V.C.
C.,Seeing that your DD isn't actually "EATING" is on the G-Tube (Gastrointestinal Tube/Feeding Tube)
I am wondering if she has an allergy to MILK?
diarrhea is one of the major signs of a MilK or latose intolerant or may be allergic to SOY if her feedings contain that ingredient, or she may NEED to be on a SOY feeding.
She may also need to see a pediatric gastroenterologist although you may be seeing one because of the G-tube.
Here is some sites that might have some info that you might find useful for your daughter.
http://www.medhelp.org/forums/gastro/messages/32957.html
http://adc.bmj.com/cgi/content/extract/79/1/2
http://www.steadyhealth.com/Toddler__chronic_diarrhea__no...
Something else you may consider that I have found is:
[Another mom took her child to see the gastroenterologist and he recommended doing 3 stool tests in a week b/c sometime one isn't enough to catch parasites if this is in fact the case. I did the three stool test and sure enough is was a parasite -
Entamoeba histolytica.
This type of parasite is very hard to detect in a stool sample b/c they tend to die before the test is actually done. So You have to take the stool sample right before you will take it to the lab and make sure they do testing on it right away otherwise they wont be able to catch this parasite.
if not caught this parasite can do severe damage to your intestine - amoeba dysentery.
maybe this is not the case with your young ones but its a thought and it doesn't hurt to check]
Gosh, I didn't realize there could be a MILLION and ONE reasons for this problem.
Here is another look at something else, unless things have been ruled out already.
CHRONIC DIARRHEA:
* diarrhea with undigested food particles, the toddler looks healthy: excessive drinking of fruit juices;
* constipation altered with diarrhea: post-infectious irritable bowel syndrome;
* coughing, hives, face flushing, watery/bloody diarrhea: food allergy;
* skin rash, watery/bloody diarrhea: celiac disease, autoimmune enteropathy, parasites; rarely: Crohn’s disease, ulcerative colitis;
* underweight, diarrhea: celiac disease, parasites, tuberculosis, AIDS, cystic fibrosis, congenital diseases of biliary tract, liver, pancreas or intestine, surgery of small intestine, marasmus, kwashiorkor, zinc deficiency.
Okay, and YET ANOTHER possibility.(Written by mom in her blog, I am giving you the site address in case you can contact her)
http://expatria.typepad.com/ex_patria/2007/09/enigma.html
Chronic Diarrhea in the Toddler
The differential diagnosis of chronic diarrhea changes during the latter part of the first year of life and into the second year. The most common cause of chronic diarrhea in this age group is irritable colon of infancy, also known as chronic nonspecific diarrhea.
This disorder is believed to be a variant of irritable bowel syndrome. It is not uncommon to find a family history of irritable bowel in parents or siblings.
Patients who have this disorder typically exhibit intermittent loose, watery stools. The presentation can vary from two to three mushy stools on one day to five to ten watery stools on other days. The intermittent nature of the diarrhea often is helpful in making the diagnosis. Stools usually are not expelled at night, although it is not uncommon to have a very watery stool immediately upon awakening in the morning. These children manifest normal growth if they are not placed on hypocaloric diets in an attempt to control the diarrhea. Because of the intermittent nature of the diarrhea, they often are misdiagnosed as having food allergies or recurrent episodes of viral enteritis. The assumption of food allergy is strengthened in the minds of the parents by the common presence of vegetable or other food particles in the stool, which are simply a manifestation of rapid transit.
The mechanism for diarrhea in this disorder appears to be altered gastrointestinal motility. Despite relatively rapid transit, absorption is intact and the child will grow well if fed adequately. Institution of a high-fat, low-carbohydrate diet is often helpful because of reduced dietary osmolality and the effect of ileal fat reducing intestinal motility. When fat reaches the ileum, secretion of gastrointestinal hormones, primarily peptide YY, slows gastric emptying and small intestinal transit, thereby providing some improvement in the child's diarrhea. We usually tell parents to encourage ingestion of meats, vegetables, butter, gravy, and whole milk and eliminate all simple sugars, especially sucrose and juices. Addition of fiber in the form psyllium mixed with applesauce also may aid in improvement. [Emphasis mine.]
That was it. As clear and as simple as that. I did more googling, now that I knew the name of the beast. It sounded, as my doctor friend Natalie put it, as if Jacob had read the article, so perfect was his presentation of all the symptoms. True, it did not explain or address the ulcers. But all the rest was there.
But here's the thing: We read this, and decided to try the high-fat, low-carbohydrate diet for one month. And today, only 24 hours after we changed his diet, he had two semi-solid poops. No more diarrhea. Just like that. And his ulcers are gone. Just like that.
We are holding our breath. The visit in the clinic in Germany is postponed, not canceled. We can't quite yet believe that it may be so simple. But so far, so good.
Apparently, Toddler's Diarrhea is fairly common. It is often connected with high levels of fruit juice intake - which is not the case with Jacob, me not being a fruit juice fan (you want fruit? then eat a fruit!). It resolves itself, as spontaneously as it comes - most kids are over the diarrhea by the time they are four. We could live with that.
But why did none of his doctors spot this? Again, taken from another site, the typical symptoms are:
1. Age between 6-30 months. Most are better by 4 years of age.
2. 2-6 watery stools per day. There can be periods of days without stools. Many stools contain undigested material and may drip down the child's leg from the diaper.
3. Normal weight, height, and head circumference growth curves without falling off.
4. No evidence of infection.
5. Stools are hematest negative.
6. The child looks well and there is no evidence of malnutrition and no history of abdominal pain.
7. Growth may be compromised if the diet manipulations that have been tried to control the diarrhea have not been enough calories.
8. There is often a history of colic, gastroesophogeal reflux, and family history of irritable bowel syndrome.
He had all of those symptoms. He - and his brother - all had bad colic. One would think that pediatric gastroenterologists - or pediatric doctors in general - would know about this. The fact that the gluten-free diet had an effect within a day should have made them wonder about fast digestion. It didn't. What is there to say?
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I hope something up above will be useful and helpful to you and your family.
