Pediatric lactose intolerance and celiac

[HMP]

My 4 year old son has had loose mucous stools for almost three months (no abdominal pain or vomiting) along with weight deceleration (10 percent BMI). The doctor would like to rule out a lactose intolerance before running a celiac blood test.  It’s been a week and now instead of having loose mucous stools he has watery diarrhea at least one time a day. Would it be beneficial to move forward sooner with the celiac blood work( doctor advised we wait two months) or do you think the lactose is still working out of his system and causing the diarrhea? 

[Scott Adams]

I’m not sure why your doctor would not do a celiac blood test, as untreated CD can be dangerous in a toddler and can cause temporary lactose/casein intolerance. Has your son been on a gluten-free diet? If so, that could be the reason. He needs to eat gluten daily for several weeks before any tests  for CD can be done.

[cyclinglady]

I agree, a blood draw is in order.  He should be screened for celiac disease and checked for anemia.  Ask for both the DGP and TTG tests.  Usually the TTG catches most celiacs, but kids that young often do better With the DGP.  Ask for both the IgA and IgG of both those tests to cover all bases.  You only need one positive on any of those four tests.   I did this with my kid.  No need to do unnecessary blood draws on a kid.  Do it right the first time.  
 

If your doctor balks, get a new one.  No child should have diarrhea for months like that!  
 

I was lactose intolerant, yet I still had celiac disease (which resolved once I went gluten free/treated celiac disease).  Symptoms from lactose intolerance usually resolves within a day or so.  Celiac disease, on he other hand is autoimmune.  Gluten just triggers the autoimmune response that causes small intestinal damage that can linger for weeks, months, or a year!  It is systemic (e.g. affect joints, make you cranky, anxious, rashes, etc).   

DO NOT put him on a gluten free diet, until you can get the blood test.  Be sure the phlebotomist uses a pediatric needle and get the best one on staff.  Then distract him, Mom!  This is when candy or a new toy is invaluable!  

Edited June 14, 2020 by cyclinglady

[HMP]

2 hours ago, Scott Adams said:

I’m not sure why your doctor would not do a celiac blood test, as untreated celiac disease can be dangerous in a toddler and can cause temporary lactose/casein intolerance. Has your son been on a gluten-free diet? If so, that could be the reason. He needs to eat gluten daily for several weeks before any tests  for celiac disease can be done.

Thank you for responding.  No, he isn’t currently (and has never been) on a gluten free diet.  I think the doctor wanted to rule out lactose intolerance test, but the more that I’m reading, waiting 2 months seems like too long for the poor kid.  His bowel movements have changed from being off lactose but they are still not right (loose watery).  Sounds like I need to push the pediatrician or just go straight to a pediatric gastroenterologist. Thank you. 

[HMP]

2 hours ago, cyclinglady said:

I agree, a blood draw is in order.  He should be screened for celiac disease and checked for anemia.  Ask for both the DGP and TTG tests.  Usually the TTG catches most celiacs, but kids that young often do better With the DGP.  Ask for both the IgA and IgG of both those tests to cover all bases.  You only need one positive on any of those four tests.   I did this with my kid.  No need to do unnecessary blood draws on a kid.  Do it right the first time.  
 

If your doctor balks, get a new one.  No child should have diarrhea for months like that!  
 

I was lactose intolerant, yet I still had celiac disease (which resolved once I went gluten free/treated celiac disease).  Symptoms from lactose intolerance usually resolves within a day or so.  Celiac disease, on he other hand is autoimmune.  Gluten just triggers the autoimmune response that causes small intestinal damage that can linger for weeks, months, or a year!  It is systemic (e.g. affect joints, make you cranky, anxious, rashes, etc).   

DO NOT put him on a gluten free diet, until you can get the blood test.  Be sure the phlebotomist uses a pediatric needle and get the best one on staff.  Then distract him, Mom!  This is when candy or a new toy is invaluable!  

Thank you so much for taking the time to read my post and answer some of my questions.  I really appreciate your advice on which tests to order (the less poking and prodding the better).  I just want an answer and to start working towards a solution so that my guy isn’t running to the bathroom and losing weight  I’m a nurse, but still hate the idea of him having to deal with needles,  I’ll def bring him to the children’s blood draw with treats in hand! Thank you, esp for you personal experience with lactose and gluten, I just feel totally lost and am starting to get frustrated with the process of getting a diagnosis/solution.