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Dr. Andrew Rynne

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My 4 year old daughter has had On and off

Answered by
Dr. Ramesh Kumar


Practicing since :1986

Answered : 2039 Questions

Posted on Wed, 30 Jan 2019 in Digestion and Bowels
Question: My 4 year old daughter has had On and off diarrhoea and vomiting for the past 3 weeks.

She goes to child care two days a week and interacts with other children.

Her first symptom was water diarrhoea for a whole day, then three days later spewed up in the morning. Then on and off for the last couple of weeks. Diarrhoea today and spewed up dinner, but then ate food after.

Still has appetite, a little lethargic and tired. Might have lost a bit of weight.

Height of 103cm and 15.2kgs.

No fevers, no redness or rash.

Panicking that it’s leukaemia, but hoping it’s just Giardiasis.

Going to doctor today.
Need information on what it could be and what to ask the doctor.
Answered by Dr. Ramesh Kumar 2 hours later
Brief Answer:
Rotavirus infection.

Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
Very likely the kid is having Rotavirus infection.Rotavirus is one of the most important cause of recurrent diarrhea in kids less then 5 years of age.

Firstly I would suggest you to ask her pediatrician to get a stool test done.
Get her vaccinated for rota virus.
Give her Oral rehydration solution pediatric with oral zinc.
As she goes to child care most likely she got infected with this virus from other kids.
However it could be bacterial or protozoal infection also but bacterial cases are usually involved with fever.
So answer is-
It could be Gastroenteritis which is infection of intestines.
It could be viral protozoal or bacterial in nature.
She should be vaccinated.
Stool test and culture should be done.
If required therapy with anti biotic and anti protozoal should be given for 5 days.
Pediatric oral rehydration solution with zinc should be given for 2weeks to replete electrolytes.
Probiotic which contains good bacterias of gut should be given orally.
As far as leukemia etc are concerned first rule of medical science is to rule out common cause first.I don't think it's leukemia or any sort of cancer.Its a Rotavirus infection which is very common at her age.
letharge and tiredness is due to loss of sodium potassium and other electrolytes from stools and vomit.ORS would take care of it.
If it's giardiasis or any other parasitic infection stool test would reveal it.
Take a print out of this answer so that you can discuss these things with pediatrician.
Hope I was helpful,
Follow ups are welcome,
Do rate the answer.
Thank you and wish her a fast recovery.
Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Ramesh Kumar 2 days later
Thank you for the information.
I took her to the doctors and we got a single stool sample test.

Usually she will do one-two watery diarrhoea per day. The day we took the sample it was thicker and held together.

She still keeps having diarrhoea and spewing approx every 2-3 days, only once.

The still test came back negative. It was the most solid stool she has had in weeks. Could this cause a negative result?

What could it be? A false negative etc?
Follow up: Dr. Ramesh Kumar 0 minute later
What other tests could we ask for etc?

And what food should we give and not give her?

Thank you
Answered by Dr. Ramesh Kumar 14 minutes later
Brief Answer:
Its Rotavirus.

Detailed Answer:
Hello again sir,
A negative test means that there is no bacterial or protozoal infection in stool.
Get her vaccinated for Rotavirus.
Give her 2.5 ml of dicyclomine drops for 3 days(to reduce motility of intestine) along with fybogel a bulk forming agent.
Add probiotic like Sporlac XXXXXXX for kids to some yoghurt and give her soft food like banana apple curd etc to eat
ORS and zinc solution should be given.
Once stools are thick and well formed stop Dicyclomine.
Solid/liquid stool has nothing to do with test.
Read research links for an idea.
What did her pediatrician suggested?

Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Ramesh Kumar 38 minutes later
Thank you for the reply.
She has been vaccinated for all viruses and childhood diseases.

She still has all of the symptoms.
We have another appointment tomorrow to work out what to rest for next.

He did advise to cut out all dairy as she might be lactose intolerant due to having been sick.

She still has an appetite but her stools are still watery and vomits every now and then. Although she says she feels like she is going to be sick.
Answered by Dr. Ramesh Kumar 24 minutes later
Brief Answer:
follow up.

Detailed Answer:
Hello again,
As she has already been vaccinated for all viruses and her stool tests are also normal.
You could now ask the doctor to go for a colonoscopy to rule out possible inflammatory bowel disease and to go for a hydrogen breath test to make clear if she is lactose intolerant or not.
Easiest way is that stop lactose from her diet for two three days if symptoms starts subsiding she is lactose intolerant.
These are the two tests which should be done now,
As of now to control loose stools and vomiting give her few drops of Prochlorperazine or promethazine which ever is available on as and when required basis to control loose motion give her antispasmodic 2.5ml as and when required as said above.

Cut lactose from her diet and follow up with reports.
If thread gets closed you can follow me at-
Regards and hope i was helpful.
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Ramesh Kumar 19 minutes later
I have ready that because only 1 stool sample that it might return a false positive. And that at least 3 stool samples should be tested.

Is there any over the counter drugs I can give or should I ask for other tests?

She did have a viral infection about 7 XXXXXXX before the diarrhoea and was taking amoxicillin
Answered by Dr. Ramesh Kumar 21 minutes later
Brief Answer:
follow up.

Detailed Answer:
Hello again,

She did have a viral infection about 7 XXXXXXX before the diarrhea and was taking amoxicillin -Sir one of the major side effect of amoxicilin is loose stools.But as you have written that she is having off and on diarrhea from past 3 weeks further testing is essential.
Again it depends on fact whether only stool routine test has been done or complete culture and sensitivity is done along with it.
Complete culture and sensitivity would take a minimum of 48 to 72 hours for results while stool routine would be there in 8 hours,
So if possible kindly clarify which test has been performed on her.
For nausea and vomiting you can give-
Bismuth Subsalicylate, the active ingredient in Pepto-Bismol 5ml twice and for loose stools you can give Loperamide(Imodium) 1mg twice daily for few days.

Feel free to follow up.
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Ramesh Kumar 13 minutes later
Thank you for the information.
It’s just strange because she has all of the symptoms for giardiasis but the result was negative.

Will talk to the doctor tomorrow about it all. Just scares us about her not feeling the same and constantly feeling off.
Answered by Dr. Ramesh Kumar 13 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Hello again my dear patient,
If you feel that it could be giardiasis then just ask her doctor to prescribe her-
De worming agent Albendazole 5ml on dose and Metrogyl 5ml thrice daily for 5 days.
They are very safe drug and would even kill any other parasite ova or cyst too.
De worming is very commonly done in developing nations.
Stool test some times misses small ova and cysts secondly as done by technician human errors are also involved.
You can go for de worming.
Would wait for what your primary doctor says tomorrow.
Thank you and feel free to follow up!
Above answer was peer-reviewed by : Dr. Yogesh D

The User accepted the expert's answer

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