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We had our 2-month follow up with Dr. L (GI) yesterday. It was a great visit. Tootsie was 37.4lbs at her last visit in December. Yesterday she was 39.2lbs...and 44 inches! She has been feeling great since the cleanse earlier this month. Dr. L said he wants her to continue with her monthly antibiotic regimen (200mg Xifaxan 2x/day for 5 days at the beginning of each month). He said we can shorten it to 3 days if yeast becomes a problem. We had to see the pediatrician for yeast on her tongue and private region after the 2nd course. He prescribed oral Diflucan, an anti-fungal, and it took care of both ends.
I read a new book, which sparked a few questions about SIBO so I asked Dr. L what he thought...
#1. I read that IBS-C (Irritable Bowel Syndrome - constipation predominant) patients generally have higher levels of methane during their breath test. I asked Dr. L if Tootsie was a methane producer and he said no. She is a hydrogen producer.
#2. I read that erythromycin can be used in low doses nightly to stimulate cleansing waves in the small intestine - possibly helping to clear the small intestine of bacteria, therefore preventing an overgrowth. Dr. L said, yes, it is true that erythromycin can stimulate cleansing waves, but he has only seen it work in IV form and doesn't show to be successful in pill form.
#3. I read that lactose can feed small intestine bacteria and it should be avoided. Dr. L didn't want us adopting a lactose-free diet because Tootsie is not lactose-intolerant. He thought her diet was restricted enough and he'd rather see her gaining and growing...and since she is feeling well while eating lactose he didn't want us to remove it.
#4. We asked how long it could take for her intestinal villi to repair - (assuming damaged villi, from SIBO, is the reason for the severity of her fructose malabsorption). He said it could take 6 months to 1 year of being inflammation free. This is the reason we are doing a 6+ month course of monthly Xifaxan. Our goal is to keep her small intestine free of overgrowth so these tiny, hairlike projections can grow back. Nutrient & carbohydrate absorption takes place at the tips of the villi. When there is inflammation, the villi become flattened and absorption is decreased.
The best part of the visit was when he said we didn't need to come back for 4-6 months!!! Woohoo! That 2-3 hour drive (one way) is a killer!
I read a new book, which sparked a few questions about SIBO so I asked Dr. L what he thought...
#1. I read that IBS-C (Irritable Bowel Syndrome - constipation predominant) patients generally have higher levels of methane during their breath test. I asked Dr. L if Tootsie was a methane producer and he said no. She is a hydrogen producer.
#2. I read that erythromycin can be used in low doses nightly to stimulate cleansing waves in the small intestine - possibly helping to clear the small intestine of bacteria, therefore preventing an overgrowth. Dr. L said, yes, it is true that erythromycin can stimulate cleansing waves, but he has only seen it work in IV form and doesn't show to be successful in pill form.
#3. I read that lactose can feed small intestine bacteria and it should be avoided. Dr. L didn't want us adopting a lactose-free diet because Tootsie is not lactose-intolerant. He thought her diet was restricted enough and he'd rather see her gaining and growing...and since she is feeling well while eating lactose he didn't want us to remove it.
#4. We asked how long it could take for her intestinal villi to repair - (assuming damaged villi, from SIBO, is the reason for the severity of her fructose malabsorption). He said it could take 6 months to 1 year of being inflammation free. This is the reason we are doing a 6+ month course of monthly Xifaxan. Our goal is to keep her small intestine free of overgrowth so these tiny, hairlike projections can grow back. Nutrient & carbohydrate absorption takes place at the tips of the villi. When there is inflammation, the villi become flattened and absorption is decreased.
The best part of the visit was when he said we didn't need to come back for 4-6 months!!! Woohoo! That 2-3 hour drive (one way) is a killer!
(playing a puzzle with Dad in the waiting room)
(posing by the wall of beads)
(perfect temp & blood pressure)
(44 inches tall)
So glad you're getting into a normal routine!! Im sure its really nice to have a doctor that confidently answers all your questions; as well as actually helping tootsie.. You're a great mama!
ReplyDeleteGAH! She is so cute and doing so well! Good job mama and thanks so much for sharing this update!
ReplyDelete