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What Causes Stomach Infection In A Child?
Question: The present symptoms for my 2-year old son are:
1. Last 40 days, his motion is not okay. Stool is semi-solid, sometimes liquid with extremely bad odor. The first morning stool sometimes shows leftover undigested food items (whole rice grains, vegetables etc)
2. The baby is getting extremely hungry and always asking for food but passes bad stool even if he is having biscuits. Previously he used to digest all of these & many more (chips, cakes, apples etc)
3. The baby is showing no sign of consuming water. He only takes water with glucose or ORS, but the doctor mentioned not to give that since it'll lead to worm in stool.
We’ve consulted two different pediatricians and this is what they have recommended:
Doctor 1:
A. Enterogermina
B. Bacigyl n syrup
Doctor 2:
A. Junior lanzol
B. Xintof
C. Nutrolin b
D. Z & D dry
Doctor had also recommended stool test to which only report came as: growth of escherichia coli. And the Doctor responded that there is nothing much to be concerned by this report.
We’re maintaining high standards of health & hygiene (to our level best capacity) but still not sure why my son is not showing any sign of cure. His weight is not improving as we’re forced not to provide him with the required nutritious meal. Please suggest the needful in this regard.
1. Last 40 days, his motion is not okay. Stool is semi-solid, sometimes liquid with extremely bad odor. The first morning stool sometimes shows leftover undigested food items (whole rice grains, vegetables etc)
2. The baby is getting extremely hungry and always asking for food but passes bad stool even if he is having biscuits. Previously he used to digest all of these & many more (chips, cakes, apples etc)
3. The baby is showing no sign of consuming water. He only takes water with glucose or ORS, but the doctor mentioned not to give that since it'll lead to worm in stool.
We’ve consulted two different pediatricians and this is what they have recommended:
Doctor 1:
A. Enterogermina
B. Bacigyl n syrup
Doctor 2:
A. Junior lanzol
B. Xintof
C. Nutrolin b
D. Z & D dry
Doctor had also recommended stool test to which only report came as: growth of escherichia coli. And the Doctor responded that there is nothing much to be concerned by this report.
We’re maintaining high standards of health & hygiene (to our level best capacity) but still not sure why my son is not showing any sign of cure. His weight is not improving as we’re forced not to provide him with the required nutritious meal. Please suggest the needful in this regard.
Brief Answer:
Remove wheat based products from diet, visit a pediatric gastroenterologist
Detailed Answer:
Thanks for asking on HealthcareMagic.
Your child is probably suffering from malabsorption. It is manifested by foul smelling stools containing undigested food matter. Since the nutrients are not adequately absorbed, weight gain is often not proper in such children.
Sometimes such malabsorption syndromes result from sensitivity to a substance called gluten which is found in members of wheat family. I would suggest eliminating wheat based products altogether from diet for at least 2 weeks or so and observe if that makes a difference. If it does, dietary modification would be recommended.
The next step would be to add pancreatic supplements and see if there is improvement in the stool odour issue. But such a decision would also involve the clinical judgement of your doctor. Visiting a pediatric gastroenterologist should be a better idea.
Escherichia coli is normally present in the stool and hence I would not be alarmed by its presence.
Bacigyl N contains Norfloxacin while Xintof contains Ofloxacin, both are antibiotics of same group and I would not recommend the combined use of these two unless you have already begun the course. If the doses have been started, please complete the course, else give only one of these two. If I had a patient like your child, I would perhaps have given metronidazole instead. It could help in reducing the overgrowth of bacteria which are responsible for the foul smell in the stool. Giving Enterogermina should help since it contains beneficial bacteria. I would insist giving plenty of curd but to avoid other milk based products.
Other medicines are proper.
Hope that helps.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Diptanshu Das
Remove wheat based products from diet, visit a pediatric gastroenterologist
Detailed Answer:
Thanks for asking on HealthcareMagic.
Your child is probably suffering from malabsorption. It is manifested by foul smelling stools containing undigested food matter. Since the nutrients are not adequately absorbed, weight gain is often not proper in such children.
Sometimes such malabsorption syndromes result from sensitivity to a substance called gluten which is found in members of wheat family. I would suggest eliminating wheat based products altogether from diet for at least 2 weeks or so and observe if that makes a difference. If it does, dietary modification would be recommended.
The next step would be to add pancreatic supplements and see if there is improvement in the stool odour issue. But such a decision would also involve the clinical judgement of your doctor. Visiting a pediatric gastroenterologist should be a better idea.
Escherichia coli is normally present in the stool and hence I would not be alarmed by its presence.
Bacigyl N contains Norfloxacin while Xintof contains Ofloxacin, both are antibiotics of same group and I would not recommend the combined use of these two unless you have already begun the course. If the doses have been started, please complete the course, else give only one of these two. If I had a patient like your child, I would perhaps have given metronidazole instead. It could help in reducing the overgrowth of bacteria which are responsible for the foul smell in the stool. Giving Enterogermina should help since it contains beneficial bacteria. I would insist giving plenty of curd but to avoid other milk based products.
Other medicines are proper.
Hope that helps.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Diptanshu Das
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Thank a lot for your answer. But I found out that I’ve missed some key points in my previous mail. Let me out line the same here:
1. The baby used to eat red masoor dal, 1 apple (boiled) and 3 bananas with Nestum rice before (till Dec 2014) and never had problems. Only when he was having Khichdi (mixed with Rice+dal+vegetable), he used to pass stool 7-8 times a day but stool consistency was good. Then we changed to the Nestum diet and found that the passing of stool has decreased to 3-4 times day. From last 40 days, he is only eating boiled rice + potato +green banana and still there is no improvement in digestion/stool
2. He is medication and whenever dosage is stop, after 1 or 2 days the loose motion starts. When the baby eats full fledged meal, immediately he goes for potty. But if we do not give full meal, he is irritated and constantly asking for more food. These days he is also consuming a lot of puffed rice (muri). Could it play any role?
3. He was taking a piece of Rohu fish (shallow fried) every day before, but now we’ve even stopped that.
Based on your last recommendation, should we start giving him Metronidazole or Enterogermina based medicine? In that case, what should be the names and dosage of the medicine, could you please specify? We are ready to stop his regular medicine from now (Junior lanzol, Xintof, Nutrolin b, Z & D dry) Also we’d be really grateful to you if you can provide some tips on his diet (apart from curd).
I am out of XXXXXXX now, and see a pediatric (gastro) as soon as I go back to XXXXXXX
We’re very anxious in this time about my son’s health and would really appreciate if you kindly provide the needful solution in this regard.
We thank you once again from the bottom of our heart for the advice and would like to have any of your clinic’s contact number so that we can meet you with my son for an appointment.
Thank a lot for your answer. But I found out that I’ve missed some key points in my previous mail. Let me out line the same here:
1. The baby used to eat red masoor dal, 1 apple (boiled) and 3 bananas with Nestum rice before (till Dec 2014) and never had problems. Only when he was having Khichdi (mixed with Rice+dal+vegetable), he used to pass stool 7-8 times a day but stool consistency was good. Then we changed to the Nestum diet and found that the passing of stool has decreased to 3-4 times day. From last 40 days, he is only eating boiled rice + potato +green banana and still there is no improvement in digestion/stool
2. He is medication and whenever dosage is stop, after 1 or 2 days the loose motion starts. When the baby eats full fledged meal, immediately he goes for potty. But if we do not give full meal, he is irritated and constantly asking for more food. These days he is also consuming a lot of puffed rice (muri). Could it play any role?
3. He was taking a piece of Rohu fish (shallow fried) every day before, but now we’ve even stopped that.
Based on your last recommendation, should we start giving him Metronidazole or Enterogermina based medicine? In that case, what should be the names and dosage of the medicine, could you please specify? We are ready to stop his regular medicine from now (Junior lanzol, Xintof, Nutrolin b, Z & D dry) Also we’d be really grateful to you if you can provide some tips on his diet (apart from curd).
I am out of XXXXXXX now, and see a pediatric (gastro) as soon as I go back to XXXXXXX
We’re very anxious in this time about my son’s health and would really appreciate if you kindly provide the needful solution in this regard.
We thank you once again from the bottom of our heart for the advice and would like to have any of your clinic’s contact number so that we can meet you with my son for an appointment.
Brief Answer:
Diet chart mentioned. Clinical assessment required.
Detailed Answer:
Thanks for writing back. Sorry for not being able to write back earlier.
Let me try to address the issues one by one:
1. I would suggest you to experiment with the diet. Instead of formula like Nestum rice, I would prefer home made cereal based meals, especially of rice. But both rice as well as potato contain starch or carbohydrate but hardly any proteins. A balance is required. You may give a mashed version of adult diet low on spices.
2. There is a normal phenomenon called gastrocolic reflex which may persist in many children and can make them pass stool everytime after each feed. There is nothing to worry, it is normal. You need not reduce the amount of feeds. Giving full feeds should be fine. No problems if muri is given but it is not likely to be related.
3. Definitely continue sources of animal protein including rohu fish as well as eggs. I would not insist you to stop such things. Rather than giving Enterogermina, giving curd should be fine. To be able to comment on the requisite dose of Metronidazole, I would need to know the weight of the child. Brand Metrogyl or Flagyl can be used. No need to stop the regular medicines. Please complete the course of the antibiotics.
Your 2 year old child needs about 1,200-1,400 calories a day. High calorie foods such as biscuits, crisps etc contain many calories.
Diet chart:
Whole grain cereal or oatmeal with milk
Bite-sized pieces of leftover cooked beef or chicken and soft cooked vegetables
Milk or yogurt-based fruit smoothies in an open cup
Yogurt with pieces of soft fresh fruit
Applesauce with whole grain crackers or roti
Rice and raisin pudding made with milk
Sandwich triangles made with egg, tuna, chicken salad, or easy-to-chew meat
Hummus, whole wheat pita and soft cooked and cooled vegetables
Soft cooked short pasta noodles, cooked pieces of fish and peas
Cream of wheat, oatmeal or other whole grain cooked cereals with mashed fruit
Homemade pancakes or waffles topped with thinly spread nut butter and fruit XXXXXXX omelets or scrambled eggs with cooked vegetables or fruit and toast
Cooked tofu pieces, sweet potatoes and whole grain short pasta noodles
Congee or rice porridge with small pieces of meat, chicken, or fish
Soft tortillas filled with beans or ground meat and tomato sauce
Vegetable, split pea, or bean soup served with crackers or a whole grain bun
Fish chowder with bread sticks
Home-made macaroni and cheese with tuna and peas
Whole wheat pasta with tomato or meat sauce
Chicken, beef, pork, or tofu cut in small pieces stir-fried with soft cooked vegetables and rice
Rice or pasta and small pieces of tender beef with cooked vegetables
Baked beans with soft taco or whole grain toast
Chili, dal or lentils with chopped tomatoes, rice, roti, whole wheat or corn bread
Soft veggies, tomato sauce and grated cheese on a whole wheat pita, pizza shell or English.
Ways to make him feed:
* Always offer 2 x courses (1 x savoury & 1 x sweet) even if the main meal is not eaten.
* Develop a routine of 3 x meals and 2 healthy snacks a day avoid high saturated or trans fat, high salt, high sugar commercial items which are low in nutrients but high in calories and fill them up.
* Be positive about food and praise your LO when they do eat.
* Children often accept small tastes of alternatives from somebody’s else’s plate even if they won’t eat it on their own plate.
* Arrange for your LO to eat with other children as often as possible
* keep offering the finger foods. Toddlers eat better if allowed to feed themselves with their fingers and not be spoon fed.
* Too many high calorie drinks in between meals can fill a child up.
* Only offer one new food at a time and serve a new food with a familiar food.
* When offering new foods remember a 'taste' can be as small as half a teaspoon.
* Have meals in a calm atmosphere with the TV off and no distractions.
* Don't let meals drag on too long, 20-30 minutes should be plenty.
* Change the venue for your meal from time to time, maybe a picnic or similar out in the garden or the park now with the good weather.
I can be reached on +91-0000. I am available at Woodlands Multispeciality Hospital on Tuesdays and Wednesdays.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Hope that helps.
Regards
Diet chart mentioned. Clinical assessment required.
Detailed Answer:
Thanks for writing back. Sorry for not being able to write back earlier.
Let me try to address the issues one by one:
1. I would suggest you to experiment with the diet. Instead of formula like Nestum rice, I would prefer home made cereal based meals, especially of rice. But both rice as well as potato contain starch or carbohydrate but hardly any proteins. A balance is required. You may give a mashed version of adult diet low on spices.
2. There is a normal phenomenon called gastrocolic reflex which may persist in many children and can make them pass stool everytime after each feed. There is nothing to worry, it is normal. You need not reduce the amount of feeds. Giving full feeds should be fine. No problems if muri is given but it is not likely to be related.
3. Definitely continue sources of animal protein including rohu fish as well as eggs. I would not insist you to stop such things. Rather than giving Enterogermina, giving curd should be fine. To be able to comment on the requisite dose of Metronidazole, I would need to know the weight of the child. Brand Metrogyl or Flagyl can be used. No need to stop the regular medicines. Please complete the course of the antibiotics.
Your 2 year old child needs about 1,200-1,400 calories a day. High calorie foods such as biscuits, crisps etc contain many calories.
Diet chart:
Whole grain cereal or oatmeal with milk
Bite-sized pieces of leftover cooked beef or chicken and soft cooked vegetables
Milk or yogurt-based fruit smoothies in an open cup
Yogurt with pieces of soft fresh fruit
Applesauce with whole grain crackers or roti
Rice and raisin pudding made with milk
Sandwich triangles made with egg, tuna, chicken salad, or easy-to-chew meat
Hummus, whole wheat pita and soft cooked and cooled vegetables
Soft cooked short pasta noodles, cooked pieces of fish and peas
Cream of wheat, oatmeal or other whole grain cooked cereals with mashed fruit
Homemade pancakes or waffles topped with thinly spread nut butter and fruit XXXXXXX omelets or scrambled eggs with cooked vegetables or fruit and toast
Cooked tofu pieces, sweet potatoes and whole grain short pasta noodles
Congee or rice porridge with small pieces of meat, chicken, or fish
Soft tortillas filled with beans or ground meat and tomato sauce
Vegetable, split pea, or bean soup served with crackers or a whole grain bun
Fish chowder with bread sticks
Home-made macaroni and cheese with tuna and peas
Whole wheat pasta with tomato or meat sauce
Chicken, beef, pork, or tofu cut in small pieces stir-fried with soft cooked vegetables and rice
Rice or pasta and small pieces of tender beef with cooked vegetables
Baked beans with soft taco or whole grain toast
Chili, dal or lentils with chopped tomatoes, rice, roti, whole wheat or corn bread
Soft veggies, tomato sauce and grated cheese on a whole wheat pita, pizza shell or English.
Ways to make him feed:
* Always offer 2 x courses (1 x savoury & 1 x sweet) even if the main meal is not eaten.
* Develop a routine of 3 x meals and 2 healthy snacks a day avoid high saturated or trans fat, high salt, high sugar commercial items which are low in nutrients but high in calories and fill them up.
* Be positive about food and praise your LO when they do eat.
* Children often accept small tastes of alternatives from somebody’s else’s plate even if they won’t eat it on their own plate.
* Arrange for your LO to eat with other children as often as possible
* keep offering the finger foods. Toddlers eat better if allowed to feed themselves with their fingers and not be spoon fed.
* Too many high calorie drinks in between meals can fill a child up.
* Only offer one new food at a time and serve a new food with a familiar food.
* When offering new foods remember a 'taste' can be as small as half a teaspoon.
* Have meals in a calm atmosphere with the TV off and no distractions.
* Don't let meals drag on too long, 20-30 minutes should be plenty.
* Change the venue for your meal from time to time, maybe a picnic or similar out in the garden or the park now with the good weather.
I can be reached on +91-0000. I am available at Woodlands Multispeciality Hospital on Tuesdays and Wednesdays.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Hope that helps.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Thank you so much for your valuable time & suggestion. We are really grateful to you.
My son’s weight is 10.5 Kg and age is 2 years. At present, he is taking these medicines: Junior lanzol, Xintof, Nutrolin b, Z & D dry.
In addition, what is/are the additional medicine/s should he take? For Metronidazole type medicines, may I kindly request you to provide us with the brand name & dosage?
I’ve noted your number and hope to be touch with you as soon as I go to XXXXXXX Meanwhile, we’ll be trying to continue with the prescribed diet & medicine as suggested by you.
Thank you again for such a great help.
P.S.: My has allergic problems with smoke, dust (along with mild child asthma-type issues as doctor told us before)
Thank you so much for your valuable time & suggestion. We are really grateful to you.
My son’s weight is 10.5 Kg and age is 2 years. At present, he is taking these medicines: Junior lanzol, Xintof, Nutrolin b, Z & D dry.
In addition, what is/are the additional medicine/s should he take? For Metronidazole type medicines, may I kindly request you to provide us with the brand name & dosage?
I’ve noted your number and hope to be touch with you as soon as I go to XXXXXXX Meanwhile, we’ll be trying to continue with the prescribed diet & medicine as suggested by you.
Thank you again for such a great help.
P.S.: My has allergic problems with smoke, dust (along with mild child asthma-type issues as doctor told us before)
Brief Answer:
Flagyl or Metrogyl are brands of metronidazole and may be given.
Detailed Answer:
Thanks once again for writing back.
For your child, giving any one of Flagyl or Metrogyl Suspension (50mg/5ml) 7.5 ml thrice daily for 5 days should be fine. Please continue the other medications as prescribed.
Many children have some amount of hypersensitivity/allergy and might be prone to catching cold. I would not really worry. Some antiallergic like cetirizine for a few days should be fine. Steam inhalation would be helpful.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Diptanshu Das
Flagyl or Metrogyl are brands of metronidazole and may be given.
Detailed Answer:
Thanks once again for writing back.
For your child, giving any one of Flagyl or Metrogyl Suspension (50mg/5ml) 7.5 ml thrice daily for 5 days should be fine. Please continue the other medications as prescribed.
Many children have some amount of hypersensitivity/allergy and might be prone to catching cold. I would not really worry. Some antiallergic like cetirizine for a few days should be fine. Steam inhalation would be helpful.
If you found my answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Diptanshu Das
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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