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Q&A with Australian Health Practitioners
Should my 7 year old son have a bowel bisopsy?
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My 7yo son is being investigation for ongoing diarrhea. We have got results back from basic bloods - nil giardia etc present, urine sample yielded nothing, blood cell count suggestive of infection and Haemotologist suggest Ix for Thalassaemia, Iron is low (1.8), CRP is high (34). Coeliac seroogy also done - gliadin normal but IgA/IgG raised (51). There is a 2 month wait for an appointment with local Paed. Just wondering whether to head straight to “the big smoke” to a Paed. gastro and pursue a biopsy as first line of action? Or????? -
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Thanks
Prof Andrew Day
Paediatrician
Certainly sounds like your son should have further tests.
Iron deficiency essentially results from not enough iron in the diet, difficulty absorbing enough in the gut, or losing blood (and hence losing iron).
Coeliac disease is a possibility: would explain the diarrhoea and the iron deficiency (consequent to impaired absorbtion due to damage to the gut). Not sure what coeliac serology tests he has had done - do you mean tissue transglutaminase? Any family history? In the meantime, until he has had definitive tests, he should continue to have a normal diet (without any restrictions)
Another possibility is gut inflammation: this could explain the CRP, the blood count changes, the iron deficiency and the diarrhoea.
From what you have mentioned, it would be best to get things worked out sooner than later (i.e. not delay for the 2 months you mention)
Once it is clear what is causing his diarrhoea, then your doctors will be able to discuss the best approach to get things under control.Report this post
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Anonymous
Thanks Dr Day. I posted this some 6-8 weeks back so there have been some developments since then. I went with my gut instinct “ignoring” my LMO advice given the lengthy delay to see a local Paed., rang Paed. Gastro surgeries myself outlining symptoms and was booked in to see someone within the week. We then went for scopes a few weeks later and got results from biopsies back last week. My son has Chrohns disease (mild to moderate but extensive areas). No Coeliac disease. And while it has cost us a significant amount of money because we went the private route to get speedy action/results, it has been worth it to get a diagnosis within a couple of months of symptoms arising.
Having said that and having read up lots of info on Chrohns, I can't help wondering if our presentation at A+E late last year with headaches, temps., blurry vision/seeing double as my son described it, nausea etc wasn't an indication that something was severely amiss (or starting) and that I wasn't just being an over-reactive mum. He then went on to have diarr. more regularly, first across the day and then the night soon after I did my original post, also complaining of a sore mouth and leg pain. Having learnt about the digestive system at school recently, my boy was also able to pin-point his pain to his intestine!
We have started medications (what a nightmare!), will be starting EEN in the next week or so and will be attending the IBD clinic in Sydney in the next couple of weeks. Heres hoping we achieve remission sooner rather than later.
Thnaks again for taking time to respond.
SharonReport this post
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