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pancreatic enzymes in colitis?



 
 
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  #1  
Old September 5th 07, 10:42 PM posted to misc.kids.breastfeeding
Akuvikate
external usenet poster
 
Posts: 143
Default 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

  #2  
Old September 5th 07, 10:56 PM posted to misc.kids.breastfeeding
Flowergirl
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Posts: 27
Default 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




  #3  
Old September 6th 07, 12:43 AM posted to misc.kids.breastfeeding
Beth Kevles
external usenet poster
 
Posts: 269
Default 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.
  #4  
Old September 6th 07, 02:13 AM posted to misc.kids.breastfeeding
Akuvikate
external usenet poster
 
Posts: 143
Default 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

  #5  
Old September 6th 07, 03:03 AM posted to misc.kids.breastfeeding
Anne Rogers[_4_]
external usenet poster
 
Posts: 670
Default 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
  #6  
Old September 6th 07, 07:16 AM posted to misc.kids.breastfeeding
Sarah Vaughan
external usenet poster
 
Posts: 443
Default 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

  #7  
Old September 6th 07, 12:20 PM posted to misc.kids.breastfeeding
Beth Kevles
external usenet poster
 
Posts: 269
Default 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.
  #8  
Old September 7th 07, 06:43 AM posted to misc.kids.breastfeeding
Akuvikate
external usenet poster
 
Posts: 143
Default 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

  #9  
Old September 7th 07, 06:52 AM posted to misc.kids.breastfeeding
Akuvikate
external usenet poster
 
Posts: 143
Default 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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