Toddler w/ GI issues- any btdt? Possible gluten allergy?

[tribe pride]

Background: DS2 is 20 months old, and has had pretty consistent diarrhea for about 2 months. The past 3-4 weeks he has also had a splotchy rash around his mouth (sometimes around his eyes, too, although not as bad), lots of mucous, and a persistent barky cough. The diarrhea was terrible around T'giving, then got a bit better for a couple of weeks, but is back with a vengeance this week. We took DS to a pediatric GI dr, and he was tested for c dif (which he was exposed to in our church nursery), as well as a few other generic viruses that I'm not sure of the name. All tests came back negative. I'm in the process of making an another appointment with the GI dr to talk about the diarrhea recurrence and other symptoms.

The doctor did say that some of DS' symptoms could indicate a gluten allergy/intolerance. At first DH and I didn't think that was likely, as DS has been eating bread, pasta, etc. since he was a baby and has had no intolerance symptoms until recently. But now, with the recurrence of symptoms, and the fact that they haven't ever really gone away and more things seem to be bothering DS, we're wondering if gluten might be the problem. We haven't been giving him anything new or different to eat, and I'm starting to keep a food diary for DS. And I'm considering going gluten free for him for a couple of weeks to see if he improves.

As a side note, DS1 is allergic to peanuts, tree nuts, milk, and eggs, and DH is allergic to shellfish and also has ulcerative colitis. So allergy and GI issues are nothing new to us, and DS2 is at higher risk for having these issues to begin with.

So... all that to say, any btdt? Anyone have a DC with GI and/or gluten issues? How did you determine what was wrong, and what kinds of things should I be prepared to ask the dr about when we get in for our next appointment? It may be nothing at all, but DH and I both agree that something just doesn't seem right with DS, and that this has been going on longer than for just a regular virus.

Thanks for any advice/thoughts!

[wendibird22]

No BTDT experience with a child, but have been traveling the gluten free journey myself for the past few months. There is a great wealth of info on the Celiac.com forums and a special forum for parents/kids that I think would be a great place to get some advice: http://www.celiac.com/gluten-free/

IMO I would hold off on the gluten free diet until you get into the GI and get testing unless you/your ped think it best. Being GF will impact the test results and can result in a false negative. You have to be consuming gluten on a daily basis for at least 3mos in order to testing to be reliable. You'll want to find out what testing is most reliable for toddlers since some of the standard celiac testing is more reliable in adults. You might also want to consider an allergist for testing since a wheat allergy is very different from a gluten intolerance.

[wimama]

The two biggest things that come to my mind are gluten and milk.

I am lactose intolerant and did not become lactose intolerant until I was in high school. It came on suddenly. I used to drink lots of milk, but then suddenly I was getting sick all the time with diarrhea. I went to a specialist who told me he could do a bunch of test on me or I could just try eliminating milk for a few weeks and see what happened. I chose the later and my symptoms went away. I do not have a dairy allergy. I can eat dairy if I take a lactase enzyme pill like Lactaid with the food. I think a lot of lactose intolerant kids lose their ability to digest milk at a few years of age.

Probably the easiest way to test things out is an elimination diet. I would consider going GFCF and then add back in either gluten or casein and see what happens. Or you could try just going lactose free for a week or two before going gluten free.

[babyonbrain]

maybe lactose intolerance. I had a severe case of food poisoning (would have went to hospital if we weren't stuck in the forest) and had sever cramping and diarrhea even after being treated with antibiotics and stool samples never found anything. Doc couldn't figure it out and just labeled it IBS, however I read on line that sever food poisoning can cause damage to intestine villi, resulting in lactose intolerance. I did not have milk intolerance prior to the food poisoning. I cut out dairy and the symptoms went away. In my case I don't know if the food poisoning just happened to coincide with the sudden onset of lactose intolerance but it seemed awfully suspicious. Since your child just had an exposure to C. diff, he may have developed an intolerance to lactose in the same way I did. You may want to try a dairy free diet for a week to see if it makes a difference.
good luck, hope your little one feels better soon.

[amldaley]

DD is lactose intolerant and has a milk protein sensitivity, though not fully allergic. She had those EXACT SAME SYMPTOMS from age 12 months - 29 months when she was drinking milk, eating milk products, etc.

The red rings around his eyes are what make me think dairy vs gluten.

[wellyes]

I'd try going dairy-free as a start.... if that's the culprit you'll see results quickly. Gluten intolerance takes much longer both to ramp up and for symptoms to ease.

[pinkmomagain]

The fact that your dh has UC is a big flag, IMO. Given you dc's issues and family history, I'd stay on top of my ped gi appts. My oldest has UC. I would not remove gluten as, if your dc has celiac, gluten needs to be in the diet to get an accurate result from a biopsy (gold standard testing)....not as scary as it sounds. If I were you, I would remove all dairy to see if that plays a part at all. Food diary is also a great idea. I would keep a record prior to your appt with the ped GI so that you are armed with some helpful information.

[tribe pride]

Thanks, everyone, for sharing your thoughts and experiences. It's really helpful!

To clarify a bit, I guess I should have mentioned that, due to DS1's milk allergy, DS2 is also on a dairy-free diet. He does have regular dairy yogurt once or twice a week, but other than that only has soy cheese, milk, bread, etc. I have been lactose intolerant since college but am able to tolerate yogurt due to the live enzymes/bacteria in them. I was thinking this would also be the case with DS2 if he is lactose intolerant, but maybe that's not the case? I'll try taking yogurt out of his diet and see if his symptoms improve at all. Thanks for the thoughts on that, lactose intolerance hadn't really occurred to me! I'm pretty sure he doesn't have a milk allergy, as he has never had hives, breathing problems, etc. when we've given him anything containing milk. (Which is what happened when we gave DS1 milk as an infant. And he had terrible eczema and red eyes since he was breastfeeding and exposed to dairy that I was eating.) Although perhaps DS2 could have a more mild allergy?

Thanks especially for the advice concerning gluten issues. I will plan on keeping DS's diet the same until we see the GI dr, so that he has some gluten in him if they run tests. The thought of a biopsy or colonoscopy for him makes me pretty nervous- he's so little! PT&P are appreciated- I made a dr's appointment today for next Tuesday, so hopefully we'll know some more then. Again, I really appreciate everyone sharing their thoughts; it's so helpful to have others' perspectives!

[chlobo]

I would definitely pursue it with the GI. Both the dairy and the gluten issues. I have heard that many people who are sensitive to milk are also sensitive to soy. So it could be the soy you are substituting for the milk that is causing the problem. Also, even small amounts of milk are enough to trigger symptoms in some people and milk takes 2-3 weeks to clear your symptoms so it still could be the small amount of yogurt that he's getting.

That said, I have heard that testing in young children can be very reliable. So if the testing doesn't yield any results the real gold standard is elimination and provocation. If you eliminate a food and the problem goes away and then you reintroduce and the problem comes back you have a definitive answer, regardless of what the GI or testing says.

I recently came across these articles, one about celiac and one about gluten sensitivity:

http://www.glutenfreesociety.org/gluten-free-society-blog/biopsy-testing-for-celiac-disease-completely-flawed/

http://www.glutenfreesociety.org/gluten-free-society-blog/science-finally-confirms-gluten-sensitivity/