Child with sever abdominal pain

[wolffka]

My daughter is 10. In May complained of occassional stomach pain. In July had an episode of diarrhea followed by intestinal cramping. Cramping has increased in frequency and severity to the point of becoming incapacitating one or more times per day, accompanied by low-grade fever 99 to 100, mid-line abdominal pain starting under the diaphragm and moving lower as the pain intensifies, sometimes small BM of soft, formed stool. All labs have been normal including VMA, porphyria, 5HIAA, fecal fat and parasites, antibody for sprue, abdominal ultrasound with no gallstones or gallbladder thickening, abdominal CT, endoscopy and colonoscopy, HIDA scan (30% ejection fraction and no obstruction). Treated with an anticholinergic, Imiterex, amytriptiline, lactobacillus, Metamucil and Miralax, and hydrocodone. Usually able to sleep through the night, but has been awakened numerous times by pain. Pain builds in waves and she feels overheated to the point that she will not allow you to touch or even approach her too closely because she can "feel" heat from you body. Differential has included IBS, abdominal migraine, choledyskinesia, familial mediterranean fever and even heavy metal poisoning but no answers yet. Any suggestions would be appreciated. She has become afraid to eat or leave the house.

[jep65]

like the above mentioned look at food allergies.also try supplements like IBS from renew life 1-866-450-1787 to answer any questions about product and dosage.IBS should help to restore digestive system back to health.if she has been on a hi dosage of antibiotics restore them with an acidophulis formula you can get at your health fod store.

[nanamisay]

Please consider food allergies. so many things have msg and even wheat or dairy can cause pain and alot of these symtons. the easiest way is to code food by color, you know the basic eat the rainbow idea. Start by eliminating the whites, white bread, flour, milk, rice, potatoes, eggs, because these are the most likely sourses. Then reds, red meats, beans, dyes in juice,ect. Also consider and research parasites on your own. A standard stool sample does not test for all types of parasites. They are clever to survive millions of years. I would definatly consider a colon cleanse for kids "Paragone is the best, for results without pain or gas from the treatment." It is silly to believe it is important to worm our dogs , cats and horses, but to think we don't need worming oursselves periodically. This I would bet is the real culprit. Praying for your family

[Kevin Pho, MD]

A comprehensive evaluation has already been performed, and many of the major GI disorders would have been ruled out already.

At this time, I can't think of other tests that can be done.  I suppose that a gastric emptying scan to evaluate for gastroparesis or an esophageal motility study to evaluate for dysmotility can be considered to complete the workup.  

Obtaining another GI opinion at another academic medical center can also be considered if the workup is non-revealing.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com