At end of my tether with Toddler Diarrhoea - help (sorry if TMI)

[bookbird]

Hi,

DS is almost three, he's never done a solid poo in his life, we often get partly digested fruit and veg etc in his nappies.

Repeated trips to see GP have got me a referal to the Children's hospital where I was met with "don't worry, it's just toddler diarrhoea, he'll grow out of it but have some imodium syrup" (Which I binned almost immediately). The Gastroenterologist at the hospital did test for Coeliacs's disease and that came back negative

We've been waiting and hoping he'll grow out of it but I started to lose patience and I've got an appointment for him to see a homoeopath in a couple of weeks.

The situation is now getting worse rather than better. The poo is exactly the same as it's always been (huge and sludgy ) but it's now actually burning his bum. He had poo in his nappy for twenty minutes this afternoon and his bum was red and very sore when I took the nappy off. He's off to bed walking like a cowboy, and I feel like I'm letting him suffer like this, how patient do I need to be, surely something can be done? (I expected a referal to a dietician at least). I think he has a very good diet, all homemade meals and I'm doing all the tricks like brown bread as a blotting agent, no apple juice etc and he doesn't get "rubbish" Any advice pleeaasse?

DS was like this, things improved dramatically when I cut back milk and yoghurt (he was a bit addicted).

Can you keep a really detailed food and poo diary and see if there is a particular things that causes his poo to be bad. I have done with ds and as you said, apple juice a big baddie, also too many tomatoes. Also try not to go mad on the fibre and brown bread as it can make things worse rather than better. Poor boy though I do sympathise. DS is a bit better now but still runny, and often liquidy. Have you done any potty training, ds was better out of nappies at least the poo gets right away from his bottom quicker. Sorry if any of this is already done by you.

I had this with DD1 it went on for a long time and I share your pain! We saw GP and after keeping a food diary we decided it was a malabsorbtion of fructose. We stopped apple juice, but also grapes and honey (which she had a lot of) and she recovered immediately. Look up Fructose Malabsorbtion and see if he eats a lot of any of the foods mentioned.

HTH

We've had this with DS1 from about 13 months till now - 2.8. Can be really demoralising sometimes. You can see stuff in his nappy that sometimes gives a transit time of 6 hrs.

At first tried some experiments with cutting back on milk, no cows milk for a fortnight, fruit juice ban. They made no difference. GPs and HVs (and also the more senior Nursery people) all very relaxed about it so we've just got on with it. Did drive us from washable to disposable nappies though .

We sometimes get the sore bottom problem - that's got better as he's got older, I think because he's got better at being obvious when he's doing a poo, or asking to be changed, so we've had less 'sitting about in poo' incidents. Have just used sudocreme or conotrane cream and it has usually fixed it. Maybe try for a bit off nappy-off time at a time of day when he doesn't usually poo? Might help.

The only thing I now really try to avoid is weetabix. The wheaty bits in the poo slick just stick like concrete. All around his willy. Yeauch and really nasty for him as I scrape away if can't realistically be left till bathtime... oh the joys of motherhood.

I think it is starting to get a bit better - but I have thought that sometimes before and we've been back in to real runny phases again. I've read that it can last until they're 4, and one GP told me that he might just be 'on the loose side' for life - but reassured me that this was better than constipated tendency. Oh good.

Interestingly, we've been potty training since last weekend and DS1's tactic has been to hold on to both poo & wee as long as possible then produce vast quantity, occassionaly on potty. So we had no poo for 3 days, then no poo for 2 days - massive intervals for him. These are the only two occassions I've seen proper formed stools since he was 13 months. But I don't think it would be very helpful to train him to hold on like that!

Thanks Total and Lanky,

I kept a few food/poo diaries last year, but no-one even looked at them. I don't see any links to particular foods myself. He does eat an awful lot of fruit and I've tried to cut back on citrus fruit and grapes. Last year I tried a month without dairy but poo was just the same, I'm a bit worried about excluding things .

Hadn't thought about tomatoes lanky - I do make lots of tomato based meals. Might try cutting back on that.

Potty training is a joke in our house. I don't think he has any bowel control (he frequently tell's me he's "pumping" when he's pooing). I suppose I just want referred to a dietician who can advise me on how to exclude foods and identify the issue. I think it's some kind of intolerance but I'm having no luck identifying what it may be. Worried I'm making things worse

Er - apols for spelling - I occasionally make mistakes!

Thanks niggle, off to look up fructose malabsorption.

Stirling, you could be me . Lol at cloth to disposables - DS is 2 3/4, we've used cloth until now, but he's off to bed in a disposable (justifying to myself that it's cut higher so kinder to his sore bits)

Also - have you read this? UK GP info

GRAPES!!! That's what did for DD. I found them such an easy fruit and she loved them, she had them all of the time, it made such a difference when we cut them out.

I reckon it is worth going back to basics with food. Give him plain things not too much mixed together IYSWIM and see if there is a direct correlation. If he is a good eater, that is.

What upsets ds's bowel = apples, apple juice, ornage juice, too many tomatoes, sweetcorn (entirely pointless vegetable IMHO), chocolate.

Is he ever sick? was he a sicky baby?
I think you can ask for GP to refer you to dietician or maybe even ask HV.
Good luck

Incidentally, like stirlingstar's ds, mine poos much less often now PT'd, once every 3 days if all normal. Obv more often if xp or MiL has given him apples, choc etc against my advice (silly beggars). Poos are not solid in the way of the LO in the toddler book who put a poo on a shelf (!) but a bit further back on the Bristol scale

(hmm, lovely reading!)

My DS is never sick and eats like a horse. I'll try plainer eating and I'm going to go back to keeping a food diary and will take it from there, thanks.

Looked at Bristol scale, great reading for a Friday night . DS is definitely a 6

Went through a stage of this with DS (albeit he was younger than yours) and the thing that really did start to make the difference was when we increased the fat in his diet.

Our diet tends to be quite low in fat and though we gave him full fat milk and yoghurt, otherwise he ate the same as us, very lean meat, I drain anything after frying/browning, very little cheese and so on.

I read something on TD which said that increasing fat might help to keep things in their system for longer, tried it and it really did the trick for us.

So might be worth a try... Hope you fix this soon, it is so miserable for them isnt it?

I gather you've already heard it form lovely mners - but another vote for detailed food and poo / symptom diary. We found out the very hard way - before I discovered mn - that ds1 was totally intolerant to dairy products, it took us til he was 20mo to figure it out
Good luck

Girl we are fighting the same battle. My DD is kind of recovering. If I follow a strict diet of carrot, bananas, rice, soya milk, soya custard and soya yoghurt and steamed chicken she is fine. Carrot juice is also fantastic (nobody else in the house tries to steal it from her).

The method? very old, tried and tested in the family and on me when I caught the tourista in Spain [wink} It works!

It can be linked with an allergy. DD has a milk and all dairy products intolerence and it started when I stopped breastfeading.

Gp said, as long as she has dhiarroea milk products should be excluded anyway, even when we did not know about the intolerence.
So he put her on soya milk. The diarrhoea took 4 to 5 days to improve when we stopped dairy and used the bland diet.
...and her mood has dramatically improved since she is better
All the best...you can do it!

Hi tulipe, you sound like an expert - HELP! DS is 2.4 and was lactose intolerant as a baby until the age of 1.2. He has always done runny poos, and TMI ALERT, they often smell like vomit (what does that mean??!). I have always thought it's something we have to live with and haven't done much about it. However for the last week his poo has been like water and we have had to throw away numerous vests and trousers and had a hideous accident in Tesco. The GP insist he has a virus. I think it's more than that. The diet you describe - is that literally all your DD has? Nothing else at all? I am willing to try anything now.

And stirlingstar - thank you - could not work out what all the stuff clinging to his willy is - bloody Weetabix!

hi doggus,
No expert but milk and gluten intolerence in the family. For my mum appeared late in life and diagnosed at 60+
the carrot/rice/banana/soya diet is only until you get rid of the dhiarrhoea.the first time it took about 2 weeks to get to that stage and then GP told me to try milk again
when dd is better she can have everything (but dairy in her case). I tend to give her a lot of rice/meat/veg. I am at the stage where she is better and we are waiting to see the dietetician to see if she is only intolerant to milk or to all dairy and how to replace milk.
If your DS always has runny poos it might be worth checking he is not intolerant to milk or other food again, or trying to get referred to a dietetician again.
Good luck

Just wanted to say that though long term diarrhoea might be due to an intolerance such as the dairy or fructose as described above, it also might not. ALL the advice we've had and published evidence that I've read said that a child who has it who is otherwise thriving, playing & growing well etc is very likely to just have diarrhoea as result of immature guts - it will not harm them and it will clear over time, though the fruit/fat/fibre diet guides help in many cases. So if cutting dairy etc hasn't helped, and your DC seems healthy otherwise, don't fret about the poo. Peg nose and get on with life...

Excellent advice tulipe, I am going to get him to a dietician. We have been giving him Lactofree and he seems slightly better today. I shall try the exclusion diet next time (not going to go down well with a child who loves his yoghurts, and hates his meat!).

stirlingstar - so it could be completely normal? That would be great news, if he just grows out of it. I am almost immune now to the stench!

Yes - apparently not that uncommon either. The more experienced people at our nursery have def seen it before, for example. I'd say certainly worth considering dairy intolerance etc, but you may fine that exclusion makes no difference.

The link I put above has some simple diet guidance to try which could be done with dietician referral as is not extreme. It didn't make much diff
to us as think we do the fruit juice and fibre stuff most of time anyway. Have to say I've not tried going for v high fat - not quite sure how we would as ds1 doesn't really like cheese and already gets full fat milk etc and creamy sauces. Post above has made me think about this again though.

There's a good paper in the Arch Disease in Childhood - will try to find reference but might be referenced in link above, which basically gives summary of recs.

Thank god for this thread!!- DD is 3.7 yrs now and we have been living with this prob on and off for 2 yrs now (sorry not v. encouraging I know) To cut a massively long and tedious story short DD had twisted hernias at 10 weeks and emergency op and also a possible intersusseption of the bowel at 7 months of age which supposedly corrected itself. She has also had several large doses of abx in her time (both for the prob at 7 months- initially treated as suspected menigitis- don't ask!!) and repeated ear infections. Anyway- there are several reasons why her poor little bowel may well have suffered and is therefore inflammed/immature/ prone to bouts of prolonged diarrhoea etc etc.

Have been under paed- had diary free diet for several months at one stage, which initially helped then not. tested for coeliac, lactose intolerance etc- all negative and therefore toddler diarrhoea diagnosed. We were advised to potty train at 2.4 months by paed due to her poor bum being red raw from repeated diarrhoea and for several months had to live with the rather messy consequences!! (Sorry TMI) After several months and reading the above toddler diarrhoea link somewhere- matters improved when we decided that fruit juices, tomato sauces, dried fruit, too much veg/fruit in combo, too much rich diary food and choc etc set things off and adjusted her diet accordingly.....all much better- until NOW-

pretty much out of no where we are suddenly back at squre one with explosive diarrhoea at least once a day- the poor child doesn't stand a chance. It is getting harder to deal with now as she is older and i went to bed in tears for her last night. Have started writing everything down again and think that the problem is probably lack of fat in the diet again- will try putting her back on full fat milk (we all have semi-skimmed usually now) and someone else at work suggested cornish-type ice cream made with cream- full of fat etc- worked with her DC's with similar prob, so will also try that.

Anyway sorry to hijack but just feeling very down about the whole thing at the moment and decidedly fed up when friends in RL have absolutely no idea....

stirlingstar - many thanks for that link. Yes it is hard to get enough high fat into them - my ds doesn't eat cheese either....

elizabethsmum - just wanted to empathise and say you are not alone! I woder why it has suddenly started again? She might have a bug? I know there is a bad tummy one here in Dorset at the moment. The only thing I have found that is like a magic cure for the raw red bum is plain old Sudacrem. I tried all the newfangled stuff and did not work for us.

thanks for reply doggus- wondered whether might have been a tummy bug- although she has been otherwise fit and well. Have had various relapses before but this one is proving longer to crack. I guesss that in children with this problem, if there is any type of upset to the status quo, as there is a problem with the general ability of the bowel to cope, whether down to immaturity or whatever reason, the slightest upset sets it off balance and takes a while to recover back to normal IYSWIM? Main problems before have been when she has been full of cold, warned by pead that this would be the case, but not so much a sniffle recently

We found the best cream to be Metanium - we had it prescribed by GP but you may be able to buy it over the counter.

In our case, any antibiotic wrecks dd2's gut for about 6 weeks afterwards.

High fat diet, and take the wholemeal bread out of the equation...small children cannot absorb it. My son was like this and it was awful until I did the above.