persistent diarrhoea and abdo pain

Thank you for writing back so quickly, my daughter has had a stool sample taken last week that came back clear. She also has been on a dairy free diet since January. The doctor said to put her on a wheat free diet to see if we can get an improvement but she is still in a lot of pain at the moment. I will let you know the outcome once she has been on it for a couple of weeks. Thank you for your time and advice.
Kerry

A routine stool sample will not detect Yersinia and may not detect Giardia. Your doctor has to specifically ask the laboratory to look for Yersinia. Giardia is so often missed that I would treat her for Giardia anyhow.
I am sorry you are having so much trouble. If the above does not detect the reason or cause improvement, she should have a urine collected and analysed for infection.
Please do let me know what happens.
David Robinson

Persistent diarrhoea after gastroenteritis

Our 4-year-old daughter has diarrhoea. It started with vomiting at the time when a lot of her Kindergarten friends had vomiting and diarrhoea with blood in the stools. Everyone else has settled down but our daughter still has diarrhoea and tummy pain. Our doctor has looked for a germ in her bowel but nothing was found. Have you any suggestions?

When diarrhoea is bloody, especially if there is a high fever as well, we think of gastroenteritis germs that are slightly unusual. Blood can occur in any form of “gastro” but it is commoner with the rare germs that cause “gastro”.

Because your doctor has not found a germ I would suspect one called Yersinia. Young children with Yersinia usually settle down in 2 weeks but it can persist and cause on-going diarrhoea and tummy pain. Yersinia does not show up on the standard tests that the laboratory uses to grow the “gastro” germs. To find Yersinia the laboratory needs to be told that your doctor suspects it. They will then test the stool specimen in a different way. I suggest you ask your doctor to send another stool specimen specifically to detect Yersinia.

There are treatments for Yersinia but some doubt whether they clear the germ from the gut faster than nature would anyway. I think if it were my child, I would want to be certain that Yersinia was present before considering treatment.