Hello
I have a patient who is 13 years old he suffered his whole life from abdominal issues in the first year of his life he constantly had constipation he suffered until he started eating and stopped drinking milk however he didn’t have lactose intolerance but milk seemed to upset his bowel, then he would experience abdominal pain every now and then, one year ago he got his appendix removed due to appendicitis and few months ago upper abdominal pain started worsening he was diagnosed at some point with celiac disease by a paediatrician but then was ruled out by a gastroenterologist then was diagnosed with IBS by another paediatrician then was referred to have an endoscopy study that showed class II Hill, as follows:
Esophagus : normal oesophageal mucosa, no varix, gastrosophageal junction located at 38cm, diaphragmatic hiatus located at the same level one scope diameter laxity, Hill class Il and with no hiatus hernia .
Duodenal biopsy:
normal 1st and 2nd part of the duodenum, biopsies were taken. The patient still suffers from abdominal pain and is worsening. biopsy seemed normal , please can you give me an advice where to go next and which of those diagnoses is right the family of the kid begs for help anywhere they just want answers what’s wrong with their kid .