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Michael Briggs

C Diff? Or Celiac, Or Other Dietary Issue?

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Back around late October, my son had a stomach flu. After that, he kept having intermittent soft stools with yellowish mucus. He would have normal stools for a day or two, then the mucus for a day or two. We had most stool tested, and he tested positive for c diff. But, apparently about 30% of kids his age (2) carry it. Since his issues weren't real severe, we tried just treating him with probiotics that have been found helpful with c diff (miyari and boulardi).

Also, thinking there was a dietary correlation, and since I and his maternal grandmother have gluten intolerance or allergy (undiagnosed), we tried removing gluten, and he improved- but still would have mucus every four or five days. I also read about"toddlers diarrhea", which involves fructose malabsorption. So we cut back on the amount of fructose he was getting. He seemed to improve a little more, but still about one day a week he would have mucusy stools.

Finally, in January, we have in and put him on metro to treat the c diff (and continued the probiotics and gluten free diet). From that point, he was fine for about 2 months, other than when he had another stomach virus that was going around (we all got it) - but with that he didn't have the mucus, instead a little vomit and normal diarrhea.

Then he was back to normal. Two weeks ago we decided to try wheat and oats again. The next two days he had mushy stools (not really diarrhea, and no mucus). We stopped the what and oats, and he went back to normal for the week. We decided to double check the oats by giving him some gluten free granola Friday morning (I can't eat any oats myself). Friday he was fine, so I gave him some more parts Saturday morning.

Saturday he had the mucus stools again. So, no more oats. Yesterday he has one nice normal stool. But then today he is back to the mucus stools.

We took a stool sample in Saturday to have tested for c diff, which should come back positive since people generally don't get rid of it fully. But, the fact that he only started having problems again after giving him oats again has me wondering if that is the real culprit.

On the other hand, of it is just the oats or other dietary factors, would that cause a good deal of mucus, which may last four a day or two?

Pertinent info: I have ulcerative colitis, although I think I have cured myself of it. His symptoms don't really match with uc, but it is of course a constant fear in my mind.

Any thoughts?

At this point, I'm considering doing a decal transplant, either with our without antibiotics, in case it is the c diff. But, while I've done those on myself, I don't know how I would manage to do them on a 2 year old.

Thanks.

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Can someone please help me understand if this is more likely to be from c diff or testing him on wheat and oats? Apparently current guideline day not to retest patients for c diff because they will test positive for the toxin for months afterwards, no matter what. He hasn't had the classic c diff symptoms of water diarrhea or abdominal pain. He was fine until we have him some oats again. But, the weird part is that after the initial day of mucus stools, he was fine for a day, then went back to mucus stools., then today he was fine again.

Could that be caused by a food sensitivity or celiac?

Thank you on advance for any help.

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Sorry, I think people have not responded because they don't have any knowledge about C-diff.  

 

Has your son been tested for celiac disease?  You can go to the University of Chicago website and they list the exact blood tests that can be ordered by your son's GP or PED or PED GI doctor.  

 

Oats, unless they are certified gluten free, can be cross contaminated by wheat in the harvesting/storage process.  

 

He could have a food sensitivity or allergies but who knows?  Reactions to foods can take minutes to days to appear.  There are over 300 symptoms for celiac and not all of them are related to the classic intestinal problems. 

 

Please check out that website as it contains a wealth of information regarding celiac disease.  Keep us posted on your progress!  

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Oh, for those diagnosed with celiac disease or NCGI (non-celiac gluten intolerance), the healing process can take months to years depending on the damage to the small intestines and the age of the patient (older folks often take longer to heal).  And you have good days and bad days…...

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Thanks for the replies everyone. The part that still is very weird to me is how he oscillates from one normal day to one day with mucus stools. Since that kept happening, we decided to go ahead and treat him with antibiotics for the C Diff, while giving him gobs of probiotics to help keep it from coming back, and also to protect his microbiota. In case anyone is interested, the less common ones we're giving him, in addition to S. Boulardii (which is somewhat uncommon, but many people are aware of it) are two spore forming bacteria:

 

 

Bacillus coagulans bc30 ("Digestive Advantage")
http://www.ncbi.nlm.nih.gov/pubmed/23088680
http://www.ncbi.nlm.nih.gov/pubmed/22014083

Clostridium Butyricum Miyairi
http://www.ncbi.nlm.nih.gov/pubmed/21700738
http://www.ncbi.nlm.nih.gov/pubmed/12654076
http://www.miyarisan.com/english_index2.htm
http://www.freepatentsonline.com/EP0456418.html

That last one (miyari), isn't sold in the US, but you can order it from Japan. I order mine here
http://en.kenko.com/shop/en-us/commodity/M215270H/

 

Thanks,

Mike

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Ugh, this is nerve racking. He had a normal stool this morning, but then two very mucusy ones later. He started the antibiotics two nights ago, so today was his second full day on them. Is this too soon to expect to see results?

Also, in wondering if giving him lots of probiotics might interfere with the antibiotics some, by giving them more bacteria to kill.... But I suppose the numbers he's getting from probiotics is much smaller than the amount in his intestines.

I'm still baffled by his lack of most c diff symptoms. No stomach pain, no fever, no watery diarrhea, no blood. Just mucus occasionally in his stool. Other than that, he's perfectly healthy. I know that the receptors that the c did toxins targets to cause the bleeding, etc, aren't developed when kids are first born, but I don't know when they generally develop. In wondering if maybe his aren't developed yet, so he isn't getting the bad symptoms, but his body may still be having an immune reaction to try to fight it off, resulting in the mucus.

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I don't know anything about c Diff but, I don't think you are supposed to have antibiotics and probiotics in your stomach at the same time. I think it might effect the antibiotics. You might look into that.

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The last time I researched the timing of taking probiotic when on antibiotic I found a lot of different answers and the studies I read had used different timing as well.  Most said take probiotic at least one hour after antibiotic -- and a good amount said take the probiotic two hours after.  I opted for two hours after.

 

Point being -- I agree with Karen that they shouldn't be given at the same time :)

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You are not suppose to take probiotics when taking an antibiotic, especially a systemic one per my MD. You are to wait a few days until the antibiotic clears from the body. Just a waste of money.

Does he have allergies or food intolerances? Have you taken him off foods like soy or milk? Mucus, (runny nose, eyes, or gut) is a normal allergic response for me when I consume milk proteins.

What does the doctor say? Did you ask for a celiac blood panel? At least you might be able to rule that out. Right now you are just guessing and that could get you into trouble. The internet is great but it is just a tool. Be careful. Not everyone has a perfect bowel movement. You said that he is healthy yourself.

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You are not suppose to take probiotics when taking an antibiotic, especially a systemic one per my MD. You are to wait a few days until the antibiotic clears from the body. Just a waste of money.

I think with some probiotics that may be the case, but some have been shown to be extremely beneficial to take while on antibiotics, such as Clostridium Butyricum Miyairi. See

http://www.ncbi.nlm.nih.gov/pubmed/12654076

It is a spore forming clostridia like c diff, but it does not produce toxins - except one that inhibits the growth of c diff, since they are competitors. The challenge with c diff is that it regrows from spores after antibiotics are stopped, and if there are not many competing microorganisms present, they will be able to take over again. Miyairi , and also bacillus coagulans, can lay spores while you are taking antibiotics, and regrow and inhibit the regrowth of c diff. At least that is what studies seem to show.

Perhaps though I shouldn't be also giving him more traditional probiotics (lactobacillus, bifidobacteria), since those haven't been found as helpful in inhibiting c diff.

The other reason for giving probiotics with antibiotics, especially miyari, is that it helps limit or prevent the damage to the microflora as a whole, although I'm not sure how it does that. But, according to the results of that study:

"Diarrhea was observed in 59% of the subjects who received only antibiotics, and total fecal anaerobes, especially Bifidobacterium, were remarkably decreased. In contrast, diarrhea in the subjects who received CBM from either the middle or the beginning of the antibiotic therapy was decreased to 5% and 9%, respectively. Concomitant administration of CBM increased anaerobes and prevented the decrease of Bifidobacterium in the subjects who received antibiotics."

"Does he have allergies or food intolerances? Have you taken him off foods like soy or milk? Mucus, (runny nose, eyes, or gut) is a normal allergic response for me when I consume milk proteins. "

We *think* he developed a sensitivity of some degree to gluten and oats (including gluten free ones) surfing or before the initial bout with c diff. We had the blood IgA testing done back then, but it wasn't elevated. Of course, I have a gluten sensitivity, but every test came back negative for me. We had him off gluten and oats for the two months that he was fine, and he only developed symptoms again after we tested him on whEat and oats (see details in the original post).

That had me thinking it was a dietary issue - I don't know if that would mesh with the weird way the mucus goes away for a day, then comes back, even though we stopped giving him wheat and oats again.

What does the doctor say? Did you ask for a celiac blood panel? At least you might be able to rule that out. Right now you are just guessing and that could get you into trouble. The internet is great but it is just a tool. Be careful. Not everyone has a perfect bowel movement. You said that he is healthy yourself.

These are definitely not OK BMs though. Well, sometimes they are, and then sometimes they are super mucusy.

The Dr says she has seen kids with c diff whose only symptom is mucusy stools. I can't remember though what she said about how he has perfectly normal days in between.

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 Of course, I have a gluten sensitivity, but every test came back negative for me. We had him off gluten and oats for the two months that he was fine, and he only developed symptoms again after we tested him on whEat and oats (see details in the original post).

 

 

To me...this is the most important fact.

 

How long had he been ingesting gluten before the first celiac antibody test?

 

How long has he been ingesting gluten now/is he still eating gluten daily?  If so, run a full antibody test and then regardless of results remove ALL gluten.

 

You have Non-Celiac Gluten Sensitivity and there is NO OTHER test besides complete gluten elimination -- sounds like this babe has already proved this test when you removed gluten and oats from his diet.

 

If removing gluten completely aided health....would he even need antibiotics/probiotics???

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To me...this is the most important fact.

 

How long had he been ingesting gluten before the first celiac antibody test?

For about a year I'm guessing. I think he probably started having wheat at around 18 months of age, and oats around a year.

 

How long has he been ingesting gluten now/is he still eating gluten daily?  If so, run a full antibody test and then regardless of results remove ALL gluten.

He had a little wheat Once two weeks ago, along with gluten free oats that day and the following. Then his stools got mushy, so we took him back off oats and wheat for a week. Last Friday and Saturday morning he had oats, and Saturday is when the mucus started. He hasn't had any more oats or gluten since then.

 

You have Non-Celiac Gluten Sensitivity and there is NO OTHER test besides complete gluten elimination -- sounds like this babe has already proved this test when you removed gluten and oats from his diet.

 

If removing gluten completely aided health....would he even need antibiotics/probiotics???

If it is just a gluten/oats sensitivity, how long would it take after removing for his symptom (the mucus) to disappear? It's been almost a week now since he stopped oats, and two weeks since the one time he had wheat.

Thanks for the help, BTW.

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It can take longer than two weeks....hard to know because everyone is different.  I would give it more time before I assumed he has serious bacterial issues -- especially if mucus in the stool is his only symptom....the antibiotics can set a healing system back and if he does not need them he should not take them.

 

From what I have read of your combined histories .... I would vote that gluten is the issue.  Some folks get gluten-free oats back after their digestive tract heals...I forget if I read - do you have issue with gluten-free oats?  Have you removed gluten yourself or just wheat?

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It can take longer tweeks....hard to know because everyone is different.  I would give it more time before I assumed he has serious bacterial issues -- especially if mucus in the stool is his only symptom....the antibiotics can set a healing system back and if he does not need them he should not take them.

 

From what I have read of your combined histories .... I would vote that gluten is the issue.  Some folks get gluten-free oats back after their digestive tract heals...I forget if I read - do you have issue with gluten-free oats?  Have you removed gluten yourself or just wheat?

I've removed all gluten and oats (both him and me). His led GI says she has actually seen symptoms like his before with c diff. I still think the wheat and oats Plays A role with what's going on, but I think it may be that the initial immune response enabled the c diff to come back.

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I think my gluten intolerance actually started after my C. diff infection during undergrad about 6 years ago. Still can't eat gluten containing foods to this day. It's important to remember that antibiotics that are decent at killing C. diff aren't always effective because of resistant strains. Having said that, if he no longer has C. diff but still has symptoms I would hit it heavy with the probiotics. C. diff and the antibiotics used to treat it can cause GI symptoms for months (I've been taught it can cause issues for almost a year, even), because you need to establish regular gut flora again. Probiotics have also been shown to reduce recurrent C. diff infections. 

 

Source: PharmD

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