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Referred to a Pediatric GI specialist

Sep 16, 2008 11:11AM - 69 comments
Tags:

pediatric

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specialist

,

Gastroenterology

,

child

,

intestinal bleeding

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colon polyps

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juvenile colon polyps

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dairy allergy

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Celiac disease

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wheat and gluten



I took Trevor in for his ped appointment this morning for the gastrointestinal concerns I had about him.
He's had small amounts of blood in his stool for over a month on a regular basis, usually tiny bright red specks in the stool or a minute amount wiped onto the toilet paper. Occasionally, he gets a sudden and random stomach ache, which will nearly double him over; very much like an IBS attack. The last time this happened was about a month ago.

I explained to his pediatrician how long this has been going on, and why I'm so concerned. Colon problems run in my family. I have IBS with severe constipation issues, and I had a pre-cancerous colon polyp removed in a colonoscopy last year (I was 22 years old) that the gastroenterologist told me would have turned into cancer within approximately 5-8 years. My mom is a colon cancer survivor (going on 7 years cancer free). She was 45 when she was diagnosed with a colo-rectal tumor. My mom's sister has severe IBS and annually has to have polyps removed; she's 50 years old and has had these issues since her 20s. My maternal grandmother also has colon polyps removed annually with her colonoscopies.
When I told the ped all this, he said right away, "I'm going to refer Trevor to a pediatric gastroenterologist. With a family history of problems like that, we don't want to take any chances."
He wanted to make sure Trevor didn't have any polyps in the rectum, so he did do a rectal exam. Poor Trevor! I was so worried that would happen, and it did! He did well enough though; just as it got painful for him and he started screaming (and I just about broke down crying because I had to hold him for that), it was over. So thankfully, I didn't turn into a blubbering mess and make it worse for my little guy. The doctor said he felt no rectal polyps and there was no blood found in the exam. I told him the last time I saw blood was Friday night, and it was all throughout the stool, but I have not seen any since.
He told me that there's a good possibility that Trevor may have polyps up higher in the colon, because he found no anal tearing, and seeing as Trevor is not in pain when he has a BM, it's unlikely that he has rectal fissures or internal hemerhoids, because those often cause pain with the BM (but not always).
So a colonoscopy or a flex sigmoidoscopy is definitely likely in the near future for my little man. He's scheduled to see the specialist on Oct. 13 at 2:00. Guess we'll find out more from there. Until then, I'm going to keep a written log of each BM he has, and I told his daycare this as well, in case he has to go when he's there.
I'm so worried! He's so young, he shouldn't have to be enduring any of these problems! I hate that I've passed this on to him, if that's the case. I feel terrible. He doesn't deserve this. He's just a little boy, not even four years old yet.
I just pray that there's nothing serious. That this won't be something that's a lifelong burden for him, that it's just a minor problem that can be fixed and nothing more. It's bad enough that I have to live with GI problems--I don't want to have to watch my son go through the excruciating pain I know first-hand that GI problems cause.

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by peekawho, Sep 16, 2008 11:26AM
Hopefully, you'll get some answers.  I hate that he had to go through that.  I was so hoping this one a minor issue.

I know this is just one quote, but I thought it might help.  This is from the Mayo Clinic:

Colon polyps rarely occur in children and adolescents. Juvenile polyposis is an unusual inherited disorder in which numerous polyps begin growing early in life, usually in early childhood. The cancer rate is slightly lower in this form of polyposis (17 to 68 percent chance of developing cancer by age 60). It is important that screening for polyps begins early in life in families where a genetic risk has been identified.

I hope there are no polyps, and that some other, easily explainable reason is discerned.  Does he drink a lot of milk?  

I found this information, too:

Dairy milk causes some infants and children to lose iron from their intestines through intestinal bleeding (the harsh casein in milk irritates the delicate lining of the childs intestines). This bleeding is pervasive and usually not sufficiently severe to be noticed in stools, but enough to cause anemia. It is estimated that half the iron-deficiency in infants in the USA is from cow-milk induced intestinal bleeding! Many studies have been carried out that show how dairy milk causes intestinal bleeding. Here are extracts from some of these studies:


Milk consumption has been shown to cause intestinal bleeding, resulting in low hemoglobin count. The result: weakness, depression, irritability. (Robert Cohen, Milk A-Z, 2001, Argus Publishing, ISBN 0965919684).


Babies who are fed whole cow’s milk during the second six months of life may experience a 30% increase in intestinal blood loss and a significant loss of iron in their stools. (Journal of Pediatrics, 1990, 116).

Children with iron deficiency had a higher intake of cow’s milk compared to those with sufficient iron. Intake of cow’s milk is significantly higher in children with iron deficiency. (Acta Paediatrica, 1999 Dec, 88:12).


Cow’s milk-induced intestinal bleeding is a well-recognized cause of rectal bleeding in infancy and childhood. In all cases, bleeding resolved completely after instituting a cow’s milk-free diet. (Journal of Pediatric Surgery, 1999 Oct, 34:10).


Significant rectal bleeding is the most common symptom in cow’s milk allergy. (West Virginia Medical Journal, 1999 Sep-Oct; 95,5).


Cow’s milk has been linked to a variety of health problems, including hemoglobin loss, mood swings, depression, and irritability. (Townsend Medical Letter, May, 1995).





by AHP84, Sep 16, 2008 01:00PM
Wow, thanks Peek!!!
He doesn't drink a lot of milk really; usually only once a day on his breakfast cereal. But he does like to eat yogurt. He eats yogurt almost every day as well. I get the Fiber One brand, which has 5 grams of fiber per cup, thinking I was doing us both a favor, seeing as how I have us on a high-fiber diet and Trevor loves yogurt about as much as ice cream. I also thought yogurt was beneficial to intestinal health.
I'm going to cut out all his dairy by the end of this week starting tomorrow. He actually had a milk allergy, or lactose intolerance, one or the other, when he was a baby; from the time he was a month old to about 36 months. He'd break out in eczema rashes, get ear infections, and throw up. He was also on a nebulizer from 2-13 months old because I didn't know he had a milk allergy until he was 10 months old.
So the milk-induced intestinal bleeding would make perfect sense, really.
But honestly, it also wouldn't surprise me in the least if he had juvenile polyps either, with my family history.
Anyway, for now, the best I can do for the next month is keep a written log of his BMs and, now that you've given me this great info about dairy, wean him off the dairy over the week and see if that improves anything.
I hope so much that it's something as simple as that.
Again, thank you so much Peek!

by have 2 kids, Sep 16, 2008 01:48PM
Poor Trevor!!!!!  
I hope it turns out to be something minor.

by AHP84, Sep 16, 2008 02:01PM
Thanks, Have 2 kids.
I'll keep this journal updated with any successful or worsening events until October. Hopefully it's just dairy allergies, like Peek pointed out. It would be so wonderful if it's an issue as minor as that!

by lhughes, Sep 17, 2008 12:02PM
Man, that pains me!!  I'm so sorry Trevor had to have that experience so young, and I'm so sorry he's having any troubles at all.  I hope that some of the info Peek mentioned will lead to a solution.  

Give Trev a hug from us.  I hope it all turns out minor.
PS... sorry to hear about your lawn mower.  You are just having TOO much fun right now!

by carisa, Sep 17, 2008 12:33PM
I'm so sorry your little son is going through this. It must make you so sad to see him in pain. Just wanted to let you know you are doing the right thing by looking into this. Colon cancer and GI problems run in my family too. My aunt got colon cancer in her late 20s. I doubt he has colon cancer this young, but it's still good to figure out what is going on so you can help him. Good luck.

Carisa

by AHP84, Sep 19, 2008 02:04PM
As of today, I have Trevor completely off of dairy.
The last instance of blood was Tues night; a little bit on the toilet paper but none in the stool that I could see.

Now all the "what ifs" are plaguing my mind.
Like what if a dietary change is all he needs? What if this is nothing?
Will I be putting him through hell these next couple of months with doctor appointments? What if he develops some kind of PSD from all these checkups?
Or what if there is something wrong with him? What if he does need a GI specialist throughout his childhood?

I'm trying not to get anxiety attacks over this, but that's easier said than done. In fact, I've been so stressed thinking about this for the last week that my own GI problems are getting triggered from the stress. I keep trying to distract myself from thinking about Trevor's upcoming appointment, but I can't help but think I'm somehow doing something wrong. I don't want him to go through any of this.
I'm not really sure how to cope with the anxiety of this.

by peekawho, Sep 19, 2008 02:09PM
Keep him completely off dairy til his appt.  Then ask all your questions of the GI doc when you take him in.  The doctor will decide if he thinks its totally dairy related, or if he thinks he needs more tests.

If the blood stops when he's off dairy, I think its a huge indicator that he can't tolerate it.  Especially with his past intolerance of milk.

by suzi-q, Sep 19, 2008 04:16PM
I wish you the best...I know how hard it is when your child is sick.  My prayers are with you

by AHP84, Sep 19, 2008 04:23PM
Thank you so much, Suzi. I become such a nervous wreck when I think or talk about this. And now every time I look at Trevor, the only thing I can think about is, what does my little boy's future hold?
Not knowing anything, and having to deal with not officially knowing anything until a month from now is eating away at me.

by peekawho, Sep 19, 2008 04:25PM
I can't help but strongly feel this is all from the dairy.  He's very young for other, more serious problems.  

by BTS1022, Sep 19, 2008 04:30PM
I would also have him looked at for Colitis or Chrons disease. My sister has both, and has had an external bag for a few months, with an internal bag that they have to alternate from. She had all of her small intestines removed. But it some of Trevors symptoms remind me of what my sister has, and has gone through.

by AHP84, Sep 19, 2008 04:30PM
Yeah, but that's not helping ease my anxieties, because now I wonder how extensively they'll want to test on him just to see if that's truly the cause.
His ped said he's likely going to need a colonoscopy.
If it's just dairy issues, I don't even want them to consider a c-scopy or a flex sig on him, and I definitely don't want him to have to endure another rectal exam.
Maybe a month is exactly what I need for him though, to have that period of time for him to adjust to no dairy at all and see if that eliminates the problem entirely so that the GI ped will listen to me when I tell him that I don't think extensive testing will be necessary, if dairy is the case.
Oh I can only hope and pray this is all dietary and things don't need to go much further than this.

by lhughes, Sep 21, 2008 07:56PM
Keep your diary of things he's eaten and what output he's having.  That will be of such help to the gastro dude.  Let them decide what tests should be done, they are the experts.  And yes, I'll admit you having IBS makes you quite an expert....but when it's your child, sometimes we get too close and let our imaginations run wild with what we already know.  So, deep breath.... keep a log of what he eats, what the reaction/output is... and hopefully the docs can determine what is necessary for determining what is going on.  

Personally, I think Peek's description is a good one, not being a doc, though...I'll leave a final diagnosis to those that truly know.  

Make sure you write down everything.  The more they know the better they can assess.

My heart goes out to you and Trev... can't imagine gastro problems.  However, I can sympathize with skin/eczema problems.

Kisses and hugs to the big man!

by BTS1022, Sep 21, 2008 09:56PM
I am lactose Intolerant, and when I have a dairy product my symptoms are almost immediate. I usually have bad diarrea, and nausea with the occasional vommiting. I never had any rectal bleeding from dairy products, however I did have some rectal bleeding due to internal hemmroids, which can be diagnosed through a rectal exam. I understand that you don't feel extensive testing is needed, but if it isn't dairy, and you hold off on the testing and it is something more severe, the chances of making it worse by waiting for a diagnosis is a good probability. My sister had issues with her GI with rectal bleeding when she was 4, my mom refused the extensive testing for fear of anastesia. She went undiagnosed for 3 years, and a simple case of Ulcerative Colitis turned in a life long struggle with Chrons disease. And because of the 3 year wait, my sister had to have her small intestines removed, and an internal bag. She also has to go through rectal dilation once every 2 months for the rest of her life, and colonoscopies every 5 to 6 months for the rest of her life. She was just recently diagnosed with Chrons disease of the throat.

I know if my mom had the choice to redo it all, she would have had all the testing done when they first occured.

I also know that it isn't easy seeing your children go through all the painful tests and procedures, but isn't it better off safe than sorry? I don't think it is torture or uneccissary to get your child tested to whatever extent is needed.

But whatever the choice is that you make, I will keep praying for you and Trevor, and I hope that everything turns out to be just fine. Im not trying to guilt trip you, just sharing my families experiances with gastro issues.

by AHP84, Sep 22, 2008 09:34AM
Thanks BTS1022 for sharing that experience. It does help me keep a lot of things in perspective that are necessary for precautionary measures.
I do plan on agreeing to any tests the Pediatric Gastro thinks are needed. I know how important it is to rule out any and all possibilities because he's so young. It's just so hard for me to see him go through the invasive exams and proceedures because he's so young that he doesn't understand what's going on or why. All he knows is that there's blood in his poop and he has to see a doctor, but beyond that, he doesn't understand what everything else is about. That's what hurts me the most, seeing the looks on his face; the fear, confusion, and tears in his eyes when I had to hold him down for that rectal exam about did me in. So to think that there's the potential of many more of those to come if there's something wrong that requires more than a dietary change just nauseates me with anxiety.
I wish I was stronger in mind and will for my son. I know he needs that from me.
I have a month to ready us both for the Ped Gastro. I just need to be able to vent my anxieties so I can build my strength for when that time comes. I need to be more in the mindset of "do what's needed to find out if he's okay" rather than "I don't want him to go through any of this because it's too hard for me to handle."
It's like Lhughes said, "When it's your child, sometimes we get too close and let our imaginations run wild with what we already know." That's where I'm getting self conflicts about putting him through all this.
But I know how important it is to catch something before it gets worse, especially personally knowing about gastro issues. So I will follow through for his well-being and my own peace of mind in the long run.

On a hopefully improved note: Trevor has made it through the whole weekend with no trace of blood in his stool. I'm praying that he can make it through this entire week with no traces of blood.
The last definite appearance was 9-16 (a little spot on the toilet paper), and a possible appearance on 9-19 (I'm uncertain; the stool was tinted red, but he had eaten spaghetti on 9-17. However, I've never noticed tomato sauce tint his stool red before, so I really don't know).
I'm just a nervous wreck. :-$

by peekawho, Sep 22, 2008 09:36AM
The gastro will not want to put him through anything that isn't strictly necessary.  They really won't.  

Crossing my fingers that everything "goes" smoothly!  (pun intended)

by AHP84, Sep 22, 2008 09:42AM
Lol, thanks Peek!
Keep the humor coming whenever you can--I definitely need it! :-D

by BTS1022, Sep 22, 2008 10:01AM
I can only imagine as a mother how you feel. I have been lucky enough to not have to have any issues with stuff like this before. The most I have been through are scabbed knee's and elbows and a few stitches and bloody noses from my 2 boys. If I were in your situation I think I would better understand, but Im not. I just want to wish you and Trevor the best, and to let you know that my family will be praying for your family. I didn't want to seem like I wasn't being sympathetic or rude....It is different that this is your son, and what I witnessed was my sister, it still hurt nonetheless, but I can barely watch my boys get immunizations without my world coming to an end....so I can only imagine what you are going through.

It's hard to be strong for our kids, they are the one true thing that can tug really good at our heart strings. But o matter how much it hurts us, we have to do whats best for our babies, even if it is the hardest thing we will ever face.

Have you tried to explain to Trevor what is going on, and why he is having these tests? Im not sure of his age, but maybe making a picture or a book together will help him understand it a bit more? Just trying to help.

Keep the faith and I will be thinking of you and Trevor during your difficult times!

by AHP84, Sep 26, 2008 10:15AM
Another appearance of blood in his stool last night.

*sigh*  :-(

by peekawho, Sep 26, 2008 10:16AM
Dang it!

by peekawho, Sep 26, 2008 10:20AM
What did he eat yesterday?    You may want to keep a food diary until he goes to the gastro guy.  

by AHP84, Sep 26, 2008 10:47AM
Breakfast: a generic brand of Lucky Charms with soy milk.

Lunch: a peanut butter and applebutter sandwich on white wheat bread, green grapes, goldfish crackers, a blueberry Nutri-Grain bar, a peach fruit cup, and 100% apple juice.

Supper: Half a Chick-fil-a chicken sandwich with honey roasted bbq sauce (yellow in color, not red), about a third of a Gala apple, and water.


The appearance was a few red specks, but they were not bright red like I usually see, but they weren't dark brown or black specks (meaning the blood was old and not fresh). He did not have a BM on Wed night. I'm not entirely sure if what I saw last night was blood, but I'm guessing it was. It looked like blood. It may not have been, though. Just maybe not...

We ate spaghetti on Wed night. Last time he ate spaghetti was Wed 9/17, and that was when, on Fri 9/19, his stool was tinted red throughout (and as I've said before, I've never seen tomato sauce *tint* his stool before).

I feel kind of stuck on what to feed him anymore that isn't pasta or a sandwich, because he's not much of a meat eater, and virtually everything has some form of dairy in it. I think if he eats anything with tomato sauce again, I'll make a note to look for any kind of "blood-like" appearance in his stool. We eat spaghetti at least once a week, and have for well over a year, and I've *never* seen it "come out the other end" in him, or me for that matter (yes, I inspect my own because of my problems).
And there are definitely BMs that he's had in the past couple of weeks that had blood in them, and that I can say with certainty, as oftentimes blood would be on the toilet paper and in the stool.

I'll keep a food diary for him starting today, too.

by BTS1022, Sep 26, 2008 11:34AM
Maybe he has an allergic reaction to anything with red dye in it? I have known a few children with that allergy. Also have you looked into the one disease (can't remember the name) when they are allergic to anything glutin. OH Celiac Disease is what it's called. It is fairly common and can cause some of the same symptoms that Trevor has been experiancing. Just thought I would bring that up.

I have IBS and im Lactose intolerant, and have never had blood in my stool except when I had hemmroids.Sorry (tmi).
My kids haven't ever passed anything red after eating sketti or anything red, but they also aren't allergic to red food dye or have any allergies to be honest.

Maybe it's someting to look into?

by AHP84, Sep 26, 2008 11:52AM
Hmmm, I wonder if it might be celiac disease. I did a brief scan on Wikipedia and found that sometimes, the person shows no symptoms of bowel disturbance.

"Symptoms include chronic diarrhoea, failure to thrive (in children), and fatigue, but these may be absent and symptoms in all other organ systems have been described.

"Classic symptoms of coeliac disease include diarrhea, weight loss (or stunted growth in children), and fatigue, but while coeliac disease is primarily a bowel disease, bowel symptoms may also be limited or even absent. Some patients are diagnosed with symptoms related to the decreased absorption of nutrients or with various symptoms which, although statistically linked, have no clear relationship with the malfunctioning bowel.

"As the bowel becomes more damaged, a degree of lactose intolerance may develop. However, the variety of gastrointestinal symptoms that may be present in patients with coeliac disease is great, and some may have a normal bowel habit or even tend towards constipation."

I'll definitely keep this in mind and mention it to the pedi gastro when we see him in October. I don't know what else to do other that to keep a written log of his BMs and now his daily diet.

by BTS1022, Sep 26, 2008 12:23PM
I think that logging his BM's and diet daily will help you narrow down what may be causing his issues. I know with animals we do the same thing when there is a gastrointestinal issue. Sometimes thats all we can do is log for them, and bring it to the docs attention. I would make copies of the logs and MAKE the gastro specialist read over it, and see if he can find any links aswell. Don't let him dismiss the logs, because some docs think they *know* it all, and say it won't be helpful, to later turn around and discover that the issue was right there in the log.

Im hoping the best for your family. And if I can think of anything else, I will let you know. I just thought of celiac's disease because we are doing a study of it in horses. So if I come across anything else..I will throw it at you lol. Have you had him checked for intestinal parasites?

Now that I think of it, if you have cats or dogs, and they have hookworms, the hookworms can be passed to humans. It is the only intestinal parasite besides the tapeworm that can be passed from animal to human. Just a thought.

by AHP84, Sep 29, 2008 10:37AM
A brief update. Last night, my sister was babysitting for Trevor, and I gave her a list of foods he could eat while in her care. After much careful consideration, I put "turkey sandwich" on the list, knowing that deli meats have whey or lactic acid culture as a primary ingredient. I figured if there's any reaction, I'll know what caused it.
Well, he had a reaction, and I feel confident that I can single out the deli meat.
My sister said he ate the sandwich (on wheat bread with mayo and mustard), a few raw baby carrots, some red grapes, and a few Toasteds brand crackers along with a juice box. She told me after he ate the sandwich that he got really picky with his other food and didn't want to eat it (especially odd to not want grapes or crackers), but he was acting normal otherwise.
She said about a half hour or so after he ate, he became quiet and slightly moody, and didn't want to interact much. Then he vomited up all his dinner.
She said after that, he was back to his normal self and bouncing all over the place and happy as could be.

He hasn't had any dairy for nearly two weeks since last night, except for minute traces in food ingredients like bread and such. He used to eat turkey and cheese sandwiches at least once a week, but now I'm thinking that since his body has not digested dairy in practically two weeks, the prominent traces of lactic acid or whey in the meat (it was Oscar Meyer deli turkey breast) caused him to vomit within an hour--the exact same reaction to formula and milk he had when he was between the ages of 2-10 months old. He'd take a bottle (or when he was around 15 months and I attempted to reintroduce milk for a week), he'd always projectile vomit in less than an hour, and until he did he'd be fussy/moody and uninterested in much that was going on around him. Then after he'd puke, he'd be fine and happy again.
Sooooo, I think I've got a significant portion of his problem solved, if not completely.

by April2, Sep 29, 2008 11:18AM
Good for you! That's interesting. I didn't know that about lunch meat. But he's ok with wheat and such? I know some people have a hard time processing wheat.

I'm still trying to figure out what I can eat or not. I think I have trouble with milk, too, among other things.

Hope everything works out real soon!
Take care,
April

by AHP84, Sep 29, 2008 11:51AM
Thanks April.
I'm pretty certain he doesn't have a problem with wheat. I can't be 100% positive though. Dairy, however, I've known he's had issues with as an infant. When I fully reintroduced dairy back into his diet last year, I figured he'd "outgrown" the troubles. I think he still had a reaction to dairy, though, but the symptoms just weren't as obvious.
Another thing is that anything that may have caused any reaction over the last year probably wasn't too obvious for me to see because I have been overly cautious about giving him lots of dairy ever since he's been 10 months old (after being barfed on up to five times a day, endless battles with eczema breakouts, about four ear infections in a year, and holding him down for breathing treatments almost daily while he'd be screaming and wriggling to get away from that smelly mist, I just haven't been comfortable with giving him much more dairy than milk on his cereal and a slice of cheese on a sandwhich for the most part). Perhaps in the last year if I'd have given him milk on his cereal each morning, and about two glasses of milk a day, along with any other dairy each day like cheese, yogurt, ice cream...whatever the day's combination would bee...I probably would have seen a more blatant reaction much sooner.
But now I think back on it, he has had a few eczema breakouts in the last year (but not all over his body); but that's just an observation I'm making now. That in and of itself may not be strictly related to dairy, but I don't know.

by TrudieC, Sep 29, 2008 01:40PM
Gluten can cause skin rashes as well.  My husband has suffered with blood in his stool for some time, weird bowel habits, bloating and pain.  They have run several ultrasounds and found nothing.  He decided to try a gluten free diet and everything feels better.  Even his so-called psoriasis has disappeared.  The good thing is that if they do do a colonscopy they can biopsy for celiac but it is important that you not change your diet to eliminate gluten before hand (there is also a blood test).  Since they can sedate adults for this test I'm sure they have some safe ways with children.  

I can understand how awful you may feel.  I had ulcerative colitis for many years until I had a surgery to remove my large colon.  My son is 22 and was diagnosed two years ago with the same.  This was not what I wanted him to inherit from me.  Good luck with everything.

by AHP84, Sep 30, 2008 09:10AM
Found a streak of bright red blood in his stool last night, as well as a decent amount when I wiped him.
(May be TMI here)
I had him lie down so I could check him for anal tearing, although I wasn't really sure what to look for. To me, his anus looked normal, but there was blood around it. After I wiped him clean, everything looked normal, so I don't think he has any tearing. Plus his stool was soft.
But I'm wondering if there was tearing if it's not visible after being cleaned up? I really do not know how, or what to look for, for anal tearing.

I feel like I'm going insane trying to figure out why he's bleeding, and where it's coming from! I wish he wouldn't have to wait until Oct 13th to be seen! I HATE that I don't know what to do to fix this! I HATE not knowing anything!

by peekawho, Sep 30, 2008 09:17AM
Its coming up pretty soon...hang in there.  Its frustrating, though.  

Hey...have they checked his hemoglobin to see if he's anemic?  

by have 2 kids, Sep 30, 2008 09:19AM
Only 2 wks to go and then you should get some answers.  Is Trevor ok with this or is he getting scared?

by AHP84, Sep 30, 2008 09:36AM
No. His idiot pediatrician did nothing more than a rectal exam.
Then when I had Trev there last week for his three year physical (he was late because I never got a reminder from the clinic when he turned three, but that's another story) and a "follow up" of the week before, I mentioned that I was concerned about a milk allergy, so could we look into verifying that.
Let's just say the pedi's response has made me decide that after Oct 13th, I'm going to switch pediatricians.
He pretty much just blew me off, saying that intestinal bleeding caused from a milk allergy is almost exclusively seen in infants and not older children. He said I should not take Trevor off dairy because if he simply has a mild intolerance, he needs to have small amounts of dairy each day to build up his tolerance to it. Great--and what if he has an ALLERGY?! How am I supposed to know?!
THEN he has the NERVE to tell me that I should consider having Trev put on ADHD medication by the time he reaches kindergarden! Followed by the comment, "It's pretty common now for school age children."
Okay, I know Trevor is a little on the hyper side, but #1: he's a boy and #2: when I express any concern about changing his diet to possibly help not just his intestinal issues, but his hyper behavior, I get shrugged off and given the "general recommendations" of limit his sugar intake, television, and most importantly, to consider Ritalin!
So no...no blood tests (even though that's one of the things I also requested), no interest in LISTENING to any of what I want to do to help my child NATURALLY, and no sense of urgency that my child is sh*tting blood once a week or more! (sorry...my frustrations are about at their peak, and I feel so helpless and lost in all this).

by AHP84, Sep 30, 2008 09:40AM
So far Trevor is okay with all this--thankfully I'm able to stay very calm and informative for him, and he's taking everything seriously but not panicking (did I spell that right?).
He's being very diligent about turning down dairy products right now. He says things like, "Does that have milk in it? I can't have it if it has milk in it because I might get sick." He's such a good boy!
He's happy as can be and he knows this is important, but he's not freaked out about it like I am. Good thing, otherwise I'd totally be a wreck, seeing him scared about it all! He's a little trooper though. I'm so proud of him.

by BTS1022, Sep 30, 2008 09:48AM
You can have an internal rectal tear causing bleeding. You can also get hemmroids internally if he has ever strained to have a BM.

As far as the ADHD cr ap I would have knocked him up side his head......ADHD and ADD is sooo over diagnosed these days. Kids are kids, and kids are going to be hyper and playful, and have low attention spans, it's because they are kids lol, and kids learn by playing.

I had a pediatrician tell me to put my youngest son on ritalin at 1 yr because he was *almost* certain he was going to have a hyper activity disorder....Bull! I have never been back to a pediatrician....I now use just a family doctor, and my family doctor doesn't believe in testing children under the age of 12 for ADD and ADHD unless they are having significant disadvantages in school.

In my honest opinion...ditch the PED, and find someone who is going to take your son's issues more seriously.

by have 2 kids, Sep 30, 2008 10:00AM
I cannot believe your ped.  suggested ritalin for Trevor without testing him for ADHD.   My daughter has ADD.   We worked
with the school and family dr gathering information and testing for close to 6 months before we started her on medication.
She is 12. For her it was the best decision we could have made.   I do believe that too many children are medicated without needing to be.   The whole concept of "give them a pill" to make it easier is BS.   The medication helps my daughter to focus but it certainly doesn't drug her.   Our dr told us kids get the drugged effect when they really don't need the medicine.
Sorry- I got off subject.   I think it's a good decision for you do find another ped.  Good luck and I'm thinking of Trevor even
if I don't respond all the time.

by AHP84, Sep 30, 2008 10:01AM
Thanks BTS...that's the plan.
Ritalin at one year old?!?!?! I would have ditched that pedi in a heartbeat as well!

by AHP84, Sep 30, 2008 10:10AM
Yeah, when the pedi made the comment, "It's pretty common now for school age children," I seriously had to bite my tongue to keep from going into a rant, saying something along the lines of, "Um, hello!!! If it's 'pretty common' does that not tell you something?!"
Like your daughter, have 2 kids, I know that there are some genuine cases where those drugs are needed and benefit the child greatly. But it's crazy that SO many children seem to "need" the meds these days.
Anyway, I don't want to get my own journal off the original subject, so I'll just leave it at that.

by TrudieC, Sep 30, 2008 10:30AM
My son was having problems concentrating, would get frustrated and go into crying spells and acted hyper.  I figured out that he was allergic to red food colouring.  I took that out of his diet and along with all other foods with food colouring and he was a different boy.  Whenever he cheated I could tell in his behaviour immediately.  He started having more ADD issues as a teenager.  We changed his diet to take out processed foods and nitrates and had him start eating more protein (eggs for breakfast) and again, made a huge difference.  

by AHP84, Sep 30, 2008 10:53AM
TrudieC, thank you for sharing! I have been taking careful note of his behavior for the last two weeks since taking dairy out of his diet, and also, I've almost completely eliminated all foods that have Red 40 dye. I'm also doing everything I can to cut out as many processed foods as I can (mainly at this point, I'm attempting to get through what I've had in my fridge and pantry, and when it's gone...no more).
It's only really been just over a week since I've started making dietary changes, but I do notice a slight difference in his behavior already (and a few other people have noticed it too). It's been a very slight difference so far, but noticeable. His behavior is less defiant and more cooperative, and he doesn't seem so "buzzed" all the time. I mean, he has always been unable to really sit still, he always has to be moving. If he had to be still, he'd fidget and twitch. But little things like that have calmed now. They're not gone, but they've calmed.
I'm thinking whether or not he has an allergy, I'm changing our diets anyway. I never gave a second thought to what we were eating before, other than to make sure it was generally healthy, fairly low in sugar, and high in fiber. But now I am so concious about dyes, preservatives, and how different types of food are digested and processed by the body--and by eliminating this, and cutting back on that, and adding better things--I'm noticing a difference in how I even function and feel each day.

by AHP84, Oct 10, 2008 09:29AM
If Trevor can make it through the weekend until Monday (the day of his appointment), he'll have officially gone for two weeks with no blood in his stool!
I've been holding my breath since the last appearance on Sept. 29, which was a bright red streak about a ½ inch in length and then a significant amount on the toilet paper. At that point, I thought it would only get worse, as that had been the worst I'd seen it. But since then, there's been nothing! Which has caused my stress level to decrease a good deal.
So Monday is the big day; I'll be taking the day off from work because he won't be going to daycare anyway as it'll be Columbus Day. But I'll be reporting back Tuesday morning.

by BTS1022, Oct 10, 2008 10:15AM
Thats great news AJ! Im glad Trevor is doing better so far. I only hope and wish for your family that he continues to get better, and that on his appointment there are no negative health issues found.

Your in my prayers, and I will keep praying until you get the answers you need!

Good luck on Monday, and remember be strong for that little Schmoo of yours :)

by AHP84, Oct 10, 2008 10:38AM
Thanks so much, BTS!
You'll be in my prayers too, seeing as your little Conner is due to make his debut any day now!

by have 2 kids, Oct 14, 2008 09:54AM
How did Trevors appt go?

by AHP84, Oct 14, 2008 04:16PM
The appointment went well yesterday. We're kind of on "stand-by" as to where we go from here. The specialist was very nice and understanding and intently listened to what I had to say (more than I can say for Trev's regular pedi now).
He told me that he feels 95% certain that Trevor has a colon polyp or two (those were his exact words). He explained to me that Trev has all the symptoms to a "T" for polyps, because basically, juvenile colon polyps are on a stalk like a mushroom and filled with tons of blood vessels. Then most of the times when a BM passes over the polyp, it breaks it open a little and makes it bleed. The amount of blood depends on the size or number of polyps. If the polyp is small, then it doesn't break open as often or bleed that much, hence the reason for minute amounts of blood in his stool so far without daily bleeding.
He told me that juvenile colon polyps are not typically dangerous and do not carry a cancer risk at this young of an age. The only health problem they generally cause is anemia if left untreated and left to grow and bleed. He said sometimes the polyp will even break off itself and pass with a BM and you'll find a bloody wad of flesh in the stool (ew, gag, bleh, can you say DISGUSTING?!--I'd totally FREAK if that happened, so good thing he told me!).
I also mentioned my concern about the potential milk allergy. He said that could also be very possible, especially since I've had him on a dairy-free diet for a month now, and Monday marked a two week time frame of no blood in his stool. He said to keep Trev off dairy for maybe one more month.
That said, we come to a conclusion: he said if Trevor passes a BM between Monday (yesterday) and the next month that has blood in it, then give him a call so he can see Trev again to do some bloodwork and schedule a colonoscopy (which should be such fun, knowing now exactly what I'll have to do to prep him for that). If he does not have any more appearances of blood between Monday and before I re-introduce dairy, then he told me I can probably conclude that it is in fact a milk allergy unless the bleeding becomes more significant.
So, wouldn't it just be my luck that I get him home Monday night, sit him on the toilet to go before bed, and he makes a BM with four rice-sized spots of blood in it!
Okay, so perhaps that might be from the spoonful of macaroni and cheese I let him eat on Saturday evening? I know, I know, I shouldn't have let him have it, but he begged me for a bite of mac and cheese because there were other kids were eating it in front of him. That was Saturday evening, and then he did not have a BM on Sunday, so maybe it sat in his colon with that allergic reaction until Monday night when he went? I don't know. I mean, he went for TWO WEEKS with no blood at all, but no dairy either.
I didn't call the doctor today because I want to rule out if that might have been the cause. I know if I see blood again after today, I'll definitely be calling.

by lindacoxx, Oct 14, 2008 05:34PM
i live in west virginia and have a daughter 11 that is having severe stomach pain and has for a while - she is vomiting green and has gree watery stools. Her dr. says she is passing white blood cells in her stool- we are having a very hard time finding a GI specialist for kids.

by AHP84, Oct 14, 2008 05:46PM
Really? What part of WV are you located? You may have to seek out a pedi GI in a larger city. I live in Huntsville, AL and there are two pedi GI specialists in this city, and a few in Birmingham. I had to wait a month for his appointment, though, because his regular pedi told me that he wasn't an "emergency case."
You may have to seek out a pedi GI specialist in a larger city and commute, or you might be fine with consulting a regular GI specialist. Ask your doctor what s/he thinks, and see if he/she will refer her to a specialist as soon as possible--she doesn't sound too good and she must be miserable. All the best to you!

by lhughes, Oct 14, 2008 08:06PM
Poor Trev.  Mac and cheese is a kid's staple of life!!!  I really hope it turns out to be JUST the milk allergy and not something more serious.  I would personally hate to put either of my kids through a colonoscopy, but sometimes you gotta do what you gotta do...and you know that, too.  I'll agree with the "ewe" factor of the potential of finding a polyp in his stool.  That would freak me out big time.

We'll be praying for just a milk allergy and you don't have to put Trev through the bigger tests.  That would be a nice simple explanation for this, wouldn't it?!  Here's hoping for simple for you both.



by AHP84, Oct 15, 2008 08:12AM
Thanks, Lhughes. But I'll be calling the doctor for him today, unfortunately. He had blood again last night. :-(

by peekawho, Oct 15, 2008 08:31AM
Dang it all!

I was so hoping it would be simple.  Send him a hug from Aunt Peek.  
I've had a few colonoscopies.  The prep is the worst part!

by AHP84, Oct 15, 2008 08:42AM
I think I'd rather have the prep that we adults get for a colonoscopy (I've had a few too). The doctor told me how I'll have to prep Trevor if he needs one. I have one of two options.
He can be in the hospital for 24 hours with a tube up his nose (not really sure how that preps him...then again, I don't think I really want to know).
Or he can do five days of Miralax and I get the lovely option to collect stool samples with that!
So this is a whole new stress level for me. I don't think he would do too well sitting in a hospital for 24 hours with a tube up his nose. And I have REALLY bad experiences with Miralax; I hate that stuff and I won't touch it if I have to use a laxative, because that stuff tears me up to no end and practically incapacitates me for a day. Maybe that's just my personal reaction to that stuff, but I can't imagine having to use it for five days straight.
I wish he was a few years older so he could do the prep in the 12 hour time-frame with a huge dose of laxatives and no food. At least that's quick and done in a short amount of time compared to what children under 5 years old have to go through.

by have 2 kids, Oct 15, 2008 10:08AM
I feel so bad for him!   Sounds like an awful lot for a kid to have to go through.
Recently our son has had blood in his stool too.   I won't go into it here because this is about Trevor.
Please keep us updated about your little man.

by peekawho, Oct 15, 2008 10:21AM
I don't understand either, about the tube up the nose or collecting stool samples.

All they do with colonoscopies is to be sure the bowel is clean, and look around.  Taking polyps or samples if needed.  Why on EARTH would you need to collect all his stools?



by AHP84, Oct 15, 2008 10:27AM
I don't know. I think it has something to do with checking the amount of blood he passes.
I'm sure the doctor will go into a lot more detail with me now that he's most likely going to have a c-scopy scheduled. He didn't say much about the prep process when I was there Monday because it was just a consultation appointment to figure out what might be the problem and to go from there should he pass blood again, which he has.

Any information I find out, I'll be sure to post.

by lhughes, Oct 15, 2008 11:09AM
I second Peek's dang it.  

by April2, Oct 15, 2008 11:15AM
You know, you might want to go with the 24 hour thing. It certainly would go faster than the 5 day thing so he wouldn't have to drag it out. And that way you're making the hospital responsible. If he's like most kids he'd probably do better with them doing it than you, you know? I'm assuming the tube down the nose is how they would adminster the prep treatment. That part would be unpleasant, though. Gosh, I don't know. Either way, it's going to be unpleasant. Poor kid. I feel for you. Let us know what happens, ok?

by swampcritter, Oct 15, 2008 12:12PM
Can Swampy ask a really radical, odd question?

If the only problem is either 1) polyps that are not dangerous, or 2) a dairy intolerance, and the only effect of these things is a small amount of fresh blood, then why even treat it? Especially a body that young, which will grow.

If it continues to be a problem, if the symptoms get worse, or of additional gastro problems develop, that would obviously mean something different.

So why put the child through all this?


by AHP84, Oct 15, 2008 01:26PM
Trust me, I've been agonizing wondering this as well.
But to answer your question about the polyps, they're not dangerous in that they're not a cancer risk in children. But if they are left untreated and not removed, they continue to grow, increasing the chances of gaining more and more blood in the stool over time, because the bigger they get, each time a BM passes over the polyp it can break open and bleed. Then eventually anemia becomes a health risk because the polyp, the bigger it gets, can't heal itself if it's getting broken open each time a BM passes over it.
Another health issue that polyps can cause it fecal impaction--which is unbearably painful. So it's best to remove them for those reasons.
I was really hoping it was simply a dairy allergy--that's easy enough to work around over time. And maybe that's what it is, but I don't know. Nothing has been officially diagnosed for him yet.
I guess the good news is that if he has to have the c-scopy, and they find no polyps or colon problems, then he won't have to worry about having another c-scopy again until probably adulthood.
But there's only one way to find out, unfortunately.

by peekawho, Oct 15, 2008 02:59PM
1)I wonder if he's so sensitive to dairy, that the small amount he had the other day in his Mac/Cheese could have set off a lot of bleeding in the few days following?

2) Has anyone done a fingerstick to check his hemoglobin yet?  To see if there is so much microscopic (unseen) blood loss that he is anemic now?

I would think they would want a baseline hemoglobin now.  


by AHP84, Oct 15, 2008 03:03PM
His regular pedi did do a fingerprick blood test on his initial appointment--the one that started this journal last month. They said everything came back normal, as did the urine analysis they did for him too.

by AHP84, Oct 15, 2008 03:08PM
Well, the appointment is made.
He will have a colonoscopy Thursday next week, Oct. 23rd. They want him to do the four-day Miralax prep. Fortunately, I must've misunderstood something at some point, because I do not have to collect stool samples from that. Not that that makes anything better anyway.

by peekawho, Oct 15, 2008 03:13PM
Well, that's good that his Hgb is normal.  That means he is losing negligible amounts of blood, really.  

I hate that he has to have this done, but I guess it will answer some questions.  and I'm really glad you don't have to collect samples!  

How are you explaining this to him, btw?

by AHP84, Oct 15, 2008 03:16PM
I don't know yet. I just got the appointment made less than an hour ago, so I still have yet to pick him up from school today, lol!
So far, he's been doing really well with understanding and accepting that he has blood in his poop, and that might make him sick so he is seeing a doctor and not eating or drinking anything with milk in it. He's cool with that and doesn't let it get to him much, it seems. He's a good boy. :-)

by peekawho, Oct 15, 2008 03:45PM
He sounds so sweet!

by enzymelover, Oct 15, 2008 10:15PM
Hi!
I just fell upon your journal. Poor Trevor! I don't know your whole story, and unfortunately I don't have time right now to say much, but I have to give you some info.
I think your son would benefit from taking digestive enzymes. I had no idea of the importance of these enzymes, and the benefit to our health from them (especially colon health), until my son became seriously ill (from soy) and I found this book,
"Enzymes for Digestive Health and Nutritional Wealth" by Karen DeFelice. Please buy this book, This book is a real eye opener. So many children with food allergies and digestive and neurological issues have been helped by taking enzymes. It  has been a miracle cure for some.
I bought my copy from Amazon.com two years ago, and my son is doing so much better because of this book. Please check it out, for Trevor's sake. And please don't give him any soy milk, or soy anything else! My son's endocrine system has been damaged by soy, and it starts with gut damage.

Best wishes,

Enzy

by lhughes, Oct 20, 2008 07:26PM
I hate to back up, but just re-reading this journal and the ped's comments which I guess I missed first time around!  I've met Trev and to me he has no signs of ADHD.  Toddler boy?  yes, absolutely.  ADHD....naw, didn't see it.  I've seen a LOT of 3/4/5 year olds (only 1 I think might have been ADD or ADHD) and they all act pretty much like Trevor... boy, boy, boy.

Smack the man.

Wishing Trevor well and an easy test on the 23rd.  Stay calm (easier said than done, I suppose).

by wildchild219, Nov 24, 2008 11:38AM
Hello,

I have an 11month old daughter that has had chronic diahrhea for months and now has blood in her stools. I am worried. Our pediatrician is blowing us off until labs showed high levels of acid in her blood and bowels. I'm not really sure what to do! I'm so frustrated and need answers. Her GI appointment isn't until JAN 14th any ideas????

by Aleciscool, Sep 11, 2009 11:24PM
Hi! Ok i was on Google looking at some stuff and saw this journal...Poor kid and I'm thinking it's crohn's disease because I had the exact same symptoms and I'm 13 (diagnosed at age 10 and doc said it had started at age 8) I hope for the best and i hope he can beat whatever he has! and if he has crohns then maybe they can get him into remission like me!

P.S. Remicade worked great for me, try asking the doc if he may have crohns and try to get him onto previcide and remicade if nothing else works! hope you the best!


Alec, age 13

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