On Monday we took Liam to see the gastroenterologist regarding his test results and symptoms. I didn't expect for there to be much forward progress at this appointment but I was looking forward to talking things over with someone more versed in these issues.
I love the doctor we saw. She was really, really wonderful and saw Liam as a whole person and not just a cluster of symptoms.
The upshot is that we're still on the fence about Celiac.
It comes down to this: Celiac is a microscopic diagnosis and the blood tests can be decent predictors but they're not definitive. The only way to be definitive is to do an upper endoscopy and take some biopsy samples. This is what the doctor recommended and what I expected to hear from her.
What I didn't expect was that she has her doubts about the blood work. While his symptoms do fit a Celiac profile, there are some things that don't quite fit. His abdominal pain, for one thing, is quite high - just under the sternum - and not lower down at all - especially now that we've increased the fiber in his diet and alleviated much of his issues with constipation. For another, I think she was a little surprised that he's not having diarrhea problems.
Third, the blood panel they did on him tested for three values. One was positive, two were negative. According to the doctor, one of the ones that was negative is a better Celiac predictor than the one that was positive. There's wiggle room here.
So, while she wants to do the scope to find out exactly what's happening and get the definitive yes/no on Celiac, she also prescribed Prilosec for him. Given his history of infant reflux and the nature of his pain, she thought it was worth a try. If it worked and gave him some relief that was a good thing. If not - well, at least we tried.
We came home Monday night and gave him his first dose and he did fine with it. Last night he had pasta for dinner. He quickly ate the fairly generous portion I served him and then asked for more. He hasn't asked for second helpings of anything in months. So, I gave him the rest of what I had - which was about equivalent to his first helping. He finished that, too. He also ate all of his applesauce. Then, he went to Tae Kwon-do and immediately upon arriving home said, "I'm hungry!" Before bed he got his second dose of Prilosec.
This morning he ate breakfast with no problems, no dwaddling, no begging from me for him to finish. As he was eating I said, "It seems like you've been hungrier since you started your new medicine. Is it helping you feel better?" He said, "Yeah, and my hunger is going up and up."
Could his weight loss have been due to not eating because of acid reflux?
Frankly, I feel really dumb not figuring this out for myself. I have lost count of the number of times my kids have seen doctors because of some weird symptoms that turned out to be reflux and DUH! I know how to deal with that. It's just that if one of my kids was going to have long term issues with this, I fully expected it to be Jamie because he was so much worse as an infant than Liam was.
This is not to say that we are out of the woods on Celiac yet, though. It's still possible that he has it and it's possible that he has both the reflux AND the Celiac pulling a double whammy on him. We won't know for sure until the endoscopy results come back. His procedure has been scheduled for the week between Christmas and New Year's when he's off school. I suspect we won't have the results back until after the first of the year.
Until then, if the kid wants to eat me out of house and home, I'll gladly allow it.