Hello Lynn-
First off, you already took the time (and spent the money) to find out WHAT needs treating in this patient (with the GI Effects test). I know that when they tested for those bacteria they found in him/her (Citrobacter, Klebsiella, and Pseudomonas), that they also gave you both natural and Rx options to treat these with (that they would be sensitive to).
So, since you have such specific info about how to help him/her… there isn’t a need to do a more general “tune up” with something like Alinia (which I use more for when I haven’t tested).
About the dosing for Alinia in a child this age (if you were going to use it in someone else when you didn’t know what needed “weeding out”), there are doses for it in epocrates down to 1 y/o (for infectious diarrhea)… I would just use these standard doses. *
*For reference these read as 100mg BID for age 1-3, and 200mg BID for ages 4-11 for example.
As for larazotide… if there are signs of weakened tight-junctions in history, on exam, or in this case in the results… then I LOVE larazotide.
And for lactulose, “why not”? In general feeding happy bacteria in the gut isn’t a bad idea….. But, having said that, in this case, if you have results that shows a lot of overgrowth of some questionable bacteria, then I would wait to start something like a prebiotic of any kind until you have gotten control of the overgrowth (so that you do not risk “feeding” these as well). Just in case. This is a more nuanced timing kind of thing.
So in short to summarize again….
Alinia: I would use what you now know would be ideal for this patient since you did the testing.
Larazotide: worth the money IF signs, symptoms, results consistent with weak tight junctions
Lactulose: I would hold off starting this (or any pre-biotic type item) until you were in the restorative phase. But then, a good an inexpensive way to support someone’s wanted microbiome.
Hope this helps!
Warmly,
Cynthia
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