Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|fyrbug08 - Fri Nov 05, 2004 12:09 pm|
My 8 year old has suffered with chronic constipation, periodic painful blisters in her mouth, unexplainable rash periodically, bed wetting every night, delayed gross motor and periodic abdominal discomfort since birth.
She recently had blood work done. Do the levels reveal any chance of Ciliac Disease for her? She seems to exihibit most of the symptoms of the diease that I have read about. I just want to be prepared for discussion and know what questions to ask when we go back to the GI in a few weeks.
Antiendomysial antibody which was <2.5, antigliadin IgG was 2.0 and antigliadin IgA was 0.3. A CBC was normal. She had a sedimentation rate that was elevated at 25. Thyroid studies were normal.
I just recently discovered the gluten tolerance testing. We were not instructed to do this before her blood was drawn. They just drew her blood upon vist, along with abdominal x-ray. They also put her to sleep and performed an anal manometry which they said did not show Hershsprung's Disease. Just a weak sphincter muscle which is common in kids with constipation this long.
My gut tells me there is more going on as I have dealt with this for so long with her.
|Dr. Heba Ismail - Sun Nov 07, 2004 4:43 pm|
I don't quite agree with you that your daughter exhibits symptoms suggestive of Celiac Disease, since it is not known to present since birth, but rather around the age of 6 months to 1 year. That's because the process starts and is provoked by the introduction of wheat and other carbohydrates that contain a substance called gluten, and that can only happen with the initiation of weaning.
Amongst other things is the absence of diarrhea.
Kindly send me more details about her condition, such as what starts the whole process, is she ever free of these symptoms, is there anything that releaves these symptoms? Is she otherwise a normal child? Does she go to school regularly?
How about her brothers or sisters, if she has any? Is ther any positive family history of Celiac?
Also, I would be much obliged, if you could send me the referance range for the lab results you've sent, as this may differ from one lab to another.
|fyrbug08 - Mon Nov 08, 2004 2:07 pm|
Dr. Heba Ismail, M.D.
Thank you so much for your time and your reply.
While I was pregnant with her, I had the Alpha Feta Protein test. It came back elevated so my OBGYN wanted me to have another one. I did and it came back even more elevated. We did an amniocentesis and the doctor who performed it said everything looked good and they would send the fluid to the lab. As far as I know, there was nothing to worry about. I do have those records as well.
At birth she had what they call "a slow transition" or failure to thrive. Her resperations where very fast and she would not eat. Her O2 sat was low as well. She did not have a bowel movement until 24 to 48 hours after birth. I would have to look at her hospital records again to be sure of the exact time. I breast fed her for 4 weeks and then switched to formula and that is when it seems like everything started happening. When she was an infant, she would not rest comfortably throughout the day, but she has always slept through the night. She seemed like she always had some belly pain and constipation. I had to go back to work. She was started on Similac and then finally ended with Allomentum. I was told to mix Phillips in her formula, did that for a while, then used Senecot at night for a long, long time which would occasionally produce a bowel movement while she was sleeping and they were very large. Also used Dulcolax for a long long time. She was weaned off of that and then replaced with Mirilax. Then we tried changing the diet. Her color looked better, but she still has constipation. I went through the total GI workup with her when she was 4 or 5, everything has come back good. She also had an MRI of her spine done with came back ok.
I also just recently found out that after she has been eating breakfast at home before school, then she will eat the breakfast at school an hour later. She will eat dinner at home and then go to the neighbors and eat there. She has been 55 pounds for the longest time. I would think that she would have been gaining some weight with all she eats. She has grown taller though. I believe she is in the 50% of her age. She is constantly drinking water. She doesn't really want anything else to drink. She does wet the bed everynight and has since she was born. I have tried the herbal remedy inhalent and also pills of the herbal remedy. I have also tried a prescribed medication from the doctor, but we had to take her off it as he upped her to the limit and it did no good. I have cut off her water and all fluids hours before bedtime. I have also purchased the alarm to wear at night. Nothing has worked for her night time wetness. She had an ultrasound done and his words were "her plumbing looks fine". Her walking and talking were delayed as well probably by 6-9 months delay then the average child.
Her 14 year old sister has a history of bilateral uterin reflux and a double ureter. She did have a uretral implant surgery performed when she was 6. They also removed her appendix as they thought this was the cause of her illness, but when her white count did not improve they further investigated and found the reflux. She is fine now and has been since the surgery. Her older brother is 20 and he has had nothing significant. Both her brother and sister developed a little sooner than the average.
I don't recall her having diarrhea except when she has had too much of the laxatives. She does pass a lot of gas though. She has a gross motor delay and was evaluated prior to beginning kindergarten and it was advised that she go to preschools with disabilities and not kindergarten. I moved in to a different school system due to a job change and the new district advised me that she would be ok to begin kindergarten. I have just initiated the testing process. However, the school system says that they have to set up an intervention plan and prove that she needs tested. So that is what they are doing now. I go back to meet with the school in December to see if there is any improvement.
She is very good with drawing and loves to sing and dance. We have no relatives with bed wetting or constipation. She goes to school regularly, but I am often called as she has the belly pain from time to time. There is no history of Celiac that I know of.
She is currently in 2nd grade. She is struggling with reading and math. She loves art. She takes ballet and tap as I thought this would help improve her coordination. She loves it but is mad because she, in her words, "can't get her legs to do what her brain wants them to do."
She is not in pain all the time, just right before she has a bowel movement as it will have been a few days since the last one. But the constipation is always there unless she is on the laxative.
How can I obtain the reference range for the lab results? My appointment with the Gastro is not until 2 weeks from now and I could ask for a copy of lab work at that time.
Should I suggest the gluten tolerance type lab testing? Where you have her eat products that contain gluten and then see if there is an elevation like they said would happen if she truly has something like this?
I don't know if there is anything medically wrong with her....I just want to make sure I cover all my avenues and try to do anything and everything for her that I can to help her with these problems that she is having. I know every child is different, she just seems to not be like the other two where.
Again, thanks for your time and concern.
|snc9369 - Fri Jun 24, 2005 10:26 am|
I have no idea if this will help anything for your daughter, but I have recently had to be under a chiropractor's care and he held a spinal care clinic where he talked about the effects of chiropractic care on bed wetting. He has had huge success with his patients. Would you consider taking her to a chiropractor?
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