This syndrome is one in which the cartilege is abnormal.  I could easily see
how abnormal connective tissue in the gut could lead to motility
abnormalities and hence constipation and/or diarrhea.  Increasing the fiber
content of the diet might help.  A 10 month old should, of course, keep on
breastfeeding, but adding solid foods with a high fiber content might help to
"bulk up" the stool and improve the constipation.  I think that a peds GI
consultant would be in order.  If the family lives in Ohio, they should be
able to find one in Cleveland, Columbus, or Pittsburgh (PA), depending on
which is closer.  They may just have to find the funds to pay for the visit,
as the situation is fairly urgent.  Meanwhile, they can file a formal protest
about the physician's managment with their insurance company.
Linda L. Shaw MD FAAP
Altoona PA

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