Medical Quest.- Loose stool for toddler...CF?

We will be booking an appointment with the doctor soon, I am just looking for some further information so I can speak confidently with the doctor.

We have 20-month-old twins (and a 2-1/2 year old nephew living with us).

My son has frequent loose pasty stools with identifiable pieces remaining (grapes, corn…). Most food is processed, but it isn’t formed at all…like thick porridge (not watery). It sometimes smells of stomach acid. We’ve identified a couple of food sensitivities (strawberries) that cause a diaper rash. He is gaining weight and is a happy growing kid and doesn’t seem to fuss when ‘going’ (no cramps). We haven’t mentioned this to the doctor, as we haven’t been overly concerned about this.

My daughter and nephew have infrequent movements and solid stools. We have had some concern over this in the past, but the doctors have not.

I am a confirmed carrier of the Cystic Fibrosis gene and my wife was ruled out of the 80% most common mutations.

I have been searching the web for information, but have some questions that remain.

  1. Am I able to distinguish fat in the stool by visual inspection? tactile inspection? (a common test for CF is a high % of fat in the stool)

  2. Some parents claim that the infant tastes salty when kissing, if I taste his skin, will it necessarily taste salty? (the common test for CF is % of salt in sweat)

  3. Does early diagnosis of CF help at this point, or will treatments begin later?

  4. Other malabsorption causes point to too much fruit juice. All three kids drink watered-down apple juice (4 parts water, 1 part juice), so if it were attributable to the juice, wouldn’t they all react the same?

Ok, for the stools only: I make it to the docs with my wife and kids whenever possible. They are 10 months and 3 y/o.

What you describe about the stools bugged me, too, but I’ve been reassured that this is quite normal. Sure, too much juice can make it worse and lead to rashes, but the description you gave matches my kids.

Different docs say this -l oose stools, food bits, etc - is incredibly normal. I don’t know about CF, but the stool description doesn’t sound any different than what is ‘normal’. CF concerns might need to be focused elsewhere.

As for rashes, cutting out juices helps, as does a little zinc oxide as a preventative whenever changing. Some swear by A+D ointment.

I think if you inquire to a doc about the stools, you will be a bit more relieved.

Pasty? Does that mean pale? If so, then there are other possibles than CF, too, like Celiac Sprue. Allergies could also be a cause. A pediatric allergist or GI specialist would be able to tell you if something is definitely ‘wrong’. Still, doesn’t sound that unusual to me.

Undigested fat can be identified by dropping a warm stool into the toilet and looking for an oil slick on the water surface.

Other than that, ask the doc. It is probably a normal variation - my two boys have pooping behavior and characteristics that are utterly unlike one-another. One is frequent and like clockwork and usually fairly soft, the other random and firm to hard unless he’s eaten something he’s allergic to. Both have undigested bits left at times.

What the other parents said about a salty taste when kissing the baby is literally true. If the baby’s sweat tastes salty, then it’s cause for concern. (My family is known to have the CF gene, and Airman’s family is undetermined, so every so often, I kiss Aaron after a nap. If it’s ever salty, he’s getting checked.)

As for treatments, likely, they will begin ASAP. There are various medications to help the baby digest his food (since CF affects the pancreas), and treatments to help clear the lungs of mucus. Fortunately, treatment for CF is a hell of a lot better than it used to be, if that is indeed the case with your child.

Robin, whose family has the gene, and who has lost a cousin to it.

Robin

Speaking as a physician and a parent of a kid with CF, you should note greasy stools, such as oil in the diaper (tomato oil is especially notable). Also oil slicks on top of the toilet water. But these show up only if the kid has malabsorption due to the CF blocking the pancreatic duct with thick secretions. Many CF kids don’t malabsorb.

Basically see the doc, get the sweat chloride test if needed, do the stool collections for intestinal infections, and wait for results. The diagnosis possibilities are endless without more data, and it’s fruitless to hypothesize at this point.

QtM, MD