Chronic diarrhea

My son will be 4 in September. He has various environmental allergies which were diagnosed by a pediatric allergist. At about 2 or so, he developed loose stools. The allergist suggested he had lactose intolerance, but the lactaid tablets/100% lactaid milk did not solve his problem.

We took him to a pediatric GI specialist, who interviewed us extensively but did no medical tests. The GI concluded that my son had a residual milk allergy. Since Feb., he has been off of all dairy products and milk proteins. His stools became normal in consistency for a while.

Since May, he has had several instances of uncontrollable bowel movements and has diarrhea often. There are other foods we are trying to link this to, without luck. We keep a food diary. It seems like bananas may have caused his problem once, although he used to be able to eat bananas without any problems.

He gets mostly water to drink, he uses rice milk (non-dairy) on his cereal in the morning and probably a glass of juice or two during the day. He is still growing fast and furiously. The allergist wants to do a food challenge for milk--she still believes he doesn't have a milk allergy.

We have an appt w/a different pediatric GI specialist next week to see if they can help with his chronic problem. Do you have any ideas of where I should turn next and what I should do for him? Please advise.

Thank you very much.

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Sue Gilbert

Sue Gilbert works as a consulting nutritionist. For many years she worked with Earth's Best Organic Baby Food, integrating nutrition and... Read more

Dear Diane,

It is important that you continue to pursue this problem with a GI specialist and your pediatrician and allergist. I am not able to diagnose clinical problems such as this, but I can share with you some information that you may want to take into consideration. There is such a condition, and it is common in the U.S. and getting more and more so, called Chronic, Nonspecific Infantile Diarrhea. It is also referred to as the irritable colon syndrome, toddler diarrhea, or the sloppy stool syndrome. It occurs without protein-calorie malabsorption, which seems to describe your son i.e. you mention he is growing fast and furiously. Studies are suggesting that it is caused, at least in part, by variations in diet.

Those children who improve with dietary manipulations generally started the problem with some acute enteritis, probably infectious in origin, but maybe of an allergic nature, and the diarrhea has persisted beyond the expected recovery. The characteristics of this situation are:

  1. stools are sometimes normal,
  2. weight exceeds height percentile,
  3. watery stools are more frequent in the afternoon and evening,
  4. calorie intake seems higher than needs,
  5. fluid intake is either excessive or consists of large amounts of juices or hypertonic drinks.

Sometimes just limiting the intake of clear fluids shows good improvement.

The child who does not show improvement when his diet is altered is generally one who was colicky as an infant, has 3 to 6 mucous- containing stools a day, equally day and night, and parents may have irritable bowel syndrome. Malabsorption should be checked for in this case.

Often, children with chronic, nonspecific diarrhea simply outgrow it. it is usually outgrown by four years of age, so perhaps your son is on the cusp of recovery. Even if this may be the case, you will want to continue and pursue any possible medical explanation.

From your description, your son seems to fit the first category if nonspecific diarrhea is, in fact, his problem.

Thank you for writing.

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