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What Causes Frequent Digestive Issues In Children?
Question: Hi
my son is 8 years old. constant tummy ailments and feels nausea. Blood work all normal just slightly elevated crp. Fecal test negative for all viruses but positive for hemoglobin. Abdominal scan revealed 5 large mesenteric lymps biggest one 29.7x13.7mm
doc scheduled a colonoscopy in 2 weeks time....but i am very worried. Any advice on the results as supplied would be greatly appreciated
my son is 8 years old. constant tummy ailments and feels nausea. Blood work all normal just slightly elevated crp. Fecal test negative for all viruses but positive for hemoglobin. Abdominal scan revealed 5 large mesenteric lymps biggest one 29.7x13.7mm
doc scheduled a colonoscopy in 2 weeks time....but i am very worried. Any advice on the results as supplied would be greatly appreciated
Brief Answer:
Antibiotic course, think of appendicitis as a basic cause >FNAC/Biopsy
Detailed Answer:
Hi.
Thanks for your query for your son.
To recapitulate:
Male/8 - constant tummy ailment and nausea - just elevated CRP - fecal test positive for hemoglobin - Scan shows 5 large mesenteric LNs - colonoscopy after 2 weeks -
The history you have provided shows 5 large LNs and has pain, this indicates infection as the most probable reasons.
I would advise a 7 day course of an antibiotic, metronidazole; follow up the progress/regress of the lymph nods by Ultrasonography and continue the treatment as required.
It is possible that within 3 weeks the lymph nodes and the symptoms of pain and nausea may get resolved and may not need any further query.
Tests of stool on 3 consecutive days is more helpful as at least one test may show the positive results.
Colonoscopy as is planned to be done.
If there is no resolution, FNAC or biopsy is a must.
For this I would advocate Diagnostic Laparoscopy. this helps in diagnosis of many things like appendicitis or any other inflammatory process that has caused the lymph nodes to grow. If there are signs of appendicitis, appendectomy can be done, FNAC or biopsy of the lymph node can be performed to have a confirmed diagnosis. Many a times by doing appendectomy the focus of infection is removed and the patients gets totally asymptomatic, this is called therapeutic use.
I hope this step by step approach helps the best as we do.
I also can understand the Doctor who is taking care of your child may be in favor of what I have said or can have minor deviation in thinking process as per his learning and personal experiences.
Second opinion of a Pediatric Surgeon is always the best option.
Please feel free to ask further question if you need to or if you feel that there is a gap-of-communication.
Antibiotic course, think of appendicitis as a basic cause >FNAC/Biopsy
Detailed Answer:
Hi.
Thanks for your query for your son.
To recapitulate:
Male/8 - constant tummy ailment and nausea - just elevated CRP - fecal test positive for hemoglobin - Scan shows 5 large mesenteric LNs - colonoscopy after 2 weeks -
The history you have provided shows 5 large LNs and has pain, this indicates infection as the most probable reasons.
I would advise a 7 day course of an antibiotic, metronidazole; follow up the progress/regress of the lymph nods by Ultrasonography and continue the treatment as required.
It is possible that within 3 weeks the lymph nodes and the symptoms of pain and nausea may get resolved and may not need any further query.
Tests of stool on 3 consecutive days is more helpful as at least one test may show the positive results.
Colonoscopy as is planned to be done.
If there is no resolution, FNAC or biopsy is a must.
For this I would advocate Diagnostic Laparoscopy. this helps in diagnosis of many things like appendicitis or any other inflammatory process that has caused the lymph nodes to grow. If there are signs of appendicitis, appendectomy can be done, FNAC or biopsy of the lymph node can be performed to have a confirmed diagnosis. Many a times by doing appendectomy the focus of infection is removed and the patients gets totally asymptomatic, this is called therapeutic use.
I hope this step by step approach helps the best as we do.
I also can understand the Doctor who is taking care of your child may be in favor of what I have said or can have minor deviation in thinking process as per his learning and personal experiences.
Second opinion of a Pediatric Surgeon is always the best option.
Please feel free to ask further question if you need to or if you feel that there is a gap-of-communication.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you for your answer and advice. this however has been going on for 8 months plus therefor my concern unless its possible that he has recurrent infections. although he doesn't have a fever. I suppose waiting out the results of the colonoscopy and the folow up ultra sound is enivitable. ...just worried and the waiting is driving me insane
Brief Answer:
Follow the protocol, patent has to get a relief too.
Detailed Answer:
I can understand the plight you are going through.
Fever is a symptoms and is seen only if the infection is acute or virulent; may not be seen in chronic cases like your son is suffering for the last 8 months.
Please try to follow the protocol (a sort of) and everything will be fine.
Discuss with your Doctors. Take further steps, or take second opinion of a Pediatric Surgeon.
..
Follow the protocol, patent has to get a relief too.
Detailed Answer:
I can understand the plight you are going through.
Fever is a symptoms and is seen only if the infection is acute or virulent; may not be seen in chronic cases like your son is suffering for the last 8 months.
Please try to follow the protocol (a sort of) and everything will be fine.
Discuss with your Doctors. Take further steps, or take second opinion of a Pediatric Surgeon.
..
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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