Yes, it's taken me a year and a half to convince my doctor to run an antibiotic test. Never mind the fact that she gave the same antibiotic to Elizabeth six times in the past 11 months. Oh well, here we go.
There are three possible outcomes.
I was betting on #1, while the doctor was sure it was #2. In fact we (playfully) had a large pizza riding on the outcome. Well nobody has to pay up, because it was #3. He got much worse. We had to pick him up from school, kicking and screaming, two days in a row, and the smell was back, stronger than ever, although it was different, in a subtle way; purer, as though some components were missing. Apparently it is a yeast byproduct. I don't really know if it's a mercaptan or not - I don't have a mass spec, and I'm not an expert in bio-smells. But he has an antibiotic in his system, and the fermentation smell is there, so it has to be yeast, doesn't it? I don't know.
I stopped the antibiotic halfway through the prescribed regimen. Yes, I can hear you crying out, especially you doctors, "Never stop an antibiotic after four days!"
Hey, you don't have to live with the fallout. Besides, there was no infection. There was no pathological bacteria that's going to become resistant. And each day of treatment gave the yeast an advantage. No thanks.
During one of his terrible episodes we rushed him to the doctor. "What's that smell?" she asked. He didn't have to breathe in her face; it was apparent from across the room. This is what I wanted her to see. She wrote a script and we ran off to the hospital for a blood test. A few days later the results came back. The PH is low, and the smell is butyric acid. Not a ketone, not a mercaptan, but an organic acid. Course there may be other odoriferous, volatile compounds that they weren't screening for, but butyric acid is definitely one of them.
Both yeast and bacteria produce this compound through anaerobic respiration, but remember, he's on an antibiotic. Guess what folks, we're back to the candida diet, and this time we have to get serious about it. Unfortunately John will not eschew sweets completely, so we're going to have to resort to some artificial sweeteners. I know, I've read all the articles too, but what can I do?
We purchased some sugar free candy with various polyols, sorbitol manitol maltitol etc, but John wasn't getting any better, so I typed "yeast maltitol" into google. Turns out, yeast like these <sugar alcohols> almost as much as they like sugar. If you're going to use an artificial sweetener, it has to have zero carbs. Aspartame, sucralose, or stevia. I'll try to keep the aspartame down to a minimum, but if he doesn't taste something sweet on a regular basis he'll sneak all sorts of high-carb treats here at home or at school.
All this leads to a perplexing question; why didn't the diflucan treatment ( a year ago) help? I searched the Net and found a <possible answer>. Some strains of candida are resistant to diflucan, and, diflucan is not terribly effective against intestinal yeast in any case. This web page recommends lamisil, which lingers in the intestines. Most people consider this a drawback, but in our case it could be just what the doctor ordered. I'll have to speak to our pediatrician about it.