Blockage or Pouchitis?

I think the only way to truly tell if it's pouchitis or not is by a scoping. And like you, I'd be concerned about giving her antibiotics if it wasn't pouchitis and it was a partial blockage. The antibiotics can exacerbate a blockage as you suspect and it's just not good to take antibiotics as a quick fix because it can lead C. diff and antibiotic resistance.

When you say the belly pain comes and goes, is it a regular 'coming and going?' Like peristalsis? If so, then that sounds much more like a blockage. The trouble with diagnosing a blockage is that xrays often don't show anything unless it's a full-on raging blockage.

Yes, if this were me and especially if this were my child, I would talk directly to the doctor. (I'm sure your daughter doesn't want to go through a scoping but I think if this were my child, I'd insist on it because of the inconclusive symptoms.)

If Jan doesn't pop in with a reply, please PM her. I would defer to whatever she says.

I hope Rowan gets some relief soon.

kathy

She eats and gets a belly ache and feels really full. Then it goes away until her next snack.

She is playing but is now asleep. Something is just not right!

It is a tough call, since those symptoms could be from pouchitis or bacterial overgrowth and the treatment would be antibiotics. But, if this is a partial obstruction, then thickening the stool would be the opposite of what you want. I'm sure you've had the same thought process.

What troubles me is that you do not say she has urgency, which would be more in line with pouchitis. Adominal distension also does not jibe with pouchitis. But, if she had bacterial overgrowth/pouchitis, that could cause enough gas production to cause distention. In a small child, it would not take much.

Sure, a scope would rule out or in pouchitis, but you probably don't want to go there unless you have to. Did the doc diagnose over the phone, or did he examine her? If they are adamant that Cipro is necessary and should be started ASAP, I would be inclined to go ahead and start it (well, maybe wait until morning). But, I'd watch her closely for new or worsening symptoms.

The thing is that kids do not necessarily present the same as adults, and the younger they are, the tougher it can be. I'm sure that is part of your quandary, since you feel responsible for her safety.

Bottom line, if you feel that the risks outweigh the benefits, call the doctor in the morning and explain your reservations. Perhaps he will be able to convince you of his assessment, or he will change his mind.

I know, a wishy washy answer, but it is the best I have right now.

Maybe when you wake up in the morning she will be cured and back to normal!

Jan

yes.. maybe you need a "heart to heart" or better yet a "face to face" directly with rowan's doctor. Also can you ask if they have a plan to treat her if it was a partial obstruction, and maybe have them try that first? even it it possibly included admitting her and putting her on iv fluids for a day or two. Kind of like going with the lesser of the evils first?

I cannot imagine the weight you have on you. Puts things in perspective for me. It is just so sad to hear of such a young child going through this.

Her urgency has grown but I am thinking the Lopermide was stopped also. And have had her on liquids and grape juice today so Idk. I spoke with the clinic nurse whom called her surgeon. I guess I would just feel much better if I'd talked directly to her doctor whom is working at Beaumont this week and not our hospital.

A J-poucher on another site suggested giving her the Cipro and see if thing improved as in her experience things usually improve in 24 hours if pouchitis.

Now that I have had more time to think maybe she was so bulked up before bc her course was 1 months worth of Cipro and the thickening if I remember correctly was only in the final weeks.

Thanks for the responses. I will see if I can get the doctor to call me back today to ease my mind.

She stopped outputting she is now admitted and NPO. Canceled Cipro order.

Oh crap! Sorry to hear this. Hope they get to the bottom of this soon.

My thoughts are with you.

Jan

Oh I'm so sorry Mary. I hope they fix Rowan right up very quickly!

kathy

so sorry to hear this. but hopefully things will resolve quickly.
praying for rowan today.
liz.

Darn it! C diff starting Vancomycin. If it doesn't help Flagyl and she gets neuropathy from Flagyl. Ugh

Sending healing vibes your way! Please let us know how she's doing when you get a chance to breathe. I'm so sorry you're all going through this.

kathy

Wow, I really hope she feels better soon. I hate the thought of a little girl feeling like this. I know how I feel when I have issues, and I can't imagine how a little one deals with it. One of my worst fears is that I pass on my intestinal issues to one or both of my kids. Good luck with this to you and Rowan.