Thursday, August 23, 2012

Poopy

When I was pregnant with Micah, friends of our family sent me a cool journal that I could keep track of each doctor appointment while pregnant, and each appointment for Micah after I had him.  I loved this journal so much, that for each subsequent pregnancy I created my own version of the journal.  I buy blank journals and make "forms" inside where I can fill in the blanks as I go.  I leave space to journal thoughts or letters to each of my children.  They are treasures.

I recently took Obadiah in for his 15-mo checkup (at 16 months, lol, a little behind).  I was concerned about diarrhea, and had made a note under the "questions/concerns" section of the journal.  I flipped back a couple pages and noticed I had made the same note at 9 months.  Hmmm.  When I thought about it, I remember him struggling with diarrhea around the same time we went to Florida, too (when he was 13 mos).

This particular episode began around the first of August.  By the time we went to his appointment, he had been pooping every day between 3-5 times per day.  Nearly every single poop was a '6' on the Bristol Stool Scale.  I haven't been able to notice a predictable pattern, except that he is not likely to poop when we are away from home.  Sometimes his poops are very acidic and leave his bottom very red.  I can tell before I even change his diaper--when I pick him up, he will be very stiff and he will cry the second we enter the room where I change his diaper.  It's heartbreaking.  :(

The first concerning thing the doctor noticed is that he has had poor weight gain over the past 4 months.  He didn't lose weight, but he "fell out of his growth curve."  Basically he went from being close to the 50% at 9 mos for weight to down to under the 25% by 16 mos.  The doctor ordered a stool sample.  The stool sample tested negative for giardia and other parasites, but it did show white blood cells present.  Based on this information, she is referring us to a pediatric gastroenterologist.  That appointment isn't until the end of September, so she said that if he "gets better" in the meantime, we can cancel the appointment.

That part is a little confusing for me.  What does "gets better" actually mean?  Especially considering my note about diarrhea at 9 months.  He may seem to "get better" for a few weeks, only to have this pop back up again later, right?  Everyone that I've talked to has encouraged me to keep the appointment regardless.  I also plan to keep a detailed diary of what he eats and how he poops, but I didn't think I should keep 6 weeks' worth.  :)

I questioned if his issues could be dietary.  I don't give him juice, the most common culprit of toddler diarrhea.  I learned that a loooooong time ago with my other kids!  Speaking of the other kids, they too have had similar poop patterns--a handful of grapes means a poopy diaper within hours.  I have always wondered if a fructose intolerance malabsorption runs in the family.  I usually try to control what they eat until they are potty trained, and then figure they can manage it themselves after that.  Knowing this, I also try to balance what Obadiah eats...a banana or applesauce to counteract acidic foods like oranges or tomato-based foods.  Obadiah seems to be worse than the other kids were, but that could be just poor memory on my part.  The one thing I have looked hard at is milk.  Afterall, right around 12 months he started getting milk in a cup and we gradually weaned from breastfeeding.  So that could be it, right?  The doctor was confident it is not milk.  So we're kind of in a holding pattern.

The weird thing is the fact that he doesn't poop away from home.  Is this a factor or just a distracting detail?  Last week while we were camping he pooped only once each day.  We came home Friday around lunch time (after he had already pooped that morning at camp) and guess what?  He pooped two more times upon arriving home!  How is that that he went Sunday (Sundays we are on the go--to church and other places) through Thursday only pooping once per day, and upon returning home he resumed his "normal" diarrhea schedule?  It's something that I plan to make note of in my diary for the G.I. doc.

I'm praying for answers to help our little man.  He is such a happy guy with a strong will and, I believe, a high pain tolerance. 


6 comments:

  1. That pattern to me sounds like he is gaining bowel control. He is probably just more comfortable at home and just goes whenever he has gas or has the urge. Do you think it is related to stress? That might be another factor to key into.

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  2. I never poop when I go camping, I could go a whole week. But when I get home stay away from the bathroom . Maybe it's generic

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  3. I would try the GAPS intro diet and see if his Gut just needs a little healing. If you can't do intro, you might still find enough healing by just adding some stock and probiotics foods daily. Intro just helps identify if specific foods are causing the problem. I think the change in pooping could be related to just not being at home as well...baby poop is a little harder to determine from a diaper, with the poop being smashed, unless it is watery it may still be a nice 4, but because of the diaper its more deceiving. Have you ever tried to catch a poop over the potty with him? There's a lot of misconception even in the GI specialty field....I learned a lot by reading the website my Naturopath suggested at www.gutsense.com

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    1. The stools are without a doubt a 6 on the poopscale. There is no question. I change a lot of poppy diapers and even from other households since I do daycare. He occasionally has mucous in the stools (another red flag). White blood cells should NOT be there either yet they showed up in the test. Since we use cloth most of the time it's also easier to determine what is really a watery stool and what is not. The microfleece lining in most of his diapers is the perfect environment for "straining" out the liquid from the solid. It's sooooo gross but helpful. And also remember this is a recurring problem...it's not a constant state of being. I don't know because I didn't make notes but the current bout started around the first of August. While he didn't poop more than once a day while camping the quality of the poop was still not good.

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  4. Katie Phifer8/24/2012 11:02 AM

    Right away I thought of gluten, perhaps. Some sort of elimination diet might be helpful. I'd try it and take notes to show the GI. Most mainstream docs are hesitant at best to look at food sensitivities unless it is testable like true Celiacs. However, there are lots of gradations of sensitivities that will it show up in any test. I'd play around and take notes. best of luck!

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    1. Celiac's would be devastating but if I started an elimination diet now and the gi doc did want to test we could get a false negative. So that makes me not want to change anything just yet. But yes it's definitely a concern!

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