Suggest Remedy For Constant Abdominal Pain In A Child

Posted on Mon, 4 Jan 2016

Question: My daughter has constant abdominal pain always around her belly button day and night and has been ongoing for over a month. Seen doctors at children's hospital and had ultrasound, blood tests, gastric study all normal. Lipase was high one evening but, back to normal next day. Then bilirubin elevated for 2 days (on wait list for genetic testing for Gilbert's syndrome). She is 7 and has missed over a month of school. No fever, diarrhea, vomiting, travel, or allergies. She is also wait listed to see GI in 8 months. I have no idea what to do I have considered the anxiety possibility however, she isn't shy or a worrier and then pain continues both at home and in school.

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
As enumerated

Detailed Answer:
Hi.
Thanks for your query and an elucidate history about your daughter of 7.

To recapitulate: Female/7 - constant abdominal pain - around belly button - day and night - for over a month - Doctors at Children's Hospital - normal ultrasound, blood and gastric study - Lipase raised for a day - bilirubin for 2 days - no fever, diarrhea, vomiting, travel or allergies - on waiting list for Gilbert's and GI (8 months) - considered anxiety

Commonest causes for peri-umbilical pains in a child of 7 are:
- Tummy tonsils meaning inflamed mesenteric lymph nodes
- Worms in intestine
- Worms can cause intermittent blockage of sphincter of Oddi causing momentary raise in Lipase and bilirubin and can even cause Pancreatitis. This may cause additional back pain too.
- Appendicitis- catarrhal form, referred pain in peri-umbilical region
- Abdominal epilepsy

These are some enumerated.
Proper investigations would help to pin-point the cause.
I would advise you/her the following:
- Stool test for 3 consecutive days
- High resolution ultrasonography (routine ultrasound already done)
- Enteroclysis under fluroscopy for real-time visualization of the small intestine
- MRCP
- Other tests as may be directed by the results of these tests and the clinical evaluation by her Doctor.

Please discuss these points with her Doctors to get an early diagnosis and provide proper treatment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (15 minutes later)

Thanks.

1day stool sample tested négative
Test for pancreatitis and appendicitis négatives

I did Forget to mention that thé pain is accompanied with extrême burping 2 week trial of prevacid fast tab no help

Appetite still good but she is pale and weak

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
sub-acute intestinal obste

Detailed Answer:
Thanks for your feedback.
Noted the findings about stool sample and additional information that the pain is accompanied by extreme burping; 2 week trial of Prevacid fast tab did not help.
Appetite is still good but she is pale and weak.

Please go for stool tests for 2 more times on different days.
Burping is an indication that there may be some although partial obstruction in the small intestine.
Enteroclysis will help a lot.
Prevacid may not help at all as it suppresses the acid and 7 year old may not be suffering from hyperacidity or gastric ulcer or so.
Domperidone may be helpful.

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar