24 month old vomiting at night and diarrhea all day for 3 weeks. HELP!

[Agatha_Ann]

My son is 24 months, and we are in the third week now of explosive, straight water diarrhea from the time he wakes up in the morning until mid afternoon. Then, each night between 2 and 4 in the morning he throws up his dinner, which most of the time looks pretty undigested.

He has not thrown up during the day, no diarrhea in the night. He feels fine. Happy go lucky, no fever, cough, rashes (not even in his diaper), sneezing, congestion, nada. It does not appear to be contagious...DH and I, our other kids, and my 7 daycare children are all completely fine.

We did the BRAT diet for 5 days with no change whatsoever, other than him getting bored and frustrated with his diet. I've also been having him eat lots of yogurt which is one of his favorite foods.

I am going to make him an appointment this week, but I was hoping someone might have some ideas. I'm starting to get really scared.

[PiggyPiggyOinkOink]

Keep him hydrated, and make you sure you take him to the doctor ASAP. If you can't get in till later this week, take him to urgent care. That's not healthy for him and he's probably already dehydrated and losing weight. 

[Aridel]

Make sure he's getting enough fluids, and call tomorrow morning to take  him in.  It sounds like it's time for someone to take a look at him. 

[sbgrace]

Did he start off sicker than he is now or it's been the same all along?
No diet changes in that time frame--correct?
Do you think he's ok in the afternoon because his tummy is empty from the morning or he eats in that time frame and holds it all down just fine?

When that has happened to us (twice) it's been either a bacterial infection that needed treated or a parasite. It's too long for it to be a transient/passing through bug I think...except, for some viruses the body can have temporary lactose intolerance type reaction after the initial bug leaves. So cutting the yogurt might be an easy thing to try. If you can't do that you could try lactaid type thing with it. I'd cut though and see. You can do dairy free probiotics in the meantime (culturelle makes a dairy free that's very good and a pharmacy type place might carry the dairy free or be able to get it easily/you could also order online).

In my son the pediatricians couldn't figure out what "it" was and we ended up having an integrative medicine MD at our hospital run a metametrix comprehensive stool and urine. Just mentioning in case it continues and cultures the pediatrician runs don't find the cause. They don't run for everything--just select things--and so in our case the culprits were missed in the labs the pediatrician ran but not in the metametrix.

This could be a diet thing too--particularly if he's eating sort of consistent stuff in the afternoon that maybe he tolerates and then something in the morning/evenings he doesn't. That said, this severe of a reaction doesn't pop up out of the blue so I'd lean away from that unless you've made diet changes in this time frame.

[Agatha_Ann]

Originally Posted by sbgrace 

Did he start off sicker than he is now or it's been the same all along?

He has pretty much been the same. He has had two days where he was diarrhea-free (not in a row) and three days without throwing up (not in a row either). Other than that its pretty much the same routine.

No diet changes in that time frame--correct?

Nope, except as it has gone on we have cut off grapes, apple juice, etc
Do you think he's ok in the afternoon because his tummy is empty from the morning or he eats in that time frame and holds it all down just fine?
 

He actually seems to eat more in the afternoon evenings during his "down time". He is still eating all day, but it is not nearly as much as he normally would. Sometimes he will ask for food in the morning and then after a bite he says 'done'.
When that has happened to us (twice) it's been either a bacterial infection that needed treated or a parasite. It's too long for it to be a transient/passing through bug I think...except, for some viruses the body can have temporary lactose intolerance type reaction after the initial bug leaves. So cutting the yogurt might be an easy thing to try. If you can't do that you could try lactaid type thing with it. I'd cut though and see. You can do dairy free probiotics in the meantime (culturelle makes a dairy free that's very good and a pharmacy type place might carry the dairy free or be able to get it easily/you could also order online).

In my son the pediatricians couldn't figure out what "it" was and we ended up having an integrative medicine MD at our hospital run a metametrix comprehensive stool and urine. Just mentioning in case it continues and cultures the pediatrician runs don't find the cause. They don't run for everything--just select things--and so in our case the culprits were missed in the labs the pediatrician ran but not in the metametrix.

This could be a diet thing too--particularly if he's eating sort of consistent stuff in the afternoon that maybe he tolerates and then something in the morning/evenings he doesn't. That said, this severe of a reaction doesn't pop up out of the blue so I'd lean away from that unless you've made diet changes in this time frame.

 

Thank you for your help

[sbgrace]

Ok. So he's nauseous in the morning too. That *could* be because his tummy emptied in the night and therefore his blood sugar may be dipping pretty low in that morning. Sometimes low blood sugar can, ironically, make it really hard to eat. My son has struggled with low blood sugar in mornings and was super resistant to breakfast.

But...that doesn't explain the loose stools that then stop in the afternoon (and appetite picks up..that makes sense..he feels good) and then vomiting in early am. That's a long time post dinner, undigested food, but that's not unusual with my child when he was vomiting...gross question--is it just dinner or do you see partially undigested food from the afternoon as well?

That is really a distinct pattern!

Does he eat similar things (dairy for example) at similar times of the day--or the same bedtime snack?

I'm going to think on this. I'd be concerned too.

[Agatha_Ann]

The undigested food seems to be mainly what he ate later in the day. Diet is pretty varied. I got him an appointment at 9:30 this morning so I will let you know what they say.

[BellinghamCrunchie]

Its almost certainly the yogurt. The rotavirus causes a temporary intolerance to dairy. Even yogurt.

We learned this the hard way. I thought giving her yogurt would rebuild her gut, but it just caused severe watery diarrhea and occasional vomiting.

He needs to stay off all dairy for at least six weeks.

[sbgrace]

I hope the doctor was helpful today?

I would cut the dairy as the pp said. I hope it's that easy (and cheap) to fix. I mentioned up thread but you can get dairy free probiotics for the time being. You'd know pretty quickly whether it was the yogurt if you cut it.

[Agatha_Ann]

Good morning, I wasn't able to access the site yesterday so I couldn't update...

She thought that he probably had a yucky virus that left his digestive system totally raw, so she thinks everything now is just sensitive while he tries to recover. She said his insides sounded really good and not like someone in the thick of an illness. She did say he smelled like rota, but since he is vaxd, has been happy/never acted sick, and no one else got it, she thought that was unlikely. So we are back on the BRAT diet and keeping an eye on him.

[Greenlea]

I would definitely give a probiotic of some sort.

[ameliabedelia]

I hope he recovers soon.

Did the dr. test for parasites at all.  That would really concern me, with it going on for that long.  Also, FWIW, two of my children have had rotavirus (not at the same time, when the middle child had it, the youngest wasn't even born yet) and both times no one else in the family got sick at all.  However, they did both recover fully in about a week's time.

is it possible an initial virus could have kicked off celiac or something. I know the diarrhea, stomachaches and vomiting are all signs of celiac disease (and the undigested food)..if he's eating dinner at say 6 PM and not vomiting until 4 AM and the food is still largely undigested, I would find that concerning. Whenever my kids have vomited after eating when sick, it was always soon after eating (like within an hour max).

I would at least pursue the parasites and insist on stool sampling and testing.