13 year old daughter very sick

[goodmother41]

My daughter started complaining of severe abdominal pain and was very lethargic on Thursday. Thursday night she started throwing up. Friday she was the same. Saturday morning I took her to Care Now who tested her for the Flu, Mono, kidney infection and checked her blood and urine. All came back fine. Saturday night, I took her to a small hospital in our town and they checked for all the same things, told her it was a bad flu going around and sent her home crying and in pain. By Sunday night, her pain level was at a 10 and she could barely walk. I took her to Cook Chilrens Hospital in Fort Worth. They tested her blood, urine, did a CT Scan, Sonogram, Endoscopy, Colonoscopy and more series of blood test as well as tested her stool. She did not eat anything for six solid days. One day she felt fine and it looked like it was getting better, the next day, without pain meds and nausea medicine, she got pale immediately, became lethargic and could barely speak at all. I thought she was going to die. This happened twice this week. Yesterday when she had the colonoscopy and edoscopy, she felt a pain level of zero for the first time and they said since all test came back fine and she seemed to be getting better, she would go home today. At 4 am the pain came back and now the nausea came back. The doctors have said that some times you just can't tell what causes pain and she may have to learn to live with it. This was a normal, healthy happy go lucky child a week and a half ago who had never been sick in her life. About two months ago, she developed lines on her back that look like scars, though she has never scratched her back on anything. Someone told me a friend of a friend child had the same thing and it was a rare blood disease. The doctors at this hospital don't look more than 25 years old and don't have the years of experience of a doctor who has ran across rare things. Please help me, we don't know what else to do. Celiac test still has not came back but if it is not that, what else could it be?

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
With such a severe pain and nausea, if all other tests are negative, then panic attacks will need to be ruled out. Since she felt zero level pain during endoscopy and colonoscopy, the loss of gas due to insertion of tubes could be the cause. Crohn’s, celiac disease, lactose intolerance and IBS will have to be ruled out. A number of times a gastroenterologist is able to diagnose these conditions by clinical examination and detailed medical history. At other times a few tests are conducted. Blood tests to rule out anemia, stool test to look for white blood cells, sigmoidoscopy, colonoscopy etc are used to diagnose ulcerative colitis. Braium meal and follow through, endoscopy etc are done to rule out GERD, Crohn’s disease etc. Irritable bowel syndrome is diagnosed by elimination of other causes. Gluten is a complex protein present in four main grains---wheat, rye, barley and oats. If you have gluten intolerance, then you probably have celiac disease or Non Celiac gluten sensitivity. There are blood tests called celiac test to detect gluten intolerance.
Crohn’s disease is a difficult entity to diagnose. Along with gut symptoms skin disorders and arthritis too are commonly seen with Crohn’s. An upper GI series using barium dye is done to see the condition of small intestines. The degree of involvement of the large and small intestine may vary from person to person.  A biopsy is the most confirmatory.
An elevated ESR does confirm inflammation in the body. Low protein, minerals and iron in blood are the other findings in Crohn’s which may or may not be present. A recent advancement in Crohn’s diagnosis is video capsule endoscopy.
I think you should discuss these possibilities with your doctor. The chances of Crohn’s disease are high.
Please let me know if there is any thing else and do keep me posted. Take care!

[LivingInHope]

I'm sorry you all are going through this!   It must be tough with having run so many tests already with them not finding the cause!

Have they ruled out brain tumor?  Did they make sure there were no problems in her heart?  They say a heart attack in females can feel like heartburn.  I wonder if the pain could be coming from her heart or abdominal aorta?  And with the turning pale, I wonder what her blood pressure is doing.  Pain can make a person feel nauseated, if it is bad enough, even if the source of pain is not the GI system.

If the lines on her back look like stretch marks, is it possible she may have Cushing's disease?  

Also, psychological trauma can cause a lot of very real physical symptoms- is it at all possible that something recently is greatly distressing your daughter?