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Infant Having Consistent Diarrhea, Stool Test Normal, Occasionally Passes Green Stools. Cause?
Question: Hi Doctor ,
My baby of 7.5 month old is having dirreaha from last 2 months almost . We have done two time stool test and it comes normal . Her stool frequncy some time reduced 3-4 in days and sometime inrsed 7-8 in days. She some time passes green color stool and sometime yellow color . Consisntancy mostly in morning is semisolid and in days get some liquid but not watery. Her last stool repoart is ;
COLOUR YELLOWISH
CONSISTENCY SEMI LIQUID
ODOUR FAECAL
MUCUS ABSENT ABSENT.
VISIBLE BLOOD ABSENT
WHITE CELLS 1-2 /HPF
RED BLOOD CELLS NOT DETECTED
MACROPHAGES NOT DETECTED
CHARCOTLEYDEN CRYSTALS NOT DETECTED
TROPHOZOITES NOT DETECTED
CYSTS NOT DETECTED
OVA NOT DETECTED
LARVAE NOT DETECTED
ADULT PARASITE NOT DETECTED
BACTERIA PLENTY DETECTED
VEGETABLE FIBRES NOT DETECTED
STARCH NOT DETECTED DETECTED
STOOL FOR CULTURE & SENSITIVITY
CULTURE; STOOL AEROBIC
SPECIMEN * STOOL
ORGANISM * NO PATHOGEN GROWN AFTER 48 HRS OF INCUBATION AT 37'C.
She is having weight almost 7.7 kg at 7 month . At six month her weight was 7.2 kg . And at birth time her weight was 2.7 kg. She is not teeting also. She is otherwise helthy i.e play etc and no dehydration as passes enough urine. Please review and advise.
My baby of 7.5 month old is having dirreaha from last 2 months almost . We have done two time stool test and it comes normal . Her stool frequncy some time reduced 3-4 in days and sometime inrsed 7-8 in days. She some time passes green color stool and sometime yellow color . Consisntancy mostly in morning is semisolid and in days get some liquid but not watery. Her last stool repoart is ;
COLOUR YELLOWISH
CONSISTENCY SEMI LIQUID
ODOUR FAECAL
MUCUS ABSENT ABSENT.
VISIBLE BLOOD ABSENT
WHITE CELLS 1-2 /HPF
RED BLOOD CELLS NOT DETECTED
MACROPHAGES NOT DETECTED
CHARCOTLEYDEN CRYSTALS NOT DETECTED
TROPHOZOITES NOT DETECTED
CYSTS NOT DETECTED
OVA NOT DETECTED
LARVAE NOT DETECTED
ADULT PARASITE NOT DETECTED
BACTERIA PLENTY DETECTED
VEGETABLE FIBRES NOT DETECTED
STARCH NOT DETECTED DETECTED
STOOL FOR CULTURE & SENSITIVITY
CULTURE; STOOL AEROBIC
SPECIMEN * STOOL
ORGANISM * NO PATHOGEN GROWN AFTER 48 HRS OF INCUBATION AT 37'C.
She is having weight almost 7.7 kg at 7 month . At six month her weight was 7.2 kg . And at birth time her weight was 2.7 kg. She is not teeting also. She is otherwise helthy i.e play etc and no dehydration as passes enough urine. Please review and advise.
Hi,
Thank you for your query on Healthcare Magic.
The stool examination is looking normal.
Her present weight is also in normal range.
Coming to the semisolid stools since 2 months duration, in infants gastrocolic reflex will be present and this causes passage of stool with each feed.
So some times this reflex is perceived by mothers as diarrhea. And stool color variation is also normal and it ranges from yellow to green.
What feeds she is receiving at present?
Are you continuing breast milk in addition to complimentary feeding?
Is she exclusively breastfeed till the age of 6 months?
I advise you to give stool for reducing substances to look for any lactose intolerance after the pediatrician consultation.
Oral probiotics like saccharomyces or lactobacillus XXXXXXX for 3 to 5 days and zinc supplementation for 2 weeks with prescription will help to decrease the loose stool.
If the stools are watery, you can give oral rehydration solutions like Pedialyte to prevent dehydration.
Hope I have answered your query, if you have any clarification please let me know along with the details I have asked for.
Regards.
Thank you for your query on Healthcare Magic.
The stool examination is looking normal.
Her present weight is also in normal range.
Coming to the semisolid stools since 2 months duration, in infants gastrocolic reflex will be present and this causes passage of stool with each feed.
So some times this reflex is perceived by mothers as diarrhea. And stool color variation is also normal and it ranges from yellow to green.
What feeds she is receiving at present?
Are you continuing breast milk in addition to complimentary feeding?
Is she exclusively breastfeed till the age of 6 months?
I advise you to give stool for reducing substances to look for any lactose intolerance after the pediatrician consultation.
Oral probiotics like saccharomyces or lactobacillus XXXXXXX for 3 to 5 days and zinc supplementation for 2 weeks with prescription will help to decrease the loose stool.
If the stools are watery, you can give oral rehydration solutions like Pedialyte to prevent dehydration.
Hope I have answered your query, if you have any clarification please let me know along with the details I have asked for.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What feeds she is receiving at present? She is currently receiving Brest feed + some solid food like Banana , rice water , moong dal water , smyly mct milk, sometime biscuit with smyly mct milk , rice cereals .
Are you continuing breast milk in addition to complimentary feeding? yes
Is she exclusively breastfeed till the age of 6 months? No , that she was receiving breastfeed+ infant formula.
And yes after each feed she passes the stool. Some time undigested and some time semi undigested. We have done the redusing substnace test also and it was normal. I am just worried if something serious about this . Also sometime her stool frequency reaches to 9-10 times but these are few days. please can you assure that its not serious.
Are you continuing breast milk in addition to complimentary feeding? yes
Is she exclusively breastfeed till the age of 6 months? No , that she was receiving breastfeed+ infant formula.
And yes after each feed she passes the stool. Some time undigested and some time semi undigested. We have done the redusing substnace test also and it was normal. I am just worried if something serious about this . Also sometime her stool frequency reaches to 9-10 times but these are few days. please can you assure that its not serious.
Hi,
Thank you for getting back.
You can continue breast feeds and complimentary feeds with rice cereals.
If the stool reducing substance is negative, it will rule out lactose intolerance.
I advise you to give oral probiotic and zinc after consulting the pediatrician.
And if stool is loose, watery you can give Pedialyte sips to prevent dehydration.
Try to maintain hygiene of her hands as children keep their hands in mouth during this age which may be the source of contamination.
And give formula feeds (simyl MCT milk) with using cup and spoon with taking care of proper reconstitution of feeds and with sterile technique.
Improper dilution of feeds may cause diarrhea.
Still loose stools are continuing, consult your Pediatrician again for reassessment and for repeating stool investigations like routine, microscopy, reducing substances, and culture and sensitivity again.
Nothing to worry and diarrhea is a little more common problems in this age and can be managed without difficulty.
Therefore I advise you to consult your pediatrician for further management.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Thank you for getting back.
You can continue breast feeds and complimentary feeds with rice cereals.
If the stool reducing substance is negative, it will rule out lactose intolerance.
I advise you to give oral probiotic and zinc after consulting the pediatrician.
And if stool is loose, watery you can give Pedialyte sips to prevent dehydration.
Try to maintain hygiene of her hands as children keep their hands in mouth during this age which may be the source of contamination.
And give formula feeds (simyl MCT milk) with using cup and spoon with taking care of proper reconstitution of feeds and with sterile technique.
Improper dilution of feeds may cause diarrhea.
Still loose stools are continuing, consult your Pediatrician again for reassessment and for repeating stool investigations like routine, microscopy, reducing substances, and culture and sensitivity again.
Nothing to worry and diarrhea is a little more common problems in this age and can be managed without difficulty.
Therefore I advise you to consult your pediatrician for further management.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
doctor .
today again we have done the stool test and everything else were ok except reducing substenance which was positive . now can you advise what food we should give and what not also what does the meaning of reducing sunsatnce postive .
we will take also our doctor help but your guidance will help full.
XXXXXXX
today again we have done the stool test and everything else were ok except reducing substenance which was positive . now can you advise what food we should give and what not also what does the meaning of reducing sunsatnce postive .
we will take also our doctor help but your guidance will help full.
XXXXXXX
Hi XXXXXXX
Thank you for getting back.
Positive for reducing substance in stool is indicative of development of lactose intolerance.
In diarrheas, there will be loss of intestinal villi which contain the enzyme lactase which is responsible for the digestion of the sugar lactose which is present in milk products.
Indigestion of lactose leads to loose stools.
So in lactose intolerance the best method to control loose stools is avoiding lactose containing milk products for a temporary period till the villi of intestine regenerate.
Lactose is present in breast milk, animal milk, and regular infant milk formulas.
So stopping milk products and giving lactose free milk formula and complimentary feeding will decrease the diarrhea.
Therefore consult your Pediatrician for the interpretation of stool reports, feeding advise, and treatment with other supportive medications like probiotic and zinc.
Hope I have answered your query, if you have any clarification please feel free to get back.
Regards.
Thank you for getting back.
Positive for reducing substance in stool is indicative of development of lactose intolerance.
In diarrheas, there will be loss of intestinal villi which contain the enzyme lactase which is responsible for the digestion of the sugar lactose which is present in milk products.
Indigestion of lactose leads to loose stools.
So in lactose intolerance the best method to control loose stools is avoiding lactose containing milk products for a temporary period till the villi of intestine regenerate.
Lactose is present in breast milk, animal milk, and regular infant milk formulas.
So stopping milk products and giving lactose free milk formula and complimentary feeding will decrease the diarrhea.
Therefore consult your Pediatrician for the interpretation of stool reports, feeding advise, and treatment with other supportive medications like probiotic and zinc.
Hope I have answered your query, if you have any clarification please feel free to get back.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor .
We have consulate our doctor as per them it is lactose intolerance hence avoid all mil including breast milk . However we were not convinced to stop Brest mil but we have done and found not much change still she is passing 5-6 stool per day.
Hence we have decided that we should we do stool test one more time . Usually we are giving stool test to home collection facility of a reputated lab. This time we dcided to give first morning sample to a lab which is attached to a hospitable.
This time her stool test reports 15-18 pus cell and mucus in stool . in stool culture test it was e- coli identified and this having resistance with most of antibiotic except
Imipenem- S
Amikacin-IS
Piperacillin + Tazobactum-IS
Now my question is it possible to get wrong results if there is some time gap between sample taken and test performed.
also why this is ecoil resistance with all this antibiotics , now can you advise what are the treatment options .
Current situation of baby
passing 5-6 stool , but stools are mostly solids not watery but her appetiate is not good . But she is playing well.
what problem can she have is she can have ameobosis. although stool repost does not show cyst or parasites. is there is different test for amebosis.
thanks
We have consulate our doctor as per them it is lactose intolerance hence avoid all mil including breast milk . However we were not convinced to stop Brest mil but we have done and found not much change still she is passing 5-6 stool per day.
Hence we have decided that we should we do stool test one more time . Usually we are giving stool test to home collection facility of a reputated lab. This time we dcided to give first morning sample to a lab which is attached to a hospitable.
This time her stool test reports 15-18 pus cell and mucus in stool . in stool culture test it was e- coli identified and this having resistance with most of antibiotic except
Imipenem- S
Amikacin-IS
Piperacillin + Tazobactum-IS
Now my question is it possible to get wrong results if there is some time gap between sample taken and test performed.
also why this is ecoil resistance with all this antibiotics , now can you advise what are the treatment options .
Current situation of baby
passing 5-6 stool , but stools are mostly solids not watery but her appetiate is not good . But she is playing well.
what problem can she have is she can have ameobosis. although stool repost does not show cyst or parasites. is there is different test for amebosis.
thanks
Hi XXXXXXX
Thank you for getting back.
Presence of 15-18 pus cells and mucus in the stool test with a positive culture for E.Coli is definitely suggestive of infectious diarrhea.
There are chances of getting wrong results if the stool sample is contaminated or the testing is being delayed.
E.Coli is resistance to most of the antibiotics as the bacteria are developing defensive mechanisms against antibiotics over a time because of frequent, inadvertent, and inappropriate use of antibiotics.
My advise is to treat her diarrhea with antibiotics which are sensitive like piperacillin-tazobactum and amikacin.
As the stool report is not showing any evidence of amebiasis infection like trophozoites or cysts, it is not looking like amebiasis.
The test to detect amebiasis is stool for ameba cysts and trophozoites and already it was done.
Appetite will improve once the infection has been treated.
Therefore I advise you to consult the pediatrician for examination, interpretation and correlation of the repeated stool test report to child symptoms and appropriate treatment plan.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Thank you for getting back.
Presence of 15-18 pus cells and mucus in the stool test with a positive culture for E.Coli is definitely suggestive of infectious diarrhea.
There are chances of getting wrong results if the stool sample is contaminated or the testing is being delayed.
E.Coli is resistance to most of the antibiotics as the bacteria are developing defensive mechanisms against antibiotics over a time because of frequent, inadvertent, and inappropriate use of antibiotics.
My advise is to treat her diarrhea with antibiotics which are sensitive like piperacillin-tazobactum and amikacin.
As the stool report is not showing any evidence of amebiasis infection like trophozoites or cysts, it is not looking like amebiasis.
The test to detect amebiasis is stool for ameba cysts and trophozoites and already it was done.
Appetite will improve once the infection has been treated.
Therefore I advise you to consult the pediatrician for examination, interpretation and correlation of the repeated stool test report to child symptoms and appropriate treatment plan.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor
We have consulted our pediatrics and she has given Azithral 100 mg and dosage 3.5 ml ,which was also intermediate sensitive to e coil as per culture report . We are very worried now as she is very small and her growth may impact this also we are just worried that about seriousness of disease. . Can you confirm that this medicine is suitable for such small child. doctor told other medicine need to be injected hence use this medicine.
Thanks
We have consulted our pediatrics and she has given Azithral 100 mg and dosage 3.5 ml ,which was also intermediate sensitive to e coil as per culture report . We are very worried now as she is very small and her growth may impact this also we are just worried that about seriousness of disease. . Can you confirm that this medicine is suitable for such small child. doctor told other medicine need to be injected hence use this medicine.
Thanks
Hi XXXXXXX
Thank you for getting back.
As you mentioned E.Coli is intermediate sensitive to azithromycin and it is an oral drug, your pediatrician have chosen Azithral for this infection.
Azithromycin is a macrolide antibiotic and it can be safely given to children above the age of 6 months.
Nothing to worry and you can continue this drug as advised by the pediatrician.
Hope I have answered your query, if you have any clarification please feel free to get back.
And thank you once again for contacting me on Healthcare Magic.
Wish your little child a speedy recovery.
Regards.
Thank you for getting back.
As you mentioned E.Coli is intermediate sensitive to azithromycin and it is an oral drug, your pediatrician have chosen Azithral for this infection.
Azithromycin is a macrolide antibiotic and it can be safely given to children above the age of 6 months.
Nothing to worry and you can continue this drug as advised by the pediatrician.
Hope I have answered your query, if you have any clarification please feel free to get back.
And thank you once again for contacting me on Healthcare Magic.
Wish your little child a speedy recovery.
Regards.
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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