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Suggest Treatment For Stomach Pain, Nausea And Headaches
Question: My 15 year old daughter has stomach pain and nausea plus shooting pain in arms and legs frequent cold n chills, lnight sweats and other body pains..in toes, neck, fingers, buttocks,
jaw H...constant headaches ....for last three months every test from endoscopy sonogram to blood from lupus lime mono rheumatoid is negative... we r at aloss
jaw H...constant headaches ....for last three months every test from endoscopy sonogram to blood from lupus lime mono rheumatoid is negative... we r at aloss
Brief Answer:
Systemic or polyarticualr JRA is a strong possibility
Detailed Answer:
HI...I have gone through the details you have provided. But I need some more information. Kindly answer the questions below -
1. What started first - fever or joint pains or shooting pains?
2. Is fever fever there daily or intermittently?
3. How high is the fever?
4. How is her activity in between 2 fever episodes?
5. Is there any rash associated with fever?
6. Did she have any serious bacterial infection sin the past or in these 3 months?
7. Is there any family history of connective tissue disorders like lupus or rheumatoid arthritis?
8. His is her appetite in the past 3 months and has she decreased in weight significantly in the past 3 months?
9. is she very pale or any blood transfusions given in these 3 months?
10. Was a bone marrow aspiration and histological examination done?
11. Have any steroids been given - and if so, before giving steroids, has a bone marrow examination been performed?
11. Are there any lymph node swellings on the body?
Suggestions -
1. Kindly upload all the reports as images for me to have a look.
2. Kindly answer all the questois above.
Possibilities -
1. Systemic onset Juvenile Rheumatoid arthritis.
2. Poly articular Juvenile Rheumatoid arthritis.
3. Prolonged viral illness.
4. Lymphoreticular malignancy.
Regards - Dr. Sumanth
Systemic or polyarticualr JRA is a strong possibility
Detailed Answer:
HI...I have gone through the details you have provided. But I need some more information. Kindly answer the questions below -
1. What started first - fever or joint pains or shooting pains?
2. Is fever fever there daily or intermittently?
3. How high is the fever?
4. How is her activity in between 2 fever episodes?
5. Is there any rash associated with fever?
6. Did she have any serious bacterial infection sin the past or in these 3 months?
7. Is there any family history of connective tissue disorders like lupus or rheumatoid arthritis?
8. His is her appetite in the past 3 months and has she decreased in weight significantly in the past 3 months?
9. is she very pale or any blood transfusions given in these 3 months?
10. Was a bone marrow aspiration and histological examination done?
11. Have any steroids been given - and if so, before giving steroids, has a bone marrow examination been performed?
11. Are there any lymph node swellings on the body?
Suggestions -
1. Kindly upload all the reports as images for me to have a look.
2. Kindly answer all the questois above.
Possibilities -
1. Systemic onset Juvenile Rheumatoid arthritis.
2. Poly articular Juvenile Rheumatoid arthritis.
3. Prolonged viral illness.
4. Lymphoreticular malignancy.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your quick response. A i INDICATED a blood test for rheumatoid conditions was done. I will send it once I can scan it...to see if something was missed
Detailed Answer:
HI...I have gone through the details you have provided. But I need some more information. Kindly answer the questions below - SHE HAS NEVER HAD FEVER
1. What started first - fever or joint pains or shooting pains?
SHOOTING PAINS SEEMED TO FOLLOW THE STOMACH DISTRESS WAS DIAGNOSED AS HYPILORI...I BELIEVE THE PAINS CAME AFTER THE START OF ANTIBIOTICS
2. Is fever fever there daily or intermittently? SHE IS FREQUENTLY COLD AND TEN SWEATS BUT NO FEVER
3. How high is the fever?
4. How is her activity in between 2 fever episodes?
5. Is there any rash associated with fever?
6. Did she have any serious bacterial infection sin the past or in these 3 months? YES HPYLORI WAS THE BEGINNING OF THIS, AND ALMOST 3 WEEKS OF ANTIBIOTICS TO ADDRESS THIS
7. Is there any family history of connective tissue disorders like lupus or rheumatoid arthritis? SHE IS ADOPTED WE HAVE NO FAMILY HISTORY BUT SHE WAS CHECKED FOR BOTH THESE
8. His is her appetite in the past 3 months and has she decreased in weight SHE HAS NOT LOST WEIGHT BUT HER APPETITE HAS DROPPED OFF...THOUGH I WORK AT MAKING HER EAT BUT OFTEN SHE CAN GO FOR 4-6 HOURS IN THE MORNING WITHOUT EATING SINCE SHE IS NAUSEAS EACH DAYsignificantly in the past 3 months?
9. is she very pale or any blood transfusions given in these 3 months? SHE WAS ANEMIC ABOUT 2 YEARS AGO BUT AFTER IRON PILLS FOR 6 MONTHS HE IRON LEVELS ARE NORMAAL
10. Was a bone marrow aspiration and histological examination done? NO WHO DOES THIS???
11. Have any steroids been given - and if so, before giving steroids, has a bone marrow examination been performed? NO STEROIDS I BELIEVE...ONLY ANTIBIOTICS IN LARGE DOSES
11. Are there any lymph node swellings on the body? NOT ON THE BODY BUT SHE FREQUENTLY COMPLAINS OF SORE THROAT AND CLAIMS THE GLANDS IN HER THROAT AT SWOLLEN, THOUGH I CAN NOT SEE IT. SHE WAS TESTED FOR STREP...IT WAS NEGATIVE.
THANK YOU FOR YOUR QUESTIONS. I WILL ATTEMPT TO SCAN THE BLOOD TEST RESULTS AND SEND THEM. i BELIEVE THE ANTIBIOTIS WERE ARITHOMYSINE AND ......FORGOT OTHER.
Suggestions -
1. Kindly upload all the reports as images for me to have a look.
2. Kindly answer all the questois above.
I SEE YOU ARE A PULMONALOGIST...SHE A;SO COMPLAINS OF SHORTNESS OF BREATH ON EXERTION AND HAD A PULMONARY FUNCTION TEST AT WHICH SHE REGISTERED 80% BUT THE PULMONALOGIST SAYS SHE DOES NOT HAVE ASTHMA.
SHE ALSO COMPLAINS THAT HER CHEST HURTS...ALONG WITH OTHER PAINS.
SHE HAS VERY FREQUENT PROLONGED HEADACHES.
THANK YOU AGAIN.
Detailed Answer:
HI...I have gone through the details you have provided. But I need some more information. Kindly answer the questions below - SHE HAS NEVER HAD FEVER
1. What started first - fever or joint pains or shooting pains?
SHOOTING PAINS SEEMED TO FOLLOW THE STOMACH DISTRESS WAS DIAGNOSED AS HYPILORI...I BELIEVE THE PAINS CAME AFTER THE START OF ANTIBIOTICS
2. Is fever fever there daily or intermittently? SHE IS FREQUENTLY COLD AND TEN SWEATS BUT NO FEVER
3. How high is the fever?
4. How is her activity in between 2 fever episodes?
5. Is there any rash associated with fever?
6. Did she have any serious bacterial infection sin the past or in these 3 months? YES HPYLORI WAS THE BEGINNING OF THIS, AND ALMOST 3 WEEKS OF ANTIBIOTICS TO ADDRESS THIS
7. Is there any family history of connective tissue disorders like lupus or rheumatoid arthritis? SHE IS ADOPTED WE HAVE NO FAMILY HISTORY BUT SHE WAS CHECKED FOR BOTH THESE
8. His is her appetite in the past 3 months and has she decreased in weight SHE HAS NOT LOST WEIGHT BUT HER APPETITE HAS DROPPED OFF...THOUGH I WORK AT MAKING HER EAT BUT OFTEN SHE CAN GO FOR 4-6 HOURS IN THE MORNING WITHOUT EATING SINCE SHE IS NAUSEAS EACH DAYsignificantly in the past 3 months?
9. is she very pale or any blood transfusions given in these 3 months? SHE WAS ANEMIC ABOUT 2 YEARS AGO BUT AFTER IRON PILLS FOR 6 MONTHS HE IRON LEVELS ARE NORMAAL
10. Was a bone marrow aspiration and histological examination done? NO WHO DOES THIS???
11. Have any steroids been given - and if so, before giving steroids, has a bone marrow examination been performed? NO STEROIDS I BELIEVE...ONLY ANTIBIOTICS IN LARGE DOSES
11. Are there any lymph node swellings on the body? NOT ON THE BODY BUT SHE FREQUENTLY COMPLAINS OF SORE THROAT AND CLAIMS THE GLANDS IN HER THROAT AT SWOLLEN, THOUGH I CAN NOT SEE IT. SHE WAS TESTED FOR STREP...IT WAS NEGATIVE.
THANK YOU FOR YOUR QUESTIONS. I WILL ATTEMPT TO SCAN THE BLOOD TEST RESULTS AND SEND THEM. i BELIEVE THE ANTIBIOTIS WERE ARITHOMYSINE AND ......FORGOT OTHER.
Suggestions -
1. Kindly upload all the reports as images for me to have a look.
2. Kindly answer all the questois above.
I SEE YOU ARE A PULMONALOGIST...SHE A;SO COMPLAINS OF SHORTNESS OF BREATH ON EXERTION AND HAD A PULMONARY FUNCTION TEST AT WHICH SHE REGISTERED 80% BUT THE PULMONALOGIST SAYS SHE DOES NOT HAVE ASTHMA.
SHE ALSO COMPLAINS THAT HER CHEST HURTS...ALONG WITH OTHER PAINS.
SHE HAS VERY FREQUENT PROLONGED HEADACHES.
THANK YOU AGAIN.
Brief Answer:
Looking forward for the reports
Detailed Answer:
Hi...I would like to bring one thing which crossed my mind to your notice. All the symptoms your kid is telling or having are subjective...What I men to say is - there are no test which can conclusively say that the kid is having shooting pains or joint pains or headache or stomach ache. She has lost appetite but not weight. She doesn't have fever either.
The symptoms you quote might fit into rheumatoid diseases or any other connective tissue disease. but the thing is it won’t present like this without fever and all tests cannot be negative. Keeping in mind the age and gender of the kid, I feel we should conversion reaction like symptoms. But I reiterate the fact that this is a diagnosis of exclusion after ruling out all other physical diagnoses. What I mean to say by conversion reaction is that it is a non-organic problem.
I am considering this diagnosis as the symptoms you quote do not fit perfectly into any known clinical syndrome. I suggest you see your paediatrician with this tip.
Your doctor was right and she doesn't have asthma.
I feel and suggest that you need to see a clinical psychologist too.
Kindly get back with any queries to this proposition.
Regards - Dr. Sumanth
Looking forward for the reports
Detailed Answer:
Hi...I would like to bring one thing which crossed my mind to your notice. All the symptoms your kid is telling or having are subjective...What I men to say is - there are no test which can conclusively say that the kid is having shooting pains or joint pains or headache or stomach ache. She has lost appetite but not weight. She doesn't have fever either.
The symptoms you quote might fit into rheumatoid diseases or any other connective tissue disease. but the thing is it won’t present like this without fever and all tests cannot be negative. Keeping in mind the age and gender of the kid, I feel we should conversion reaction like symptoms. But I reiterate the fact that this is a diagnosis of exclusion after ruling out all other physical diagnoses. What I mean to say by conversion reaction is that it is a non-organic problem.
I am considering this diagnosis as the symptoms you quote do not fit perfectly into any known clinical syndrome. I suggest you see your paediatrician with this tip.
Your doctor was right and she doesn't have asthma.
I feel and suggest that you need to see a clinical psychologist too.
Kindly get back with any queries to this proposition.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I was happy with your inquiry but now that she. Does not fit the mold... it must be psychological... it is nit she spent last nigh throwing up...she has pain in the ribs and throat...yesterday she broke out in a rash. I resorted to this service because doctors I have seen seem unable to do diagnostic work...how sad....if a case is a liitle more
complicated...!?there musT be a be a better answer
I am no satisfied to send her to therapy...there is a digestive problem and she is not getting the nutrition she needs and the antibiotics have upset the equilibrium of here system...what so I do now....sadly western Medline throws your it's hands...I would like another
opinion.
complicated...!?there musT be a be a better answer
I am no satisfied to send her to therapy...there is a digestive problem and she is not getting the nutrition she needs and the antibiotics have upset the equilibrium of here system...what so I do now....sadly western Medline throws your it's hands...I would like another
opinion.
Brief Answer:
Could be an inflammatory bowel disease
Detailed Answer:
Hi....At that time as the symptoms which she had were only subjective, that is, they can only be perceived. But now the rash and vomiting she has is objective.... So I take back my suggestion that it could be psychological.
If you remember right, I had already asked about rash in our previous conversation as I had inflammatory bowel disease in my mind. The other possibility is inflammatory bowel disease (IBD)....because, though it primarily affects the bowels, it can have extra intestinal manifestations like what you are describing.
The investigations I suggest is that, she should undergo an endoscopy and a biopsy would be required. Histopathological examination is the gold standard for diagnosis.
Regards - Dr. Sumanth
Could be an inflammatory bowel disease
Detailed Answer:
Hi....At that time as the symptoms which she had were only subjective, that is, they can only be perceived. But now the rash and vomiting she has is objective.... So I take back my suggestion that it could be psychological.
If you remember right, I had already asked about rash in our previous conversation as I had inflammatory bowel disease in my mind. The other possibility is inflammatory bowel disease (IBD)....because, though it primarily affects the bowels, it can have extra intestinal manifestations like what you are describing.
The investigations I suggest is that, she should undergo an endoscopy and a biopsy would be required. Histopathological examination is the gold standard for diagnosis.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
She had an endoscopy and biopsies of tissue and nothing was found...I found something like gate pareses no sure of spelling but slow emptying of bowel how do u test for that and can if just be inflammation of sad stomach nerves...how do u diagnosise and treat this...i am at a dead end.
Brief Answer:
Gastroparesis - suggestions
Detailed Answer:
Hi...it is not gut paresis, but gastroparesis..and it is a part and parcel of intestinal motility disorders....and applies to abnormal intestinal contractions, such as spasms and intestinal paralysis... in which the gut has lost its ability to coordinate muscular activity because of causes inside the body or extraneous. Features could be...Abdominal distention/ Recurrent obstruction/ Severe abdominal colicky pain/ Severe constipation/ Gastroesophageal reflux disease
Intractable and recurrent vomiting.
Workup may include laboratory studies, diagnostic imaging, manometry, electromyography (EMG), endoscopy, and diagnostic laparoscopy or laparotomy.
This is my reply to your suggestion about gastroparesis. But as such inflammatory bowel disease is a very very slowly evolving disease and one normal endoscopy and biopsy doesn't rule out the disease. Sometimes inflammation may be not be there or missed in the particular section of biopsy where the tissue was taken. There are cases reported where a repeat testing and investigation have revealed the disease at a later date.
At thus juncture as she has not lost weight and active otherwise, I suggest you wait... Or let the disease evolve.
Regards - Dr. Sumanth
Gastroparesis - suggestions
Detailed Answer:
Hi...it is not gut paresis, but gastroparesis..and it is a part and parcel of intestinal motility disorders....and applies to abnormal intestinal contractions, such as spasms and intestinal paralysis... in which the gut has lost its ability to coordinate muscular activity because of causes inside the body or extraneous. Features could be...Abdominal distention/ Recurrent obstruction/ Severe abdominal colicky pain/ Severe constipation/ Gastroesophageal reflux disease
Intractable and recurrent vomiting.
Workup may include laboratory studies, diagnostic imaging, manometry, electromyography (EMG), endoscopy, and diagnostic laparoscopy or laparotomy.
This is my reply to your suggestion about gastroparesis. But as such inflammatory bowel disease is a very very slowly evolving disease and one normal endoscopy and biopsy doesn't rule out the disease. Sometimes inflammation may be not be there or missed in the particular section of biopsy where the tissue was taken. There are cases reported where a repeat testing and investigation have revealed the disease at a later date.
At thus juncture as she has not lost weight and active otherwise, I suggest you wait... Or let the disease evolve.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So what do you d pi for symptoms I. The meantime..
She is miss III mg school nausea..
And in pain..what is the,treatment
She is miss III mg school nausea..
And in pain..what is the,treatment
Brief Answer:
Symptomatic treatment - prescription drugs
Detailed Answer:
Its only symptomatic treatment in the meanwhile. I am sorry to say this. But sometimes before the disease reveals itself, extensive investigations are only going to hurt and depress her. Instead let her be her own self, let her recuperate with good diet and symptomatic treatment.
I suggest -
1. Ondanisetron for vomiting. She can be added on proton pump inhibitors like Omeprazole as the stress can cause gastritis.
2. Hydroxyzine or cetrizine for rashes.
3. Only paracetamol (maximum 650mg 6th hourly) and strictly no NSAIDS or pain killers for pain.
Some of these are prescription drugs and kindly see your pediatrician for them.
Meanwhile in her diet, you can avoid spicy ingredients.
Regards - Dr. Sumanth
Symptomatic treatment - prescription drugs
Detailed Answer:
Its only symptomatic treatment in the meanwhile. I am sorry to say this. But sometimes before the disease reveals itself, extensive investigations are only going to hurt and depress her. Instead let her be her own self, let her recuperate with good diet and symptomatic treatment.
I suggest -
1. Ondanisetron for vomiting. She can be added on proton pump inhibitors like Omeprazole as the stress can cause gastritis.
2. Hydroxyzine or cetrizine for rashes.
3. Only paracetamol (maximum 650mg 6th hourly) and strictly no NSAIDS or pain killers for pain.
Some of these are prescription drugs and kindly see your pediatrician for them.
Meanwhile in her diet, you can avoid spicy ingredients.
Regards - Dr. Sumanth
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
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