seems as if the enzymes are no longer working?

momtohazel · Jun 16, 2011

so for about 5days or so, my DD who just turned 1, started having the worst poops ever! not formed, very foul smelling and explosive. stool sample was "normal". we are maxed out on enzymes. she lost 4 oz in the last month and another 2 oz in the last one and half weeks. what is going on? cf doc says next step is to add an antacid and if that doesn't work to treat for "bacterial colonization"? i am just wondering if others have had such a sudden and dramatic change in stools and if so, how did it resolve. did adding an antacid make a huge difference the other things is she seems to have lost her appetite for everything except bananas and apples. and of course we are supposed to be adding another 300 calories to her diet but she just refuses everything! i swear all i do is cook for her in hopes she will like something. she still breastfeeds and enjoys that but i don't think she is getting very much. i tried cows milk but unsure if that agreed with her. we will try a prescription formula that the cf nutritionist happen to have a sample of. any help, suggestions or advice would be greatly appreciated thanks

momtohazel · Jun 16, 2011

so for about 5days or so, my DD who just turned 1, started having the worst poops ever! not formed, very foul smelling and explosive. stool sample was "normal". we are maxed out on enzymes. she lost 4 oz in the last month and another 2 oz in the last one and half weeks. what is going on? cf doc says next step is to add an antacid and if that doesn't work to treat for "bacterial colonization"? i am just wondering if others have had such a sudden and dramatic change in stools and if so, how did it resolve. did adding an antacid make a huge difference the other things is she seems to have lost her appetite for everything except bananas and apples. and of course we are supposed to be adding another 300 calories to her diet but she just refuses everything! i swear all i do is cook for her in hopes she will like something. she still breastfeeds and enjoys that but i don't think she is getting very much. i tried cows milk but unsure if that agreed with her. we will try a prescription formula that the cf nutritionist happen to have a sample of. any help, suggestions or advice would be greatly appreciated thanks

momtohazel · Jun 16, 2011

so for about 5days or so, my DD who just turned 1, started having the worst poops ever! not formed, very foul smelling and explosive. stool sample was "normal". we are maxed out on enzymes. she lost 4 oz in the last month and another 2 oz in the last one and half weeks. what is going on? cf doc says next step is to add an antacid and if that doesn't work to treat for "bacterial colonization"? i am just wondering if others have had such a sudden and dramatic change in stools and if so, how did it resolve. did adding an antacid make a huge difference the other things is she seems to have lost her appetite for everything except bananas and apples. and of course we are supposed to be adding another 300 calories to her diet but she just refuses everything! i swear all i do is cook for her in hopes she will like something. she still breastfeeds and enjoys that but i don't think she is getting very much. i tried cows milk but unsure if that agreed with her. we will try a prescription formula that the cf nutritionist happen to have a sample of. any help, suggestions or advice would be greatly appreciated thanks

Ratatosk · Jun 16, 2011

An antacid would help the enzymes work better --- helps them to reach their destination -- the small intestine rather than getting eaten up by stomach acid.

Has she been tested for C-diff? What color are the stools? Orangish? Or are they greasy?

DS would stop eating for a number of reasons and have horrible stools for a couple different reasons -- teething, ear infection and constipation. With the latter his tummy would get distended and his feeding would decrease. He was still stooling, but it was whatever could slip thru past. So we'd need to give him some milk of magnesia to get things cleaned out.

Ratatosk · Jun 16, 2011

An antacid would help the enzymes work better --- helps them to reach their destination -- the small intestine rather than getting eaten up by stomach acid.

Has she been tested for C-diff? What color are the stools? Orangish? Or are they greasy?

DS would stop eating for a number of reasons and have horrible stools for a couple different reasons -- teething, ear infection and constipation. With the latter his tummy would get distended and his feeding would decrease. He was still stooling, but it was whatever could slip thru past. So we'd need to give him some milk of magnesia to get things cleaned out.

Ratatosk · Jun 16, 2011

An antacid would help the enzymes work better --- helps them to reach their destination -- the small intestine rather than getting eaten up by stomach acid.
 
 Has she been tested for C-diff? What color are the stools? Orangish? Or are they greasy?
 
 DS would stop eating for a number of reasons and have horrible stools for a couple different reasons -- teething, ear infection and constipation. With the latter his tummy would get distended and his feeding would decrease. He was still stooling, but it was whatever could slip thru past. So we'd need to give him some milk of magnesia to get things cleaned out.

momtohazel · Jun 16, 2011

i think they are testing for c-diff? at least that is what the cf doc told me. hope those orders reached the lab. the stools are mucousy (so i guess greasy) and dark green. she has also been extra gassy and they smell horrible too. this is out of the ordinary for her. her abdomen is soft. i don't think constipation as stooling quite normally before this most recent event. i understand the mechanism of the antacid just wondering if the effect will be that dramatic. i just don't get how things changed to suddenly

momtohazel · Jun 16, 2011

i think they are testing for c-diff? at least that is what the cf doc told me. hope those orders reached the lab. the stools are mucousy (so i guess greasy) and dark green. she has also been extra gassy and they smell horrible too. this is out of the ordinary for her. her abdomen is soft. i don't think constipation as stooling quite normally before this most recent event. i understand the mechanism of the antacid just wondering if the effect will be that dramatic. i just don't get how things changed to suddenly

momtohazel · Jun 16, 2011

i think they are testing for c-diff? at least that is what the cf doc told me. hope those orders reached the lab. the stools are mucousy (so i guess greasy) and dark green. she has also been extra gassy and they smell horrible too. this is out of the ordinary for her. her abdomen is soft. i don't think constipation as stooling quite normally before this most recent event. i understand the mechanism of the antacid just wondering if the effect will be that dramatic. i just don't get how things changed to suddenly

ehtansky21 · Jun 17, 2011

could she be teething??? That always messed the boys tummies up and made the poops horrible!!!

blessings,
missa

ehtansky21 · Jun 17, 2011

could she be teething??? That always messed the boys tummies up and made the poops horrible!!!

blessings,
missa

ehtansky21 · Jun 17, 2011

could she be teething??? That always messed the boys tummies up and made the poops horrible!!!
 
 blessings,
 missa

hmw · Jun 17, 2011

Introducing cow's milk for the first time can be tough on any child, cf or not. If her weight loss and change in stools corresponds strongly to her reducing breastfeeding and introducing milk, I would consider that as the biggest culprit and introduce the formula the nutritionist has in mind (which may be much easier for her to digest.)

In our case, greasy stools and mucusy stools are two different entities... grease is 'shiny' (kind of like melting, oily peanut butter) and mucus is 'slimy' ...just different. We often see mucusy stool mixed with nasty green stuff. This is just our experience though. CF poop is one icky world hehehe.

Using probiotics is a very good idea as well, I think, no matter what the end outcome of this is. Our kids are often on so many abx that they are at higher risk than the average child for c.diff and other stool issues, and they also have anti-inflammatory and other potential/anecdotal benefits. A good multi-strain dose can only help, imo!

When Emily started Prevacid early last year it definitely made a difference in her weight gain. She was on the max. recommended dose of Creon for her weight and was still malabsorbing. Adding Prevacid made a big difference in her stools, she gained a few pounds fairly quickly, and her stools have looked pretty good since (whenever not dealing with obstruction.)

Re. mechanism of action of the antacids:
In addition to digestive enzymes, the pancreas also releases sodium bicarb, which helps counteract the acid secreted by the stomach and maintain a balanced ph in the gi tract. When this can't happen as it should due to the damage CF causes to the pancreas, there is excess acidity which can affect how well the enzymes work. (This is also why so many kids with CF have GERD.) Meds like Prevacid, etc can help restore a normal ph.

hmw · Jun 17, 2011

Introducing cow's milk for the first time can be tough on any child, cf or not. If her weight loss and change in stools corresponds strongly to her reducing breastfeeding and introducing milk, I would consider that as the biggest culprit and introduce the formula the nutritionist has in mind (which may be much easier for her to digest.)

In our case, greasy stools and mucusy stools are two different entities... grease is 'shiny' (kind of like melting, oily peanut butter) and mucus is 'slimy' ...just different. We often see mucusy stool mixed with nasty green stuff. This is just our experience though. CF poop is one icky world hehehe.

Using probiotics is a very good idea as well, I think, no matter what the end outcome of this is. Our kids are often on so many abx that they are at higher risk than the average child for c.diff and other stool issues, and they also have anti-inflammatory and other potential/anecdotal benefits. A good multi-strain dose can only help, imo!

When Emily started Prevacid early last year it definitely made a difference in her weight gain. She was on the max. recommended dose of Creon for her weight and was still malabsorbing. Adding Prevacid made a big difference in her stools, she gained a few pounds fairly quickly, and her stools have looked pretty good since (whenever not dealing with obstruction.)

Re. mechanism of action of the antacids:
In addition to digestive enzymes, the pancreas also releases sodium bicarb, which helps counteract the acid secreted by the stomach and maintain a balanced ph in the gi tract. When this can't happen as it should due to the damage CF causes to the pancreas, there is excess acidity which can affect how well the enzymes work. (This is also why so many kids with CF have GERD.) Meds like Prevacid, etc can help restore a normal ph.

hmw · Jun 17, 2011

Introducing cow's milk for the first time can be tough on any child, cf or not. If her weight loss and change in stools corresponds strongly to her reducing breastfeeding and introducing milk, I would consider that as the biggest culprit and introduce the formula the nutritionist has in mind (which may be much easier for her to digest.)
 
 In our case, greasy stools and mucusy stools are two different entities... grease is 'shiny' (kind of like melting, oily peanut butter) and mucus is 'slimy' ...just different. We often see mucusy stool mixed with nasty green stuff. This is just our experience though. CF poop is one icky world hehehe.
 
 Using probiotics is a very good idea as well, I think, no matter what the end outcome of this is. Our kids are often on so many abx that they are at higher risk than the average child for c.diff and other stool issues, and they also have anti-inflammatory and other potential/anecdotal benefits. A good multi-strain dose can only help, imo!
 
 When Emily started Prevacid early last year it definitely made a difference in her weight gain. She was on the max. recommended dose of Creon for her weight and was still malabsorbing. Adding Prevacid made a big difference in her stools, she gained a few pounds fairly quickly, and her stools have looked pretty good since (whenever not dealing with obstruction.)
 
 Re. mechanism of action of the antacids:
 In addition to digestive enzymes, the pancreas also releases sodium bicarb, which helps counteract the acid secreted by the stomach and maintain a balanced ph in the gi tract. When this can't happen as it should due to the damage CF causes to the pancreas, there is excess acidity which can affect how well the enzymes work. (This is also why so many kids with CF have GERD.) Meds like Prevacid, etc can help restore a normal ph.

momtohazel · Jun 17, 2011

missy - just read your latest blog post. glad to hear the appt went well. have you switched enzymes? how is that going? Hazel certainly has been teething. i remember you mentioning the changes with your boys. hopefully maybe that is all it is. Harriet - we started the prevacid today. i was thinking the milk too as the timing was right. she has been off it for almost 3 days so i suspect if that was it then we should be going back to "normal"? but also starting the prevacid so may be hard to tell? offered the formula - not interested at all. she is all about breast milk - from the tap or bottle, unfortunately though (despite much effort) i am not producing as much (i do think that could account for her recent weight loss). we also do a probiotic but she has not been getting it recently just because she won't take the formula and i stopped the milk (i was adding it to her bottle) ad not eating enough food that i could add it. but i need to plump this baby up NOW and she just isn't a eater. i can get in a little smoothie (with almond butter and coconut oil), bananas, applesauce and she never turns down her coconut oil. i offer so many different kinds of food but she is very particular about what she wants and makes it clear if she does NOT want something. thanks for the help, advice, suggestions etc

momtohazel · Jun 17, 2011

missy - just read your latest blog post. glad to hear the appt went well. have you switched enzymes? how is that going? Hazel certainly has been teething. i remember you mentioning the changes with your boys. hopefully maybe that is all it is. Harriet - we started the prevacid today. i was thinking the milk too as the timing was right. she has been off it for almost 3 days so i suspect if that was it then we should be going back to "normal"? but also starting the prevacid so may be hard to tell? offered the formula - not interested at all. she is all about breast milk - from the tap or bottle, unfortunately though (despite much effort) i am not producing as much (i do think that could account for her recent weight loss). we also do a probiotic but she has not been getting it recently just because she won't take the formula and i stopped the milk (i was adding it to her bottle) ad not eating enough food that i could add it. but i need to plump this baby up NOW and she just isn't a eater. i can get in a little smoothie (with almond butter and coconut oil), bananas, applesauce and she never turns down her coconut oil. i offer so many different kinds of food but she is very particular about what she wants and makes it clear if she does NOT want something. thanks for the help, advice, suggestions etc

momtohazel · Jun 17, 2011

missy - just read your latest blog post. glad to hear the appt went well. have you switched enzymes? how is that going? Hazel certainly has been teething. i remember you mentioning the changes with your boys. hopefully maybe that is all it is. Harriet - we started the prevacid today. i was thinking the milk too as the timing was right. she has been off it for almost 3 days so i suspect if that was it then we should be going back to "normal"? but also starting the prevacid so may be hard to tell? offered the formula - not interested at all. she is all about breast milk - from the tap or bottle, unfortunately though (despite much effort) i am not producing as much (i do think that could account for her recent weight loss). we also do a probiotic but she has not been getting it recently just because she won't take the formula and i stopped the milk (i was adding it to her bottle) ad not eating enough food that i could add it. but i need to plump this baby up NOW and she just isn't a eater. i can get in a little smoothie (with almond butter and coconut oil), bananas, applesauce and she never turns down her coconut oil. i offer so many different kinds of food but she is very particular about what she wants and makes it clear if she does NOT want something. thanks for the help, advice, suggestions etc

kitomd21 · Jun 17, 2011

DD didn't start to gain weight well until we switched to Zenpep. We also add Duocal powder to her Pediasure (have been doing so since under a year of age). What has really helped her is Pediasure 1.5 (350cals per 8oz) but I know Hazel isn't ready for that yet! <img src="i/expressions/face-icon-small-sad.gif" border="0"> Her dietician suggested an antacid when she wasn't gaining well, but we've been able to avoid it thus far. Each individual is different - even down the type of enzyme formulation that works for them. We tried Creon and her BMs shot up to 6x daily. With Zenpep, she has 1-2 BMs daily. We saw a lot BM variation when she was on Pancrease, but now she's - uh, regular.

kitomd21 · Jun 17, 2011

DD didn't start to gain weight well until we switched to Zenpep. We also add Duocal powder to her Pediasure (have been doing so since under a year of age). What has really helped her is Pediasure 1.5 (350cals per 8oz) but I know Hazel isn't ready for that yet! <img src="i/expressions/face-icon-small-sad.gif" border="0"> Her dietician suggested an antacid when she wasn't gaining well, but we've been able to avoid it thus far. Each individual is different - even down the type of enzyme formulation that works for them. We tried Creon and her BMs shot up to 6x daily. With Zenpep, she has 1-2 BMs daily. We saw a lot BM variation when she was on Pancrease, but now she's - uh, regular.

seems as if the enzymes are no longer working?

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