Hello.
Thank you for posting your query at DoctorSpring.com
I understand your concerns.
Before, I can guide you any further, please clarify the following queries:
Since when does your son have these problems?
Do these problems occur everyday?
Are these problems associated with any particular food/ food groups?
Are these problems associated with any change in bowel habits? change in frequency/ colour/ odor of stools?
Is there any history of worms in stools? or perianal itching at night time?
How are his growth parameters - Height and weight ? Is he tall enough for his age?
How s his appetite in general? Does he dislike particular sub-group of foods? Does he have any rash after ingesting any particular food?
What do you do? What are your occupations (father and mother)?
Does anyone else in the family have similar symptoms?
Regards
Dr. Saptharishi L G
Patient replied :
Hello doctor This problem started when stopped breast feeding , diagnosed lactose intolerance stopped cow milk and on soy milk since now.
PROBLEM DOES Not OCCUR ever day but thrice a week
he regularly consume eggs raw and eggs boiled.
No regular bowel habits , excessive wind with odour smell
AGE 9 years old patient10MONTHS his ht is 141 cm wt 30 kg regular de worming once in 3 months .. Albendazole 400+ IverMECTIIN 1ST DAY AND 15TH DAY
No perianal itching , no rash so far ...occasionally flu and wheezing. Very poor appetite.
Father business HT- 6.2"
mother home maker---HT 5.8"
HIS COUSIN HAS INTOLERENCE TO MILK SOY EGG WHEAT
Dear Parent,
Thank you for providing me the above information.
I am not really convinced about his diagnosis of LACTOSE INTOLERANCE. You say that he has been on SOY milk for 9 years old patientnow !!! I am assuming that the doctors who gave you this advice must definitely have got intestinal biopsy/ IgE levels, etc.
Are those reports available with you? Did they tell you that the child has COW/ANIMAL MILK PROTEIN ALLERGY? Have you got TTGA levels or work up for Celiac disease? Has upper/lower GI endoscopy ever been performed in your child?
On a positive note, your child's height seems to be appropriate for age. However, weight of the child is significantly lower than expected.
Regarding these allergy tests, they return positive in many individuals. Actual lab positivity does not correlate with clinical symptoms in most children. Most of my patients get positive results to more than twenty food items despite being asymptomatic and on those foods since childhood. Such instances are many. So personally, am not much in favour of these in-vitro allergy testing.
I am unable to pin-point a specific cause of abdominal complaints in your child based on the information provided above, but it is reasonably clear that you need to see a pediatric gastroenterologist in-person.
Your child requires an gastrointestinal endoscopy and intestinal mucosal biopsy as well as evaluation for celiac disease.
I hope this was helpful. Let me know if I can assist you any further.
Regards.