Is nausea normal

[wrrywart]

Is nausea in the morning normal for pediatric crohns. My child has nausea a lot in the morning. Sometimes it clears up and sometimes it lingers and he can't keep anything down and then by afternoon it's gone. Eating and drinking doesn't help. He is on 20mg humira weekly. There doesn't appear to be any connection to doses and nausea.

 

[my little penguin]

For my kiddo nausea /vomiting was indicative of flaring …
What is his weight since he only on 20mg ?
Most kids actually need the adult dose of humira at 40 mg
They burn through it faster than adults

 

[wrrywart]

He is 12 and 80 lbs. GI said he wasn't big enough for a larger dose. The goal is to get him gaining weight so he can be on the 40 mg.

 

[my little penguin]

88 lbs is the max for humira pediatric crohns
It used to be 66 lbs btw when Ds was in on it at age 9 since it wasn’t officially approved for pediatric crohns he got the juvenile arthritis dose
It’s the docs preference

88 lbs is light for age 12
Does he drink shakes ?
Pediasure , peptamen jr or kids boost
My kiddo drank two of those in the am
Was a requirement even if nauseous
Then went to school and ate a normal lunch
Then 1-2 more later in the day after dinner
Helps them grow and gain
Puberty is a very short window
They need all the calories they can get

Ds was dx at age 7 barely 50 lbs
Now 19 and 5’11” /170 lbs
So they can grow
He still drinks 2-3 carnation instant breakfast shakes a day

 

[crohnsinct]

How is his hydration? Dehydration can make them nauseous as can active disease. Hard to flesh out what is what. When were his most recent labs or when are his next labs?

 

[wrrywart]

How is his hydration? Dehydration can make them nauseous as can active disease. Hard to flesh out what is what. When were his most recent labs or when are his next labs?

Labs 1 week ago were all normal. He drinks 20 -30 ounces water a day, plus applejuice. He is chronically constipated that's why he has the juice.

 

[my little penguin]

Constipation can be part of crohns
It is for my kiddo
Daily miralax helps with that
It also contributes to nausea
Nothing moving through makes things push on the stomach
Ds has had daily miralax for 12 years

 

[crohnsinct]

Ahhhh yes! Chronic constipation could definitely contribute to nausea and in that case 20-30 ounces is nothing. It takes quite a lot of fluid to get things moving nicely. Exercise as well. Either way, you could call the GI and just FYI them and see what they say.

 

[asadmom]

Labs 1 week ago were all normal. He drinks 20 -30 ounces water a day, plus applejuice. He is chronically constipated that's why he has the juice.

If your son can tolerate kiwis:
https://www.ncbi.nlm.nih.gov/pmc/ar...it daily are,considered as a treatment option.

There is data that kiwis can help move things along, again, if his body can tolerate it. I don't recommend depending on miralax.

Lifestyle changes like sitting on the toilet daily (without straining) after dinner for 15-20 minutes to retrain the nerves help - this takes about 6 months to completely retrain the body.

 

[my little penguin]

Miralax is not a laxative
It is an osmotic so it simple pulls water from the body into the stool so it’s easier to pass
In my kiddos case (rectal prolapse ) from crohns requires softer stool so miralax is a must to prevent more damage
Constipation just like diarrhea can cause damage to the body when crohns is the cause

 

[asadmom]

Miralax is not a laxative
It is an osmotic so it simple pulls water from the body into the stool so it’s easier to pass
In my kiddos case (rectal prolapse ) from crohns requires softer stool so miralax is a must to prevent more damage
Constipation just like diarrhea can cause damage to the body when crohns is the cause

Laxative or not... there are much better ways to correct and retrain the body before jumping on Miralax or Miralax~similar for that long. I am glad that your son is doing well on Miralax daily for 12 years but I am really speaking to parents who have lots of other options.

 

[crohnsinct]

Fwiw- when my non IBD daughter had bad constipation issues, they used Miralax to help with the bowel retraining. They said we had to make it do sift she couldn’t hold it and then SLOWLY work our way back.

I would talk with your GI about the management of the constipation You really don’t want to risk damage to the anus (fissures, sphincter muscles etc) as you need that area in tip top shape when you have IBD.

 

[my little penguin]

Just as you don’t just add fiber or take an anti diarrheal med to stop diarrhea in crohns patients the same holds true when the constipation is caused by crohns
It’s not the same as regular constipation .
It’s not a retraining issue
Please speak to your Gi
To determine the root of the constipation

 

[Maya142]

My daughter has also been on Miralax for many years due to a motility disorder and constipation with her Crohn’s. In the past, she had more constipation and was on two capfuls of Miralax daily when her Crohn’s flared. Now as she’s grown up, she tends to have diarrhea more when she flares.

Sitting on the toilet every day for 10-15 minutes every day can help retrain the bowel unless it’s inflammation causing the constipation. It’s not a bad habit (in fact, it’s good to make it a habit) but if it’s inflammation causing the constipation, it’s really not going to do a whole lot.

Adding fiber caused a lot of cramping when she had active Crohn’s. So I would be careful with that. Making sure he’s drinking enough water is important though (especially if you add fiber).

I definitely agree that shakes like Peptamen Jr or Pediasure peptide are a good idea to help him gain weight. My daughter was severely underweight due to Crohn’s and the only thing that helped her gain weight was these supplemental shakes. Shakes like Pediasure peptide and Peptamen Jr are semi-elemental (partially broken down) so much easier to digest than Ensure or Boost which are polymeric shakes.

I also want to add that being malnourished can also cause nausea which then makes the child want to eat even less and then you get into this vicious cycle where they’re nauseous, can’t eat, become malnourished and then become even more nauseous.

His Humira dose is on the low end. My daughter was on the adult dose of Humira before she was 88 lbs. in fact we even switched her from 40 mg biweekly to 40 mg weekly before she was 88 lbs. She was 13 at the time. She was probably between 80-85 lbs at the time.

 

[Pangolin]

Magnesium citrate supplements (gummies or capsules) are great for reducing constipation, and most people probably aren't getting enough magnesium in their diets anyway.