Child with irritable bowel

[annajones]

Hi

I would like to ask Dr Mich Erlewyn-Lajeunesse some questions.

Our daughter was born very prem and had numerous probs including NEC.

She is now 9 and her bowels have never been normal. She has diarrhoea after every meal (goes about 15-30 mins after eating).

Her dr cant find any trigger for this. He is on imodium & buscopan.

Is it worth having her tested for food allergies? We know that she doesnt tolerate diary, but given the frequency of diarhoea its more than just this.

Any advice would be greatly received

anna.

[christine bailey]

From a nutritional perspective it is recommended that you rule out coeliac disease - this can be undertaken via your GP through a blood test. Coeliac Disease is an autoimmune condition where gluten found in wheat, barley, rye is the trigger. Under the NICE guidelines regarding ongoing IBS symptoms a screen for Coeliac Disease is recommended. You may also wish to consider other underlying factors too - in some cases lactose intolerance can lead to diarrhoea. Other food intolerances may be worth considering via blood testing but it is important to do this through a qualified practitioner. Stool testing for microbial infections may be relevant depending on your child's health history. Are there any other family members with bowel disorders such as crohn's or colitis for example?

As your child was born premature and may have had a number of courses of antibiotics there may be value in supporting his gut health with probiotics. Saccharomyces boulardii a probiotic yeast has in research shown to help reduce diarrhoea symptoms too.

There are foods that traditionally have been used to help with ongoing diarrhoea but as mentioned above it is important to look for any underlying causes. Mashed up banana, stewed apple, mashed up papaya, carob powder with stewed apple, rice bran. Taking a food diary can be very helpful - does dairy aggravate the diarrhoea or eating gluten grains make his symptoms worse for example? In severe cases of diarrhoea zinc levels may be low and you may wish to check iron sufficiency too so consider requesting a blood test from your GP and rule out Coeliac Disease in the first instance.
Christine Bailey

[Dr Anton Alexandroff]

Hello Anna,

I completely agree with Christine Bailey.

Just to mention that if the condition proves to be a difficult to treat irritable bowel syndrome, there is now some emerging data that dermatological patch testing may in some cases point to trigger food allergies.

With best wishes,

Dr Anton Alexandroff MRCP(UK) CCT(Dermat) PhD FRSM FAAD
Consultant Dermatologist
Bedford and Leicester
www.alexandroff.org.uk