How to treat possible yeast flare or gut flora issues

[JSL25]

DD has been on several abx over the last few months for a variety of illnesses, but her PANDAS symptoms have been relatively under control. After the the last round of abx to treat an ear and respiratory infection, her PANDAS symptoms have flared like NEVER before. She usually responds well to ibuprofen during a flare and I can get her back under control pretty quickly, but this time nothing I do is helping. Everyday her rage and emotional lability is worse. And her tics are bad, and she’s up at night multiple times. I think she had a vagknsl yeast infection during the last abx but i thought it seemed much better after a few vinegar baths. 

I’m wondering if this flare is due to her gut flora being off from all the abx or maybe due to yeast. How can I correct this??

[MomWithOCDSon]

Is she taking a regular probiotic, and if so, which one(s)?  I would suggest trying sachromycces boulardi ("sach b"), sold in most drug stores under the brand name Florastor, as well as under its organism name via other brands such as Jarrow (you can get it at Whole Foods or Vitamin Shoppe).  Sach b is a "beneficial yeast" that supposedly helps crowd out and kill off troublesome yeast organisms like candida.

Another intervention we used about once a week when DS was taking abx and probiotics was some bentonite clay.  This can be purchased in powder form at Whole Foods.  We would stir about a tablespoon into a glass of juice and he would take it before bed; it made the juice a little grainy, but there was no negative impact on flavor.  Supposedly, the clay helps "sweep" the intestinal tract of detritus, die-off, etc. and promote a better environment for the beneficial flora to populate.  I don't know if that supposition holds up under research, but I will say that it seemed to benefit our DS.  He was taking abx and probiotics regularly for nearly two years, and we did not have any yeast or c-diff issues.

Good luck!

[bobh]

Yeast is probably a reasonable guess.  Our son did not do well with probiotics (several made him worse, though I never trialed sach b), so we felt we had to bring out the "heavy guns" and use a prescription med like nystatin.  Nystatin doesn't absorb into the bloodstream, so it has some inherent safety that way compared to most meds and supplements.  If it is yeast, be prepared for a herx on nystatin - might need to start slow.

[Lyentzer]

How can you tell if it’s yeast?

[bobh]

There are tests, but I found them more expensive than the treatment, so I convinced a prescribing doctor to grant us some nystatin to check it out.  The reasoning for this route is that nystatin is quite benign - it doesn't absorb into the blood stream, so no side-effects outside of the gut.  If no reaction, you probably haven't got yeast in the gut.  A PANS child that gets a a herx on nystatin is very likely dealing with yeast (provided no reaction to nystatin itself, which you would have to research to distinguish it from herx).