Saturday, August 20, 2011

Ding dong the bugs are dead!

This past week we got the results back from Ellie's stool test... I'm thinking this requires a little background.

Back in November Ellie was really, really sick in spite of going off dairy, soy, gluten, eggs, citrus and a number of other foods. We were seeing a chiropractor at the time, who was doing cranial sacral therapy and adjustments to help unkink some stuff that got kinked during Ellie's very long labor. Anyway, the chiropractor also recommended doing a stool test because, she said, kiddos with issues with that many foods are likely not allergic to all of them, but have some underlying gut dysbiosis. Back then I had no idea what gut dysbiosis even was. So we did the test and the results came back showing two bad things: Ellie had major overgrowth of some bad bacteria, including something called klebsiela pneumonia, which was at a pathogenic level of 4 out of 5. The second thing was that Ellie had zero growth of lactobacillus, which is a beneficial bacteria. We put Ellie on antibiotics to kill the bad stuff, and her symptoms greatly improved while she was on it, but as soon as it was done she was sick again. And that's when we discovered the Specific Carbohydrate Diet, which we started Jan. 8.

OK! So fast forward to this summer, when Ellie is still not doing well in spite of having been on the diet for months.

We decided to start seeing a naturopath, who referred us to a nutritionist and we have been working closely with both of them since then. The nutritionist developed a theory that Ellie was having trouble digesting fats and foods high in saturated fat in particular (coconut oil, ghee, beef, pork, lamb, etc.). As part of our trouble-shooting the naturopath suggested re-doing the stool test to see if Ellie's gut bacteria situation has been affected at all by this diet. I was skeptical that we would see any major shift, since she was still doing terribly at the time of the test (mid-July).

But something amazing has happened. The bad bacteria are GONE! Completely gone!!! This is such fantastic news and I feel incredibly lucky to have done the test when we did it and now to have done it again to see that these diets (SCD and GAPS) really do work to change the balance of our gut flora.

It wasn't all good news, unfortunately, because her gut still has zero growth of the good guys, the lactobaciullus. I wonder if perhaps her body needed to focus first on moving out the bad guys before there would be room for the good guys? The naturopath also said it's possible that the lack of lactobacillus could be something Ellie struggles with her whole life. We are planning to bombard her system with additional lactobacillus and re-test in six months to see what we can accomplish.

So then of course the question comes back to, if the bad bacteria is gone then what is making Ellie sick? Thankfully the naturopath ordered a more extensive version of the stool test than the one we did in November, and this one took a look at fat in Ellie's stool. And the test showed that there are high levels of fat, cholesterol and long chain fatty acids in Ellie's stool. What this means is that the theory is correct: Ellie is not appropriately digesting fat and it's ending up just going in one end and out the other. This is a big problem and could explain lots of things, like why she's low on the weight percentile and why she experiences stomachaches, reflux and cramping when she eats fatty foods.

Another interesting thing we learned recently (through some blood work) is that Ellie's pancreas is producing healthy levels of lipase, the enzyme that helps to digest fats. So the breakdown of her digestive system is likely happening in the liver/gallbladder area. 

Several weeks ago we started giving Ellie digestive enzymes before each meal. At first the enzymes didn't seem to be helping, although they did do one important thing, which was to get Ellie to start pooping regularly again. Then a random thing happened - I just happened to feed Ellie only chicken and salmon as her protein sources for three days and she did amazingly well. We went back to eating pork and lamb and she was getting sick again. So we cut back to chicken, turkey and seafood exclusively and that - combined with the enzymes - was the missing piece of the puzzle. She has done incredibly well since then. She is sleeping through (most) nights, pooping (most) days and those poops have been formed for two weeks. Her skin is clear and she is happy and never complains of a stomachache anymore.

Two days ago we started giving her bile salts. This works under the theory that her liver isn't producing enough bile to digest fats and that by giving her these bovine bile salts we may be able to trigger her liver into producing them itself. It's too early to tell whether this latest step is going to help, hurt or be neutral.

After two years of desperate searching for answers it feels amazing to feel like we are finally on top of what is wrong. The news that the bad bugs are gone is a huge victory, and here's hoping we'll knock out her other problems and maybe even move toward a more expanded diet sometime in the future.

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