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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Having Bloated Stomach, Flatulence, Loose Stool, Has Lump Under The Rib Cage. Diagnosed With Ileitis. Normal Ultrasound. What Could The Lump Be?

hi i am very concerned my daughter is 4 she has had a bloated stomach and lots of gas and lose stool and normal colo ur stool but no vomitting, fever , and doesnt complain of pain and she has lost some weight i went to the doctor and they said it looked like she had some sort of bacterial infection calle illeitis and they did some blood work and her white blood cells were okay i found a little lump in the middle of her rib cage and i dont know what that is would that be the problem to her bloating it wont go away what do i do she did and ultrasound but that never showed up they didnt say anything to me if it was something would it have been seen in the ultrasound? I tried to pay but my card was declined how can i get an answer i am having sleepless nights and i feel like i am having a nervous breakdown i need help all i do is cry please help me
Sat, 23 Feb 2013
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Pediatrician 's  Response
Hi tdasilveira1,
It sounds like your daughter might be suffering from Coeliacs Disease. This is an intolerance to gluten a substance found in wheat, barley and rye. When children with this condition eat gluten containing products eg. bread, they develop an immune response that damages their small intestines making it difficult for them to absorb food as it passes through the gut. As a result all the sugars and fats remain in the gut and ferment causing gas, bloating and oily offensive smelling stools. The children also do not grow well as they are not absorbing nutrients, they may also appear lethargic and weak.
To confirm the diagnosis I would suggest getting two tests performed: a TTG (tissue transglutaminase) and an quantitative measure IgA antibodies to TTG (also known as Coeliac antibodies). If these are positive, I would then suggest seeing a pediatric gastroenterologist who will have to do an intestinal biopsy to confirm the diagnosis.
If you are reluctant to to do the tests I would suggest removing wheat containing products from her diet and see how her symptoms change over a period of 3-6 moths. The difficulty is if you perform the tests after a period of not taking wheat you may get falsely negative results (because there is no gluten in the system to stimulate the necessary reaction). It is therefore worth doing the tests before you remove wheat from the diet.
There is a lot of information on the internet about foods you can feed children with Coeliac's disease. All the best,
Tamara
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Child Having Bloated Stomach, Flatulence, Loose Stool, Has Lump Under The Rib Cage. Diagnosed With Ileitis. Normal Ultrasound. What Could The Lump Be?

Hi tdasilveira1, It sounds like your daughter might be suffering from Coeliacs Disease. This is an intolerance to gluten a substance found in wheat, barley and rye. When children with this condition eat gluten containing products eg. bread, they develop an immune response that damages their small intestines making it difficult for them to absorb food as it passes through the gut. As a result all the sugars and fats remain in the gut and ferment causing gas, bloating and oily offensive smelling stools. The children also do not grow well as they are not absorbing nutrients, they may also appear lethargic and weak. To confirm the diagnosis I would suggest getting two tests performed: a TTG (tissue transglutaminase) and an quantitative measure IgA antibodies to TTG (also known as Coeliac antibodies). If these are positive, I would then suggest seeing a pediatric gastroenterologist who will have to do an intestinal biopsy to confirm the diagnosis. If you are reluctant to to do the tests I would suggest removing wheat containing products from her diet and see how her symptoms change over a period of 3-6 moths. The difficulty is if you perform the tests after a period of not taking wheat you may get falsely negative results (because there is no gluten in the system to stimulate the necessary reaction). It is therefore worth doing the tests before you remove wheat from the diet. There is a lot of information on the internet about foods you can feed children with Coeliac s disease. All the best, Tamara