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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Has Chronic Diarrhea, Lactose Intolerant, No Improvement With Lactose Prevention. Options?

Hi I have a 3 year old son. All his life he has chronic diarrhea . About 3 to sometime 6 episodes a day. He has gotten an endolscopy and colonoscopy . They did a biopsy and confirmed he was lactose intolerant. I have took him to an allergist I ve taking anything lactose away from him and he still getting the diarrhea. I feel hope less
Mon, 29 Oct 2012
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Allergist and Immunologist 's  Response
Hello Kersy,
Sorry to note that you feel helpless with your current situation.
Chronic diarrhoea in a three year old can have several reasons:
1. Depending on the geographical location, coeliac disease (immne reaction against wheat proteins) definitely must be excluded. Blood tests such as IgA-TTG and IgA-endomysium are available, and duodenal biopsy is the final test if serological tests are inconclusive. I am not sure why a diagnosis of lactose intolerance was made with the biopsy as it is NOT possible to say, this needs to be discussed with your doctor.
2. Lactose intolerance is far commoner than coeliac disease, and complete avoidance usually leads to normalisation of GI system, unless he has a concominant wheat intolerance as well.
3. Irritable bowel syndrome can happen in kids, although toddler's diarrhoea at this age is also a possibility that settles on its own as he grows up.
4. Infection-related diarrhoea needs to be excluded, or whether he is antibody deficient (such as IgA deficiency, or hypogammaglobulianemic [all 3 Ig isotypes low] which can be diagnosed with a simple blood test.
I hope that was helpful.
Thanks.
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Child Has Chronic Diarrhea, Lactose Intolerant, No Improvement With Lactose Prevention. Options?

Hello Kersy, Sorry to note that you feel helpless with your current situation. Chronic diarrhoea in a three year old can have several reasons: 1. Depending on the geographical location, coeliac disease (immne reaction against wheat proteins) definitely must be excluded. Blood tests such as IgA-TTG and IgA-endomysium are available, and duodenal biopsy is the final test if serological tests are inconclusive. I am not sure why a diagnosis of lactose intolerance was made with the biopsy as it is NOT possible to say, this needs to be discussed with your doctor. 2. Lactose intolerance is far commoner than coeliac disease, and complete avoidance usually leads to normalisation of GI system, unless he has a concominant wheat intolerance as well. 3. Irritable bowel syndrome can happen in kids, although toddler s diarrhoea at this age is also a possibility that settles on its own as he grows up. 4. Infection-related diarrhoea needs to be excluded, or whether he is antibody deficient (such as IgA deficiency, or hypogammaglobulianemic [all 3 Ig isotypes low] which can be diagnosed with a simple blood test. I hope that was helpful. Thanks.