You might have deduced it from yesterday’s post, but it appears the parasite may not have been the cause of J’s GI problems, after all. There was a little nagging worry in the back of my mind that the parasite was normal (it’s part of the “normal gut flora” for 20% of people), but J made it awhile without the diarrhea starting back up so I really thought we were all done with this.
J is on week 4 (?) of continuous diarrhea. We have an appt. out of state next week to see a GI who specializes in Loeys-Dietz syndrome (a related disorder with lots of GI issues), but our pediatrician wanted us to see someone local in the meanwhile. Not only is the diarrhea not helping J’s malnutrition at all, but he’s started requesting to eat bowls of crushed ice so I’m pretty sure he’s anemic again.
After looking over all of J’s recent records and asking lots of questions, plus doing a rectal exam and getting an abdominal x-ray, the new doctor sat down and mapped out several possible diagnoses. He said this could be a malabsorption issue, an allergy issue, or “toddlers’ diarrhea.” He ruled out toddlers’ diarrhea right away, given the malnutrition and anemia. The doctor thinks most evidence points to a malapsoroption issue (some of which could be metabolic disorders; crohns and celiac also fall in this category. We have definitely ruled out celiac and crohns does not look likely.) and suggested we start testing for that category first.
Yesterday J had a test to check for bacterial overgrowth in the small bowel. They were looking to see whether his body can break down glucose. It was negative, so now we might have to do it over again to check fructose…we’ll see when we meet with the doctor again in a few weeks, as well as what the out of state expert has to say.
In case your child ever has to do a glucose/fructose/lactose breath test (hydrogen breath test?), here is what you can expect.
First, your child will have to drink a sweet drink. How much depends on your child’s size; J is 25 lbs and he had 4-6 ounces. But, since he can’t drink thin liquids, he had to have an NG tube put in. Warning: it is very sad to watch. You should also know there is the chance your child will gag up the tube, so that it will come out his mouth, covered in snot.
During set intervals, your child will need to breath into a bag. At first it’s every 15 minutes, then every 30. If one of the bags comes back positive, the test ends. Otherwise, the test lasts 3 hours.
There is a lot of downtime. I suggest taking the opportunity to explore the hospital!
That’s basically the whole test! It is a fasting test though, so know that if your child is young, they may be super cranky by the end. J was!