Posted 01 November 2001 - 07:53 PM
All,I'm going to tell a long story that leads to a sequence of events related to this board, please bear with me. I'm hoping these events are familiar with some of you and can offer me some knowledge and or insight to address this problem.I have a 7 year old daughter who has had chronic D her entire life. At about age 3 we attempted to get a diagnosis from her GP, he had a few stool tests run, all came back normal and never followed through with it after that. 2 years ago, we relocated and made a commitment with a new doctor to pursue the issue and hopefully get it resolved.With a referral, we contacted a GI who, again, did a few stool tests and dropped the ball again. So we spun our wheels until February of 2000 when my daughter got real sick. One Friday after school, she came down with a fever and an ear ache. I immediately took her to the Dr. and had them check for ear infection as she's got a history of chronic ear infection as well. He was wishy washy with the diagnosis, saying she didn't have a full blown infection but her ears were red. He put her on Augmentin and by the following day, the fever was gone and she seemed to be getting better. By Sunday, she was complaining that her stomach was hurting and was functioning mostly normal for the first few days of the problem i.e. eating, drinking, and going to the bathroom normally, well for her anyhow. By Tuesday, her stomach did not get better, she was crying in pain that her stomach was hurting. She vomited for the first time since this started. Her appetite began to get less and less, her drinking also cut back. With her chronic D, she really needs to maintain a high liquid intake to keep hydrated.About 5 days into it, she appeared to be getting better, she was eating and drinking somewhat normally again, by this time we had stopped the Augmentin as it has possible side effects of abdominal pain and distress.We left town the following weekend for a family gathering at a distant resort. She seemed well that Thursday night but by Friday afternoon was again complaining of her stomach. By Friday evening she was getting lethargic and wanted to only lay down. Saturday she continued to get worse eating and drinking less, but still seemingly to go to the bathroom normally. Saturday evening/Sunday morning she was awake crying in pain again. She attempted to vomit but didn't as she tends to fight it. We almost took her to the ER but she managed to calm down and get back to sleep.By Sunday morning, she was a tired, lethargic mess. We had a 4 hour drive home and immediately took her to the ER once we got home, they took xrays, urine, and blood. The X-ray showed an 'abnormal' amount of material in her intestinal tract and that was all that the Dr. offered. There was some initial speculation that she had a blockage or twist in the intestine. The blood and urine were showing that she was getting dehydrated, which with her D and lack of drinking was not too surprising. Other than that the labwork came back normal. He suggested a follow up with her GP, the following day and if she got the stomach pain again to bring her back in so they could x-ray while it was occurring.Well later that night/morning, she again woke up in pain, and this time, she did vomit. My wife took her to the ER and essentially they sent her right back home as the Dr. who had seen us earlier was no longer on shift and any of his notes were seemingly ignored. The Dr. during this visit was more concerned about her chronic D and focused on that. My wife insisted that she has been like this her whole life and that for her it is normal. The following day, my daughter slept the entire day on the couch, up until the follow up with her GP. After review with him of her condition and her, now 11 day ordeal, he admitted her to the hospital for dehydration. She vomited again at the hospital, shortly after being admitted, only this time she wasn't complaining of major pain, it just happened. About an two hours after her IV, she began to improve, and started to become more alert and awake. While she was at the hospital, her GP had called for a GI consult. It appeared that her chronic D condition had finally sank in and we now had the support of her Dr. Suffice it to say, that 2 days later, after many urine, blood and stool tests all of which came back normal minus a small amount of blood in the stool, which was expected given the trauma that her insides had gone through, she went home. The Dr.'s never did figure out what was wrong with her. They all suggested a virus but I found that next to impossible as neither my wife, I, or our 3 year old at the time had gotten sick. To this day, it still nags at me as to what the hell it was.Now to the GI, we continued to see him for quite some time after the hospitalization. He ran many more stool tests on her, she was tested for Chron's, Cystic Fibrosis, Celiac Sprue, malabsorption, and others that my brain can't recall. Everything came back normal. We tried dietetic changes with no effect. We tried lactobacillus with no effect. He eventually closed her case and diagnosed it as IBS. He has prescribed loperamide, the active ingredient in immodium, up to 16 MG a day. This was effective, for a time. We were giving her just 2 mg a day(1 pill) which seemed to work in the beginning but seems to be becoming less and less effective. At this point I'm giving her up to 3 a day and her BM's are as frequent and cosistency is the same as before she went on the medication.She continues to thrive and remains in the 75th percentile for her age group. So at this point the chronic D doesn't appear to effect her growth, it's just an inconvenience if we're out in public. We vacation a lot, in particular Disneyland and it's real frustrating to be in a line for a ride and have to find a bathroom for her. A quick rundown of her symptoms - just chronic D, several times a day, often yellowish chunky alon g with what I can describe as whisps of material in it, I don't know what these could be, they almost appear as undigested skins of vegetables or something, it's hard to describe. It doesn't appear as the mucous that others speak of here. She has never complained of stomach pain other than the hospitalization incident.So, my question to you all is, does this single hospitalization incident combined with the chronic D sound like IBS or just chronic D? Is just chronic D one manifestation of IBS? Will having her on loperamide for the rest of her normal life have a bad effect on her? This is assuming it remains effective with an increased dose. Do any of you have children with this condition? If so, do you have any suggestions for alternative treatments? I hope this doesn't ramble too much. I appreciate any helpAt the end of my rope,-John
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Guest_John Wolf_*
