Martin D. Fried MD, Pediatric Gastroenterology and Nutrition explains what GI Lyme disease is and how it can be treated in children and in grown ups.
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Treating GI Lyme Disease in Children Male: You as a GI doctor many times have a question such as thing as GI Lyme disease. Is such a thing exists? Martin Fried: In the 20 years that I've been practicing pediatric gastroenterology and nutrition, I've had the opportunity to biopsy over a hundred children from the stomach, small intestines, and their colon. Initially, we send the biopsies for a special silver stain by a Harvard pathologist who found the actual infection in their GI track. We then follow that up with polymerase chain reaction testing on biopsies where they look for the outer surface protein A which is specific for Lyme disease and we found in over half of the cases that children actually had evidence of Lyme disease in their stomach, their intestines and their colon. Male: What would be your approach if the diagnosis is made? What would you do? Martin Fried: It depends on when the diagnosis is made, how long it’s been and what their other symptoms are. But if they haven’t been on antibiotics they need to be treated with antibiotics. Male: The antibiotics of choice in an older child are Doxycycline. But a younger child would be Amoxicillin. Martin Fried: Amoxicillin for anyone under eight, Doxycycline for over eight. The problem with Doxycycline in the summer is this is a photosensitivity and if you’re on that medication you might breakout in the photosensitive rash. Male: And the Doxycycline is always concern with the teeth and it can increase pressure to the head, is that correct? Martin Fried: Right. But in kids over eight years of age that’s less likely bone problems. They're usually are old enough to tolerate Doxycycline. The other concern is now the ticks that are picking up Lyme disease are also picking up other infections from the deer called Bartonella known as Cat Scratch Fever. And also Mycoplasma and we referred of Mycoplasma in Gulf War Syndrome, Mycoplasma Fermentans, Mycoplasma Penetrans. So you can get multiple infections from one tick. Male: And if they have Mycoplasma, would Doxycycline cover that? Martin Fried: Doxycycline covers all three. Doxycycline covers Bartonella, Mycoplasma and Lyme. Male: But Amoxicillin won't? Martin Fried: Amoxicillin would only cover Lyme and it would not cover Bartonella or Mycoplasma.