Toddler with chronic diarrhea.

[Laurene]

Hello all! I am new and would appreciate some advice. I have three kids, but my question is regarding my 21 month old, Malia. When Malia was about 4 months old she developed extremely watery diarrhea. We found out she had C. Diff., but even after treatment her diarrhea continued. They retested and the C. Diff had indeed cleared up, but months later she still had diarrhea the consistency of brown water. They had us giving her probiotics, but it did not seem to help. At 6 months when we tried to add food she had no interest and she was dropping in her weight curve. At about 8 months it resolved and she seemed healthy and fine, but it started again at about 11 months. Same thing "brown water" and what little food we could get her to eat seemed to come out looking like it did going in. At 12 months her height and weight curve had both gone down. Her weight went from 50th percentile to less than 1% and her height had gone from the 50th to the 10th. The Dr had us start feeding therapy because she was still not eating well. Told us to give probiotics for diarrhea. At 15 months her diarrhea had improved some. It was still diarrhea, but better than brown water. At 16 months it suddenly resolved again and she started eating like we had been starving her. At her 18 month check up her weight was at the 50th percentile again and her height was up to the 20th. She's been doing very well since and I thought we could put it all behind us. Well, 2 days ago she stopped eating well. I know toddlers can have ups and downs in their appetite so I wasn't too concerned, but this evening she started having her brown water diarrhea with undigested food again. I'm going to wait until Monday to take her to the Dr, but I really don't think it's a bug ... It's just her "normal" diarrhea returning.

Other points - she also gets bad diaper rashes and anal fissures with the diarrhea. She is a little cranky, but doesn't seem otherwise ill during these episodes.

Could this be Crohn's? Something else? Any advice or tips would be greatly appreciated. How do I talk to the pediatrician to get them to investigate this further than testing for C. Diff? I feel like something isn't right.

Thanks so much for taking the time to read/respond. I apologize in advance for my ignorance.

 

[Catherine]

Welcome to forum, sorry you had to find us.

Has your daughter seem gi?

There will be others long shortly who know more.

 

[Laurene]

No, the pediatrician has always been more worried about her bit eating so they sent us for food therapy and never really followed up on the diarrhea. I'll take her in Monday and see if I can get a referral though.

 

[farfalle5]

My daughter as a baby had diarrhea and was diagnosed with allergic colitis and was put on a elemental formula and that cleared it up. I also did not start feeding her solid foods till she was 2 1/2 I kept her on the formula(this was to give her digestive system time to grow and heal). Are you seeing a GI dr or just a ped. I would recommend a GI dr for this problem you are having. Hope this helps

 

[Catherine]

Where are you? Eg what country.

Calling Dusty, hopefully she will be long shortly now I mentioned her name.

 

[Laurene]

I'm in the U.S. TX to be exact.

 

[Jmrogers4]

I have to agree with the others. Have her see a GI and hopefully get some answers and on the road to feeling better. They could probably run a fecal calprotectin and at least test for inflammation. Have the done any stool testing recently

 

[Laurene]

My daughter as a baby had diarrhea and was diagnosed with allergic colitis and was put on a elemental formula and that cleared it up. I also did not start feeding her solid foods till she was 2 1/2 I kept her on the formula(this was to give her digestive system time to grow and heal). Are you seeing a GI dr or just a ped. I would recommend a GI dr for this problem you are having. Hope this helps

She was primarily breastfed until a few months ago, but I had to wean her because I dried up. They were considering a feeding tube at one year when her height and weight got so low. So far we have just seen the pediatrician and feeding specialists. Hopefully we can get in with a GI dr soon.

 

[Laurene]

They haven't done stool testing recently. We had several months of normal stools and hoped all of it was in the past.

 

[Catherine]

There are lots of great parents here some of them have real little ones.

Does your daughter have other medical issues or mouth sores or rashes?

They done any blood testing?

 

[farfalle5]

She could have it from breast milk or regular milk, sounds to me like what I went through with Maddie. You need to take her to a GI dr, they will probalby do blood work and stool samples. I just dont understand why your ped did not send you to a GI dr sooner.

 

[Laurene]

I haven't noticed rashes (other than the diaper rash from the diarrhea) or mouth sores.

Farfalle5, I'm pretty frustrated we were never sent to a GI Dr. I'll look into allergic colitis. I just want my little Bug healthy.

 

[Catherine]

What was ped treating her for?

I am just trying to get some more information for the more experience parents when they come along.

You do need a gi.

 

[Laurene]

Well here most kids see a pediatrician as their primary Dr so initially it was just well baby visits. They decided she may not have been eating because of a sensory disorder, so we were going to get help with that, but as soon as the diarrhea stopped she would eat. I think she just doesn't want to eat because her tummy gets upset. Otherwise she is healthy and has met all of her developmental milestones on time.

 

[Clash]

It sounds the same to me Laurene, and I think you are heading in the right direction by getting a Ped GI. I think I would insist to the GP that you want to explore that avenue as well as with the allergist. That way you will have two specialist working to get to the bottom of your sweet one's problems.

MLP, will probably be by at some point and she has alot of info on food allergies and such as well as IBD.

I hope you get answers for your little one real soon! And welcome to the forum!

 

[Catherine]

Your question could it be crohn. Yes it could be crohn but it could also be alot of other things. What makes you think it crohn?

The referral to a gi is the first step to finding answers and getting your girl well.

 

[Laurene]

When I was researching chronic diarrhea, crohns kept coming up and I also read that it can have periods without symptoms. I don't know a lot about any of it, but it just seemed like a good place to start looking. Y'all have confirmed for me that we need to look harder for sure so hopefully I can convince her pedi of that. Thanks so much for everyone's help. I'm going to sleep for now, but will check in tomorrow and keep everyone posted.

 

[Catherine]

Sleep well

 

[Farmwife]

Hi and welcome.
My little Girl is Grace and she's undiagnosed as well.
She how ever goes to the other end. Constipation. One thing with IBD, no two kids are alike.
Grace had c. diff and I have read two report on c. diff inducing permanent colitis. Sorry I lost the studies.
C. diff can be tricky. It can hide in the folds of the intestine and flare up when the gut flora is disturbed.
Does you kiddo have joint pains?
I hope she get's better and you get into a GI soon.

Oh by the way, Grace has small lapses of remission as well. Now sadly to say they don't last to long.
Pm me any time with question if you wish.

 

[DustyKat]

Hi Laurene and :welcome:

I am so very sorry to hear about your little one...:hug:

You have been given wonderful advice and I can only reiterate the need for your little girl to see a paediatric gastroenterologist. I also think faecal calprotectin is a good base test to get you started.

In the interim and if you aren't already doing so I would suggest that you start a diary. Have a look at the suggestions we have in the wiki...

http://www.crohnsforum.com/wiki/Diary-Inclusions

...tracking symptoms can be helpful when you are searching for a diagnosis and when you are living this day in and day out as you are it is not difficult to forget to smaller details.

Good luck Mum. Please keep us posted with how you are getting on and if you have any questions don't hesitate to ask.

Dusty. xxx

 

[Sascot]

Just wanted to say welcome - no real advice here as we never dealt with poo issues, just tummy aches. I agree with everyone else - a GI doc is the way to go. Definately worth getting the faecal calprotectin done - at least it's a painless test!

 

[izzi'smom]

Just stopping in to say hello...hoping that you get that GI consult...would love for testing to come back negative but would give you some peace of mind at the very least. Did they do bloodwork or a stool sample at the peds office?

 

[my little penguin]

Hugs...
It could be a lot of things getting into a ped Gi / allergist is key.
Gi first
Texas children's is good among others.

Make sure the look into Egids, allergic colitis as well Ibd.
Your breast milk can contain allergens in trace amounts so depending on when she reacted it could be related.
Keep a detailed food diary . Ate x amount at time abc reaction xyz happened at time xyz.
Second the elemental formula .
Neocate
Elecare
Your Gi will prescribe them , give you samples .
I would not start it until you see a Gi and get a scope.
Since the formula will fix it but without knowing what it is the follow on treatments as she ages will .
I recommend you check out parents of kids with food allergis
Www.kidswithfoodallergies.org
To cover the allergic colitis & egids angle just in case - lots of parents who have btdt with babies there.
Apfed.org
Has info on egids as well.

Any rashes hives???

 

[my little penguin]

http://apfed.org/drupal/drupal/symptoms_of_EGIDs

Symptoms of EGID?
What are the Symptoms of EOE?
Symptoms vary from one individual to the next and may differ depending on age. Vomiting may occur more commonly in young children and difficulty swallowing in older individuals. SYMPTOMS MAY VARY GIVEN THE DEVELOPMENTAL ABILITY AND COMMUNICATION SKILLS OF THE AGE GROUP AFFECTED. It is not unusual for it to take several visits to the physician before eosinophilic esophagitis is diagnosed. Some symptoms are common to all age groups.

Common symptoms include:
Reflux that does not respond to usual therapy (medicines which stop acid production in the stomach) – infant, child, adult
Dysphagia (difficulty swallowing) child, adult
Food impactions (food gets stuck in the esophagus) older children, adult
Nausea and Vomiting – infant, child, adult
Failure to thrive (poor growth, malnutrition, or weight loss) and poor appetite – infant, child, rarely adult
Abdominal or chest pain –child, adult
Feeding refusal/intolerance or poor appetite – infant, child
Difficulty sleeping due to chest or abdominal pain, reflux, and/or nausea – infant, child, adult
What are the Symptoms of EGID?
Symptoms may vary considerably, depending on the area affected.

Symptoms include:
Nausea or Vomiting
Diarrhea
Failure to thrive (poor growth or weight loss)
Abdominal or chest pain
Reflux that does not respond to usual therapy (which includes proton pump inhibitors, a medicine which stops acid production)
Dysphagia (Difficulty swallowing)
Food impactions (food gets stuck in the throat)
Gastroparesis (Delayed emptying of the stomach)
Anorexia (poor appetite)
Bloating
Anemia
Blood in the stool
Malnutrition
Difficulty sleeping

Since none of these symptoms are specific for EGID, and many occur at times in healthy children or adults, the diagnosis is generally sought only after the symptoms have failed to resolve. Eosinophilic disorders can mimic the symptoms of other diseases like inflammatory bowel disease, food allergies, irritable bowel syndrome and reflux, among

 

[my little penguin]

http://community.kidswithfoodallergies.org/displayForum/forum/eosinophilic_disorders

http://www.neocate.com/


http://m.elecare.com/

 

[Laurene]

I can't thank y'all enough or tell y'all how helpful you have been! :rosette2: As I suspected her diarrhea has continued through the night and into the morning. She's eating a little, but not much. I will take her to the Pedi first thing Monday to discuss seeing a GI Dr and allergist.

Allergies were not an angle I had thought of. When she was younger she used to get hives and had to have breathing treatments a couple of times, but we thought it was due to outdoor allergens. Now I wonder. She hasn't had hives since she was 6 months old though.

With the prior two episodes of diarrhea they did test her stool, but I don't know if they tested for anything besides C. Diff. They did not do any blood tests. I really don't know if her joints hurt or even for sure that her tummy hurts (just don't see how it could NOT hurt) because she's not extremely verbal just yet. She didn't sleep well last night and her tummy is noisily gurgly and she just wants to sit in my lap this morning, but she can't tell me what's wrong, which stinks.

Again, y'all have been so helpful. I will start the symptom/food journal and insist the pedi gives us a referral. Thanks for all of your support. Hopefully I'll have good news of a referral to share soon!

 

[my little penguin]

One thing any hives breathing etc within two hours of an ingestion of a food is an IgE food allergy and can result in anaphylaxis . There is no way of knowing who will get just hives and who will progress to death.
Past reactions are not predictive of out ones of future reactions
Anything that shows up after two hours typically is non IgE except for Fpies .
Glad you are seeing the Gi soon.

 

[farfalle5]

Maddie was on both Neocate and Elecare as a baby and toddler. Laurene my best advise to you is getting your daughter in with a GI dr ASAP. The above link to kids with food allergy is excellent I used to be a member to it when Maddie was a baby and toddler. When she grew out of her allergic colitis I stopped the membership. But unfortunaltly for my daughter she was diagnosed with crohns last year. And a new journey of learning how to live with crohns has begun for us.

 

[farfalle5]

That allergy website deals with GI allergies as well as food allergies( or it did when Maddie was a baby/ toddler).

 

[my little penguin]

Kids with food allergies still deals with kids with Gi issues ( related to food allergy or unknown origin) as well as traditional allergies.
Membership is free.
I have volunteered for them for years since my son has food allergies as well.

 

[farfalle5]

Kids with food allergies still deals with kids with Gi issues ( related to food allergy or unknown origin) as well as traditional allergies.
Membership is free.
I have volunteered for them for years since my son has food allergies as well.

I loved that site it helped me help my daughter when none else new what was going on. Going back 8 years noone heard of neocate and elecare my poor little Maddie was the only baby I knew on it. Thank god today more people are aware of allergic coitis severity.

 

[farfalle5]

knew

 

[kimmidwife]

Hi Laurene
Welcome so glad you found us! I agree with the others you need her to see a ped GI ASAP. About the breast feeding even if you feel like your milk is drying up. You still have some in there and if she is interested I would keep nursing her. The antibodies in breast milk probably help her a lot. I have continued to nurse my youngest who we suspect may have crohns and I really believe it h helped her.

 

[izzi'smom]

Laurene, hoping Malia is feeling better today and that you get the referrals you are looking for from the pediatrician!