said it was food allergy, and at that point, I decided to see an allergist to actually have her tested because it only seemed to be a problem when exposed to antibiotics. The skin test came back positive for dairy, almonds, peanuts, and oats. So, I cut that out of my diet. The allergist did blood work on her for allergies, and it turns out she has NO allergies in a RAST test, so they decided that she just is very fair, and that it was a false positive on the skin test.

At that point, the allergists consulted together and decided I should just feed her normal, and wean her on to whole milk. About two weeks after we started giving her whole milk, she had blood in her diaper. Again. Quite a bit. So I called the GI doctor, but he was "busy" and leaving town and his assistant said it was "nothing to worry about, unless it got worse."

But I was worried, so I called the Ped to get an appointment for her, and to get some ointment because the poop she has is so acid and so hot it was instantly burning sores on her butt. So I took her in, and while I was there, she did another bloody diaper. A LOT of blood. Like, horrifyingly huge amounts. The doctor was shocked...and all of a sudden, they were on the phone with the GI's office talking to the GI doctor on call, trying to decide whether to hospitalize or not. I spent the next 24 hours scraping bloody poop into containers to "test" for the same things they had already tested. The blood wouldn't stop, so we took her to PCH, which blew her off and sent us home. They told us sometimes babies just have blood in their diaper and blood "can" be normal. NO IT ISN'T!!!!!!!!!!!!

So, at that point, we waited for testing of the stool. It came back "normal" no diseases or infections. I kept her off everything. I still kept nursing her. Well, four weeks ago, she passed some HUGE blood clots. More blood. I think truthfully, there is blood even when it isn't visible most of the time. I actually took some diapers that I didn't see blood in to her ped, and made them test it. They didn't see the need, but I really did. Both diapers tested positive. That was when I really knew there were issues. Generally it is in smaller amounts, but sometimes it is HUGE amounts of blood.

So, I finally agreed to let GI scope her-which freaked me out because I didn't want to put a baby under general anesthesia. (he had suggested to do it three months earlier) The results were very frustrating and concerning.

While her stomach and esophagus look great, her intestines have this "rashy" look to them. When he scoped her colon, she had open bleeding sores, thus the source of her bleeding. But the worst part was that I asked him if she was in pain, and he told me absolutely. She is "inflamed" from her tummy down, plus she has the horrible sores inside her colon. Poop so acidic it burns her butt instantly...this is a really sick baby. I am just sad...and angry, and frankly, very hopeless. I suspect Crohn's.

We got results back yesterday. Basically-we don't know anything more. It is not eosinophil's in her digestive tract-so that is good. But she has horrible inflammation and these bloody sores. I flat out asked him if it was Crohn's, but he told me that while she has the information and sores, she doesn't have permanent damage-yet. He seems so hung up on "allergies" which so far haven't really panned out. So he still wants me to keep her and myself (still nursing) off dairy, oats and nuts, she started flagyll last night for 7 days, and in 3 weeks we are supposed to do a calprotectin test to look at the inflammation, at which time if it is gone, great, if not, he wants to put her on Pentasa for 6-12 months.

This baby has never had a normal poop in her life. every. single. diaper is diarrheah, most often it is bloody (visibly). It smells horrific. It is so toxic it burns her butt and leaves sores if it is not immediately tended to. She started falling off the growth chart as soon as she was born. She was barely 18.6 pounds at 1 year. She is still in 6-9 month clothes at 13 1/2 months old. She has already been hospitalized twice, once at 6 weeks for a high fever and cold, and again at 3 months for severe RSV. She started another fever last night-but don't know why this time. I am so very worried!

So, I guess what I am wondering from you ladies is am I on the right tract? Are we being aggressive enough? What worries me is that he is treating her as a Crohn's patient-without calling her a Crohn's patient. This poor baby is only 13 months old and has been bleeding since 3 months!!! Please, any suggestions or help would be really wonderful.

I have a generally distrust in doctors (REALLY bad experiences)-and I really just need to know if we have found a doctor that really knows his stuff or not.
 
Can you get her a second opinion?
even if its just a paper review- you send the biopsy slides as well as the medical history to one of the top places and they review for you.
Getting a second opinion appt is better but records review can work as well.
The top pediatric IBD centers in the country are Boston CHildren's
Children's Hospital of Philadelphia or Cincinnati CHildren's.
IF the travel to these can't work- National Jewish in Denver Co has a really good GI/Allergy program.

Pentasa is very mild but is a 5 ASA which is generally not effective at treating crohn's as a mono therapy. Most GI's equate using 5 ASA's to giving aspirin for Brain cancer- not going to hurt but not going to help much either.

Have you tried an elemental formula?
Neocate or Elecare

When formula is taken as sole nutrition - EEN -( no other food) it can be as effective as prednisone and reduce inflammation in the gut as long as the kiddo stays formula only.

It is used as standard formula in other parts of the world as a first line of therapy for kids diagnosed with IBD regardless of age.

Might be something to ask your ped or GI about.

give them this paper

http://www.naspghan.org/user-assets...nteral_Nutrition_for_the_Control_of.29[1].pdf

please read some of the other research papers here:
http://www.crohnsforum.com/showthread.php?t=43002


including

*IBD in Infancy - Paper

http://www.iagh.org/Portals/44fa756...3, Number 1, Spring 2008/Dr.Najafi-13-1-1.pdf

http://www.google.com/url?sa=t&rct=...1n9ADBOTTo-DoOGJ_W8zNOg&bvm=bv.57155469,d.aWc


Definitely try for the second opinion ASAP.

If you need any pointers on second opinion let me know.
Ds has had two already.
most good welcome a second opinion.
 
Hi and welcome.

My girl is 4 but much like yours has dealt with this since infacy.

MLP gave some good advice. So no need to repeat that.

BUT..............you brought up eosinophil's and she had none.
Was she still on a food restituted diet at the time of scopes?
 
Hi and welcome.

My girl is 4 but much like yours has dealt with this since infacy.

MLP gave some good advice. So no need to repeat that.

BUT..............you brought up eosinophil's and she had none.
Was she still on a food restituted diet at the time of scopes?

No. She was not restricted on anything but dairy. The allergists determined that there was no food allergy issues-other than possibly dairy. So she was not eating dairy, but I was. (I am nursing). But the GI doctor seems convinced that she has intestinal allergies. This is soooo new to me. I have no idea what I am doing, or what I need to do. I have 9 kids and in school fulltime, and I feel like my life just got flipped upside down.

Immediately after the scope he restricted her diet to chicken, Turkey and some veggies and fruit. No eggs, no dairy, no gluten, no fish, no corn, no soy. Since he got the biopsies back and she doesn't have eosinophil's in her digestive track, he said just dairy, eggs, oats and nuts.

She did however have elevated eosinophil's in her blood work. But I am unclear what that actually means.
 
Can you get her a second opinion?
even if its just a paper review- you send the biopsy slides as well as the medical history to one of the top places and they review for you.
Getting a second opinion appt is better but records review can work as well.
The top pediatric IBD centers in the country are Boston CHildren's
Children's Hospital of Philadelphia or Cincinnati CHildren's.
IF the travel to these can't work- National Jewish in Denver Co has a really good GI/Allergy program.

Pentasa is very mild but is a 5 ASA which is generally not effective at treating crohn's as a mono therapy. Most GI's equate using 5 ASA's to giving aspirin for Brain cancer- not going to hurt but not going to help much either.

Have you tried an elemental formula?
Neocate or Elecare

When formula is taken as sole nutrition - EEN -( no other food) it can be as effective as prednisone and reduce inflammation in the gut as long as the kiddo stays formula only.

It is used as standard formula in other parts of the world as a first line of therapy for kids diagnosed with IBD regardless of age.

Might be something to ask your ped or GI about.

give them this paper

http://www.naspghan.org/user-assets...nteral_Nutrition_for_the_Control_of.29[1].pdf

please read some of the other research papers here:
http://www.crohnsforum.com/showthread.php?t=43002


including

*IBD in Infancy - Paper

http://www.iagh.org/Portals/44fa756...3, Number 1, Spring 2008/Dr.Najafi-13-1-1.pdf

http://www.google.com/url?sa=t&rct=...1n9ADBOTTo-DoOGJ_W8zNOg&bvm=bv.57155469,d.aWc


Definitely try for the second opinion ASAP.

If you need any pointers on second opinion let me know.
Ds has had two already.
most good welcome a second opinion.

WOW! Thank you soooo much for your quick reply! There is a ton of information to go through here! THANK YOU!

We tried Neocate, and we tried to put her on Ellacare, but she refuses it altogether. I have figured as long as I keep nursing her, she is at least she is getting the nutrients she needs right now. Plus, breast milk should be very easily digested-right? Is this not correct?

I am going to look into getting a second opinion for sure. I have read that a lot of moms here have gotten second opinions from Boston's Children's...does insurance cover that? How do I do that? I will start gathering what little records I have so far.

I actually took the Baby to Phoenix Children's ER when she was bleeding (actively for more than 24 hours) and they told me blood in the diaper was normal and they saw it all the time. They didn't even examine her-at all! They told me she was happy and thriving, so, she was fine.

She has been running a fever for two days now. She quit eating after the first dose of Flagyl, but I don't know if it has something to do with the flagyl, or the fever.

I would love more info on how to submit records. Can you request a certain doctor? Is on better than another? Who is the leading expert in this subject?
 
Breast milk is easily digest able but it has whole protein in it from the foods you eat so even if she isn't allergic then sometimes there will still be an issue.
Most kiddos won't take formula if they are breastfed
This includes neocate / elecare
But that said some parents have more luck with a 50/50 mixture of elemental formula and breastmilk other just keep trying different bottle nipples since you need to by pass the taste buds.
Also helps if someone other than mom gives the bottle.
Or if she likes a sippy cup for other drinks ( water juice)
Then give it in a sippy cup.
It can be done.
As far as second opinOn most insurances will cover it.
Just pull up the website for Bch cchmc or chop on their Ibd page .
It will say to contact them call
Once you call they will put you in touch with an intake coordinator whose only job is second opinions basically . They email phone etc with you and explain his to get records released and biopsy slides sent.

Elemental formula is amino acid based . It does not have any intact proteins so it is more digestible than breastmilk . 99.9% of kiddos can tolerate one or the other either neocate or elecare . There are a few flavors plus some moms have put a little sugar in it until the kiddo gets used to it - ask your Gi or ped about it.
 
No. She was not restricted on anything but dairy. The allergists determined that there was no food allergy issues-other than possibly dairy. So she was not eating dairy, but I was. (I am nursing). But the GI doctor seems convinced that she has intestinal allergies. This is soooo new to me. I have no idea what I am doing, or what I need to do. I have 9 kids and in school fulltime, and I feel like my life just got flipped upside down.

Immediately after the scope he restricted her diet to chicken, Turkey and some veggies and fruit. No eggs, no dairy, no gluten, no fish, no corn, no soy. Since he got the biopsies back and she doesn't have eosinophil's in her digestive track, he said just dairy, eggs, oats and nuts.

She did however have elevated eosinophil's in her blood work. But I am unclear what that actually means.

Oh DeeD welcome to my life. You do adjust to the eight free life after awhile.
My Grace has EGE also. That's what they were looking from in your baby probably.
Have you asked why the top 8 free if they didn't find eosinophil's? Plus what if dairy was the trigger??? Some kids only have one. Just trying to give ideas. How about FPIES?


I'll check back in tomorrow. :hug:
 
In allergic colitis, the milk proteins cause a reaction within your baby’s body that irritates his colon (large intestine) and creates small ulcerations in its lining. If left untreated, it can lead to serious problems, so it’s important to diagnose and treat it early. Fortunately, once identified, allergic colitis is quite easy to treat.
Allergic colitis is also sometimes called “cow’s milk protein allergy (CMPA)” or “milk protein allergy.”
Two to three percent of infants have this condition.
While symptoms may appear until a baby turns 6 months old, most babies show signs within the first two months of life. In most babies, the symptoms start off mild and gradually worsen.
Allergic colitis is treated by removing the protein from your baby’s diet, and it usually disappears by the time the child turns 1.
Medication can help your baby’s reflux until she outgrows it.
- See more at: http://www.childrenshospital.org/health-topics/conditions/allergic-colitis#sthash.DMwyWf6F.dpuf

From
http://www.childrenshospital.org/health-topics/conditions/allergic-colitis


Allergic colitis is probably what your gi was referring to.
It is common and can be outgrown
Neocate /elecare can fix it.
 
Did you remove all milk from your diet ?
Anything that had milk listed in the label
May contains items , shared facility items
Things may were made on the same lines that may have been cross contaminated with milk protein ( you would have to call the companies)
Did you pumps and dump for two weeks until the milk protein was out of your system?

Also per our gi allergic colitis can happen in older kids .
It also can happen with any protein milk and soy are the most common.

Elemental formula removes that variable .
Did you try e028 splash from neocate ?
They come in flavored juice boxes not sure about those since she is just one though ...
Might ask your gi
 
High IgE in the blood means your kiddo is more than likely atopic ( basically likely to develop true allergies or asthma or ezcema later in life).
The atopic march starts with ezcema as an infant or toddler ( sometimes true food allergies which are IgE mediated - think epi pen ) then on to asthma and finally pollen allergies.

Allergic colitis is not an IgE immune system reaction which is why your child can have a gut reaction but not be allergic in the traditional sense that shows up on skin/rast tests.
 

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