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Dr. David
Dr. David, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 1281
Experience:  Board-certified pediatrician at children's hospital, former chief resident, multiple publications
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My 5 year old has had yellow stools for about one week,

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My 5 year old has had yellow stools for about one week, mostly steatorrhea. She has vomited only a few times, but it has bee since Friday (4 days). I am an MD, Board Certified in FP, and I know although rare in the US, this fits the profile of having giardiasis. And she still tends to obliviously put all sorts of crap in her mouth, so I wouldn't doubt it. I took her to her doc today (where she was smiling and happy of course), I am awaiting a culture for O and P of her stool. She is not dehydrated and has been drinking, but has eaten little (and then throws up). She has intermittent low grade temp, and intermittent lethargy and weakness (which is what is worrisome). She has otherwise been extraordinarily healthy her entire life.
Are there any other acute things that can cause the steatorrhea? If it weren't for her pale stools, I wouldn't be so worried, and would just chalk this up to a run of the mill viral gastroenteritis.Iam worried while waiting for the culture results.Any ideas?
Hello and thank you for your post. A few questions if you please: when you say steatorrhea, how do you know this is the case? Did you (or her doctor) test her stools for fat? Are her stools really acholic (gray or white)? Have you been traveling or around animals lately? Anyone else sick?

Please let me know and I will get back to you. Thanks, ***** *****
Customer: replied 7 years ago.
Her stool smells foul, it floats, it is greasy appearing in the toilet, and the color is very pale, like a banana (not the peel, the inside). She is very gassy too. I gave the stool to her doc early this morning, I do not know if they will test for fat. We have not been travelling anywhere outside NJ the past month. We have been to the pet store quite a few times in the past cuouple of weeks (buying her fish), which is a new thing actually. Every time we go, she has to touch the big birds they have there (parrots, cockateils, etc), and she pets the cats. But I did not think that could be a cause. No one else is sick that I know of, however, she is in Kindergarden, so anything is possible. Thanks for your help. I used to be an ER doc, and now that I am a Mom, it stinks "knowing" too much. I am trying not to let my mind wander to the worst case scenario, and hoping it is just viral.
Thank you for the additional information and followup question. Yes I understand the "knowing too much" issue--I have had this with my own children.

With regards ***** ***** question, it really does sound like a parasitic infection is possible. It is often impossible to discern one type of parasitic infection from another (this could easily be crypto or something else, but I think Giardia is a reasonable guess too). I would therefore ask your doctor about starting Alinia empirically--it covers a whole host of parasites and is generally well tolerated. You may also want to consider probiotics such as Lactobacillus GG (I use the brands Lactinex or Culturelle).

I hope this helps. Please let me know if I can help further. I hope she is feeling better soon. Sincerely, ***** *****
Customer: replied 7 years ago.
Thank you so much Dr. David. I appreciate your advice. I hate to give meds if not needed, so I understand why her pediatrician is waiting, but I waited (unfortunately) 6 days alrteady (since onset of abnormal stools) and 4 days since onset of intermittent vomiting. It's amazing how like when you bring your car to the shop, it works fine for the mechanic....that's what happened today with her (she looked great). But as she lays here weak and fatigued at night, I am wishing something was started for her. I will ask him to start the Alinia ASAP. I have given her probiotics since she was born actually (a real believer in its ability to prevent stuff), and she eats and loves yogurt every day too. But interestingly enough, she refuses yogurt right now (yet ate a hamburger of all things), and she throws up the probiotic I gave her. (the food too for that matter). At least she is drinking and holding that down. Thank you again for the re-assurance. Have a nice evening. Can I ask specifically for you in the future if I need advice?
You are welcome. Glad to help out. It is always great to help out a fellow physician (and parent). Yes, I would be happy to help out again in the future--if you would kindly start your question with "For Dr David..." the other experts will almost always respect this.

Thank you again and I hope she feels better soon. Best wishes, David
Customer: replied 7 years ago.
That is awesome, thank you.
Just curious, do you practice in my area? I know it's a long shot, but I have been using docs at an urgent care center for her lately who I like much better that the pediatricians I have taken her to in the past. I like the urgent care docs, but the continuity is not the same obviously, and heaven forbid if she needs hospital admission, they don't have privileges.
I just thought I'd ask. Or if you know anyone in the central NJ area you would recommend (near Rutgers).
Thanks again, And I will ask for you in the future for sure.
Again you are welcome. Actually I'm a hospitalist in Delaware so do not have much knowledge of the central Jersey area, sorry.

Thanks for your kind words and good luck. David
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