pancreatic enzymes in colitis?
Anyone know of any research on giving mom pancreatic enzymes to help
babies with bloody stools despite mom attempting an elimination diet? I found one study from 1999 in the Journal of Pediatric Gastroenterology & Nutrition but it had a whopping 4 patients and is nearly 10 years old. It would seem sensible to follow this up with a stronger study but I haven't found anything. I have a patient with this problem and though part of the problem may have been not giving the elimination diet sufficient time to work, would be interested in this possibility. As I suspect it would involve a battle to get the enzymes covered (I believe they're a pretty expensive drug) I would need to have some evidence to back me up. Kate, ignorant foot soldier of the medical cartel and the Bug, 4 years old |
pancreatic enzymes in colitis?
"Akuvikate" wrote in message ups.com... Anyone know of any research on giving mom pancreatic enzymes to help babies with bloody stools despite mom attempting an elimination diet? I found one study from 1999 in the Journal of Pediatric Gastroenterology & Nutrition but it had a whopping 4 patients and is nearly 10 years old. It would seem sensible to follow this up with a stronger study but I haven't found anything. I have a patient with this problem and though part of the problem may have been not giving the elimination diet sufficient time to work, would be interested in this possibility. As I suspect it would involve a battle to get the enzymes covered (I believe they're a pretty expensive drug) I would need to have some evidence to back me up. Kate, ignorant foot soldier of the medical cartel and the Bug, 4 years old No help sorry - but if you do find any info, please let me know. A friend of mine's 2nd child had colitis (which was eventually Dx as breastmilk colitis) and she was on a very resrticted diet (I've posted about that here before). Her elimiatnion diet did seem to work for the bub, but she was only able to eat about 8 foods in total. The bub was bf for 18 months (even though the paed. gastroenterologist kept urging my friend to wean her bub and give her Neocate), and was on very few solids when she weaned ... but then improved markedly in both her gut problems and solid intake and tolerance. (This child - now almost 2 years old- still has food intolerance issues, but can now eat sufficient solids). .... so even though this situation is slowly resolving, I'm sure my friend would still like to find out more about the issue as she was never happy with what any of the specialists were telling her (much of the advice from different specialists was contradictory). Amanda |
pancreatic enzymes in colitis?
Kate -- How long and how strictly has mom been on the elimination diet? Also, does the baby have any symptoms other than the bloody stool, such as rash, failure to thrive, etc.? Hoping this resolves before you have to do further research, --Beth Kevles http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic Disclaimer: Nothing in this message should be construed as medical advice. Please consult with your own medical practicioner. NOTE: No email is read at my MIT address. Use the AOL one if you would like me to reply. |
pancreatic enzymes in colitis?
On Sep 5, 4:43 pm, (Beth Kevles) wrote:
Kate -- How long and how strictly has mom been on the elimination diet? Also, does the baby have any symptoms other than the bloody stool, such as rash, failure to thrive, etc.? Hoping this resolves before you have to do further research, She was on cow's milk elimination for one week and then a stricter elimination diet for 1 week (dairy, soy, wheat, egg, nuts, citrus, fish, and shellfish -- I think that was it). It's a somewhat more challenging setting because she's low-income and non-English speaking, so I tried to tell her about reading labels for things like casein and albumin but it's harder to guage how well she can follow it. I couldn't find any written materials available in Spanish, and some more radical elimination diets are not going to be feasible in this setting. She says she eats little processed food so that makes it easier. The baby is gaining weight like a maniac and has no other symptoms except perhaps fussiness (always hard to really know if it's regular newborn crying or more than the norm). I'm now realizing that a week might not have been quite enough time. When they next come in for a well check I might suggest she try it again for longer. As it stands I told mom to go ahead and eat what she likes and keep breastfeeding, because it's quite mild and I think the baby is better off pooping a few flecks of blood every couple of days than stopping breastfeeding altogether. Kate, ignorant foot soldier of the medical cartel and the Bug, 4 years old |
pancreatic enzymes in colitis?
She was on cow's milk elimination for one week and then a stricter elimination diet for 1 week (dairy, soy, wheat, egg, nuts, citrus, fish, and shellfish -- I think that was it). It's a somewhat more challenging setting because she's low-income and non-English speaking, so I tried to tell her about reading labels for things like casein and albumin but it's harder to guage how well she can follow it. I couldn't find any written materials available in Spanish, and some more radical elimination diets are not going to be feasible in this setting. She says she eats little processed food so that makes it easier. The baby is gaining weight like a maniac and has no other symptoms except perhaps fussiness (always hard to really know if it's regular newborn crying or more than the norm). Contact LLL, I'd be surprised if they didn't have the information available in Spanish. As for the length of time to try elimination diets for, I always thought it was 3 weeks, 2 weeks to get it out of the system and further week to see if it helps. Anne |
pancreatic enzymes in colitis?
Akuvikate wrote:
Anyone know of any research on giving mom pancreatic enzymes to help babies with bloody stools despite mom attempting an elimination diet? I found one study from 1999 in the Journal of Pediatric Gastroenterology & Nutrition but it had a whopping 4 patients and is nearly 10 years old. It would seem sensible to follow this up with a stronger study but I haven't found anything. I have a patient with this problem and though part of the problem may have been not giving the elimination diet sufficient time to work, would be interested in this possibility. As I suspect it would involve a battle to get the enzymes covered (I believe they're a pretty expensive drug) I would need to have some evidence to back me up. I'd have thought your best bet would be to contact the company that makes the stuff and ask them. They're bound to have every scrap of evidence favouring their drug on file, and would be delighted to share it in the cause of getting someone to buy it. ;-) All the best, Sarah -- http://www.goodenoughmummy.typepad.com "That which can be destroyed by the truth, should be" - P. C. Hodgell |
pancreatic enzymes in colitis?
For bloody stools ... figure about one week for the allergen to clear mom's system, one week to clear the baby's system, and one final week for the baby's gut to heal. So a 3-week elimination is definitive. For your Spanish-speaking mom, it might help to give her a list of "safe" foods to eat during this period. If you email me the list of things she's eliminating (bethkevles at aol dot com) I'll see if I can put something together for you. By the way, is the list created from common infant allergens or does it have a specific basis in her personal food history? --Beth Kevles http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic Disclaimer: Nothing in this message should be construed as medical advice. Please consult with your own medical practicioner. NOTE: No email is read at my MIT address. Use the AOL one if you would like me to reply. |
pancreatic enzymes in colitis?
On Sep 5, 11:16 pm, Sarah Vaughan wrote:
I'd have thought your best bet would be to contact the company that makes the stuff and ask them. They're bound to have every scrap of evidence favouring their drug on file, and would be delighted to share it in the cause of getting someone to buy it. ;-) Good thought. I despise money-grubbing pharmaceutical companies but this is one situation where their devious self-promotion could work to my favor. Kate, ignorant foot soldier of the medical cartel and the Bug, 4 years old and a little something else due 4/11/08 |
pancreatic enzymes in colitis?
On Sep 6, 4:20 am, (Beth Kevles) wrote:
For bloody stools ... figure about one week for the allergen to clear mom's system, one week to clear the baby's system, and one final week for the baby's gut to heal. So a 3-week elimination is definitive. For your Spanish-speaking mom, it might help to give her a list of "safe" foods to eat during this period. If you email me the list of things she's eliminating (bethkevles at aol dot com) I'll see if I can put something together for you. For the first week she avoided just dairy, and for the second week she avoided dairy, soy, wheat, egg, nuts, citrus, fish, and shellfish as best I recall. I made the list from common allergens, not anything particular to the situation. I'd be reluctant to try to create a list of safe foods as I might well not think of basic staples of her cuisine that are safe (I don't know exactly where in Latin America she comes from) and might over-represent things that she and her family aren't all that interested in eating. It was almost comical to read one website that recommended nothing but range-fed turkey and some obscure grain for a week or two. Last I checked the WIC package doesn't include vouchers for Whole Foods (though would be lovely if they did, and stopped giving gallons of juice to all my obese pediatric patients). Kate, ignorant foot soldier of the medical cartel and the Bug, 4 years old and a little something else due 4/11/08 |
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