Should a child be given antibiotics without having a diagnosis?

[Fauve]

We've had a long saga of illness with my ds, just 13. He has stomach cramps on a regular basis, which we are all convinced are food-related (we have kept a food diary, etc). Coeliac disease has just been ruled out, and the paed gastroenterologist wants him to have a week of antibiotics because he seems to think giardia (a waterborne parasite) can't be completely ruled out.

I'm a lentil-weaver, and ds has never had antibiotics. I just can't accept the idea that he should have some now 'in case' he might have this usually tropical disease (ds hasn't been anywhere abroad, except Italy with the school). Surely the doc should be attempting a diagnosis of giardia before banging in the antibiotics? He says tests are unreliable, but I'm not sure I buy that.

Or is it normal procedure?

giardia is common in the uk. Presumably you have excluded threadworms - sorry - don't mean to offend or anything but this is such a common cause of tummyache and it is amazing how many people just don't check.

Has a stool test been done for giardia? Usually giardia causes nausea and diarrhoea as well as cramps. IBS is another possibility, as are stress and anxiety.

I hope you get it sorted out soon. What are your conclusions from the food diary?

Forgot to say that the antibiotics used to treat giardia are vey specific, not broad spectrum.

The tests for giardia rely on an expert parasitologist spotting the wriggly thing down a microscope in a fresh poo sample. Not great. If the antibiotics cure it then the post hoc diagnosis is that it was giardia, which is good enough for docs, but can see how it doesn't impress you.

What did the food diary show?

Do the symptoms tie in with the trip to Italy at all?

Giardia often shows as intermittent diarrhoea and tummy cramps, rather than being there all the time. You may have symptoms for a couple of days, be fine again for a few more then back to pains/trots again. Hope your ds is feeling better soon.

Thanks for all these responses - in a rush now - will respond in the AM!

I do sympathise - I don't know if it helps, but I have always avoided antibiotics etc wherever possible. I have 3 children, and they have all had fewer than 5 courses of antibiotics in their lifetime, and the eldest is 18. However, if I thought there was a real possibility that giardia was the problem, I wouldn't hesitate to treat as advised. It just can't be treated any other way as far as I know. (We have a plumbed in water filter, and have had for nearly 15 years. Bottled water can contain some pretty noxious bugs, but a proper filter is well worth the cost).

The consultant told us that a stool test for giardia wouldn't be any good. Basically he's been very arrogant with us, which is really getting my back up. The food diaries, and our and ds' experience, show a clear link between stomach cramps and eating large amounts of bread or pizza. If I wanted to make him ill tomorrow, I could - by feeding him loads of bread and pizza. He had a biopsy to exclude coeliac disease, which his dad has, and he has the gene; however it appears coeliac disease is not it. The bl@@dy consultant said he would also use the biopsy to test for wheat allergy, then unaccountably changed his tune and said wheat allergy couldn't be tested for by biopsy. Ds is to be tested for lactose intolerance, and then later for wheat allergy, perhaps.

Giardia was suddenly flung into the ring out of the blue. Ds only has cramps, not diarrhoea or nausea. And he's had them for over a year - altho I understand that's possible with Giardia. As it happens - and the doc doesn't know this - giardia is conceivable because ds has done a lot of watersports in a local lake. So I'm not averse to ruling it out, I just wish it could be given a bit more consideration, rather than just bunging antibiotics in him and treating his mum like a moron. If I'm convinced he needs the antibiotics, of course I'll give them to him; but I'd like a few more indications that giardia is a real possibility.

Sorry for ranting . Do you know if giardia symptoms are related to eating? Eg, do they come on if you overindulge? I think I would recognise threadworms, btw - I have experience

Fauve, my brother had giardia (picked up in india) and he told me that it makes fat much harder to digest; he would get pain and diarrhoea if he ate fatty foods....

and that's the sum total of my knowledge, but hope that might be a little bit of help!

oh, and the other thing is that my bro was tested for giardia and given a specific diagnosis. but whether your doc is right and tests are unreliable, I don't know....my bro had to send a stool sample to the institute of tropical diseases in london.

Thanks - that's it; I don't see why we can't send a stool sample of ds' somewhere; I see what MrsBadger says about the difficulty of diagnosing it that way, but surely with a child it's worth doing.

we all got giardia at villa in spain one year, made most of the kids v farty and smelly but I hardly had any symptoms

I don't suppose it ever resolves itself? I wonder if people have it for years and years and years? (I know I'm grasping at straws here.)

I don't think so fauve. just to add something else into the pot - I had IBS as a teenager, after a nasty tummy bug I picked up abroad..ended up on lots of medication for cramping, nausea, intermittent diarrhoea...and only got off all the drugs when I had a fab GP at university who explained to me about the mind/body link in the gut (I did lots of exercise plus used my brain in a different way - did some life drawing which I found incredibly absorbing) and I was off everything in a month. only recently has this post-bug theory of IBS been proven (so a gastro told me recently) but I knew it years ago

Guts, eh? The mystery of the organism. We are pursuing the overall health line, more exercise, postural work, etc; but he's a v happy kid except when in pain.

And as a teenager, he's actually less smelly and farty than most

You can have it for years and years but it never actually resolves itself - the bug just lives on making you slightly ill but not killing you - typical parasite in fact.

If you're in London or the SE ask to send a sample to the Hospital for Tropical Diseases, or if you're further north the Liverpool School of Tropical Medicine.

Yes, thanks, I think I will insist on a sample being sent off before resorting to antibiotics. We are in London, and we're covered by dh's health insurance, so we can do that. I guess the consultant is used to parents popping the antibiotics without making a fuss, maybe.