Childhood Diseases

Posted by: Peta | 2012/02/14


Faecal loading vs gastro...?

hi Dr
Us again...3yr old tube fed little boy.

Tay has been quite well, poohing etc as what l think is normal, with 5ml laxette at night in warm water.

Sunday morning he suddenly went down on all 4''s, then flat on his tummy, gagging and gagging and obviously not throwing up since he has had the anti reflux op but in obvious - and vocal - discomfort. l attached a tube to mickey and took a 60ml syringe and sucked out 2 x 60ml of bile l food, just yellowly liquid. He stopped gagging and all fine.

Then a huge +++ runny pooh nappy with little solid pieces along with major liquid pooh, followed by another episode of gagging as above.

Then okay for rest of day, except for occasional gag. Then yesterday he started the whole gaging thing again and l called the paed who said it is gastro even though l said that his pooh is now little hard " bok-drolletjies / pellets" 

Tay has had faecal loading in the past and l am wondering if he hasnt got it again? Apparently tube fed kids are prone to this?

He is eating well and then suddenly will just start gagging until l syringe his stomach again, same thing as before with yellowly frothy liquid coming out?

Should l put an enema through the tube just to see once and for all what is up with that tummy? He keeps telling me it is sore so not sure now?


Expert's Reply



It is difficult to be sure about what is going on here, but I do agree that this could be due to faecal loading. Certainly leaking of stool past the constipated stool is a feature of faecal loading.What worries me is the fact that Tay is gagging. This is not usually a feature of faecal loading.Also the bile that you are sucking back. Is he developing some form of bowel obstruction? Of course I may be over-reacting, but I think we need to get a paediatric surgeon's opinion about this.

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