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Child diagnosed with fructose malabsorption, IBS, vitiligo. Having digestion problem. Proper treatment?

My 8 year old daughter has been diagnosed with a Fructose Malabsorption using the HBT. She also has vitiligo . She has all the symptoms of IBS even without fructose ingestion . She has chronic constipation . Intermittent explosive bowel movements that are extremely acidic. She can sleep 14-16 hours a day and still be tired and then a few days later she will sleep 8 hours and be fine. She is an active child when she is awake. Her behavior can only be described as a roller coaster. She always seems to have some kind of rash somewhere on her body. She was originally seen by the GI DR for encopresis . She also has enuresis and I can honestly say that she has not been dry since she was 3 years old. The encopresis started at 6.5 years old. She had lead poisoning as a baby. She had a prolapse rectum as a baby. We have removed all fructose from her diet including fructans, etc. We have removed all sucrose from her diet because after removing the fructose each ingestion of sucrose or sucrose containing foods lead to EXTREME explosive diarrhea. Under the guidance of a nutritionist we also removed gluten. With these changes we have been able to take her off the myriad of laxative medications she has been on and only use them as needed. Erin has had a colonoscopy that was normal. She had a barium enema which was normal. She had lactose, H Pylori, Fructose and Glucose HBTs. Only the fructose showed a reaction. Her thyroid has been checked (high and low numbers) and they were within normal limits. She has had 3 sweat chloride tests. She also had the sitz marker test which was negative, anorectal manometry - negative, 3 MRIs - negative, and a host of urinalysis and bloodwork. Her GI DR has released her from care stating, We are getting more questions than answers at this point. If anything changes us, call. We are not satisfied with this answer but also don t want to waste anyone s time by getting a second opinon if there is nothing that can be done. Please advise as to what you would do if it were your child.
Asked On : Thu, 24 Jan 2013
Answers:  1 Views:  244
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Pediatrician 's  Response
Feb 2013
Thank you for your query,
You continue the fructose, sucrose and gluten free diet.
The reason for the encopresis in your child may be chronic constipation with probable fecal impaction.
So use laxatives whenever she is having constipation, as treatment of constipation will lead to decrease in encopresis.
For enuresis you restrict the fluid intake from 7 pm onwards daily, positive reinforcement with a star and calender technique and by giving incremental rewards on dry days.
You be in regular follow up with your Pediatrician and Gastroenterologist for the proper management of your child problems.
Hope i have answered your queries.
Answered: Thu, 31 Jan 2013
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