Chronic diarrhea in a toddler

[BekahMomToOliver]

My nephew is 26 months old and has multiple food allergies. He is anaphylactic to nuts, allergic to dairy, and was recently diagnosed with celiac disease. He was failing to thrive and had never had a firm stool in his life, then they switched to gluten-free and he's been much better.
These past couple of days though, his diarrhea has returned. We're baffled, as are his doctors. He's a tiny little thing as it is so we're quite concerned.
Anyone with experience? Or any ideas what it could be? TIA!

[kjbrown92]

You might have more responses on the allergy subforum.

One thought: He may have food intolerances as well as food allergies. And once gluten was taken out, he started eating more of _____, which he is intolerant to. For instance, corn. A lot of people when they take out gluten, start using cornstarch for gravy, and corn-based cereals, etc. and if he hadn't been having that much before because he was having gluten, then it's possible that once he started having more of it, he started reacting. Could be any other food that was increased.

Other thought: Are they sure there wasn't cross contamination with gluten (toaster? cutting boards? wooden spoons?). Did they make their house gluten free? Did they eat out? Did he kiss someone who had just been eating something with gluten? For instance, my DS can't have milk. DH and DS were taking turns playing the trumpet. DH was having coffee with cream in it at the time. My DS got a rash on his lip from the cross contamination. If it went away for a few days going gluten-free, and the family isn't used to being gluten free, odds are that somehow he got into it.

[sbgrace]

I'd be thinking cross contamination with glutens or his nut allergen first. Particularly, gluten free staples and foods (including flours, oils, gluten free cereals, crackers, etc.) are almost always cross contaminated with either nuts or sesame (which nut allergic people are often allergic to sesame as well). Rob's Red mill flours have heavy nut contamination, all my oils had nut contamination, my spices had sesame contamination, all our gluten free cereals had nut contamination, all our gluten free crackers and rice cakes had sesame contamination, etc. They may know this but if they didn't (I didn't) this is the first stop. I really struggled to find even a safe flour to use for baking for him.

That was the issue with my nut allergic gluten free son. He was getting diarrhea because he was consuming trace nut constantly. Gluten should be out of this kids house also as it can cross in toasters, non stick pans, crumbs on counters and in jelly (side note our jam had nut cross too...it's been a nightmare here).

I can give them my list of nut free gluten free staples if they would want that. Actually, I posted it on a recent thread about allergen free O's cereal.

Pull every bit of cross contamination and if he's still not better I'd suggest a metametrix stool test to see if there is anything going on like parasites or bacterial overgrowths. This is more common that you would imagine.

If that's clear I'd wonder if he's been scoped for EOS disease and that would be my next suggestion if that hasn't happened-pediatric GI would do this. However, knowing what I know about the problems with nut contamination in gluten free everything I'd lean toward that being the issue.

[BekahMomToOliver]

Thanks for your replies. I understand that they've made their home dairy, nut and g-free. I'm not 100% sure whether they ate out previous to this episode. They did spend the day out so perhaps there was some cross contamination. It seems quite severe for that, though.
He hasn't yet seen any specialists, or a pediatrician, his appointment for that is in a month. He was allergy tested and a blood test confirmed celiac.
His bowel movments are super frequent and pure liquid. He's at our local pediatric emergency ward as I write this as he's becoming dehydrated.

[Llyra]

Could it be that he's just picked up a virus? Rotavirus can cause terrible diarrhea in little kids, and it can last for up to two weeks.

I have ulcerative colitis, and a few times I've picked up one of these nasty GI viruses from my kids, and then went and thought my UC was flaring when it was really just the virus giving me diarrhea.