Peter's probiotics regime - Part One

Kids with short bowel syndrome (SBS) tend to have recurrent bacterial overgrowth (BO) in their intestines. We haven't had to deal with this in ages with Peter, but in December Children's Boston suggested that Peter's difficulty with feeds may be due to BO. ***UPDATE: I think the more frequent abbreviation is SBBO - Short Bowel Bacterial Overgrowth, versus just BO.***

We have had terrible luck with enteral antibiotics in the past, resulting in hives, mystery ailments ending Peter up for hospitalization, and intestinal bleeding. We had tried 3 different enteral antibiotics (flagyl, augmentin, and cipro), each presenting one of those problems. We had put Peter on kefir for several months after the antibiotics had failed and the BO odor was returning. That worked well for many months, but apparently did not work well enough to be the sole prevention for BO, possibly given the small amounts we had to give Peter.

Peter has now been on powdered probiotics since late December, and we think we are seeing a huge improvement! We started on 15-35 Probiotic which has 35 billion organisms per capsule, but it also has enough sodium in it that Peter ultimately began to refuse it due to taste. We moved on to Florastor, which is a yeast organism. He has been on this for 2 weeks and we will keep him on it one more week. The initial response on Florastor was that he smelled quite poopy most of the time, but at this point he does not and he is acting like he feels just wonderful. Perhaps the poopy smell was him clearing out the BO?? He takes the Florastor in a little baby food and is no longer refusing elecare. He is sleeping better at night too!

We will then go to VSL#3, which is quite similar to the 15-35 Probiotic, but no sodium. We'll give that for two weeks, go back to Florastor for two weeks, and then go for a two week break off all probiotics. Meanwhile we are hoping to begin increasing elecare again to see if he can tolerate it better now that the BO is out.

Still waiting to hear back from the nephrologist about what is going on with Peter's kidneys if anything.