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Child is having midsternal chest pain. Not related to gastric problem. Taking ibuprofen. Cause and cure?

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I have an 8 year old c/o mid sternal chest pain. He states that it is sharp and rates the pain more often than not 10/10.He has seen pediatric gastroenterologists the first one took out his gallbladder and had endoscopy and colonoscopy with eosinophilia colitis being the dx and the 2nd(Childrens hosp Seattle) for chronic constipation and delayed gastric emptying. they state that this pain is not related to any gastric problems . He has had this pain on and off for 3 years or so and has recently increased in severity and duration. He has had EKG's chest xrays abd ultrasound,all neg. Lab work, all which is normal..This pain has interferred with school and his everyday normal activities. Currently he takes ibuprophen and when pain is intense hydrocodone liquid. Sometimes it helps and other times it doesn't. I can tell when he is struggling with the pain he continues to try and find a comfortable position but to no avail.He is scheduled for an echo of his heart but his pediatrician does not feel that this will be positve.Now we are also sched to see a phycologist to help him deal with this pain. help
Posted Wed, 1 May 2013 in Lung and Chest disorders
Answered by Dr. Y V Siva Sankara Murty 1 hour later

Thanks for writing to health care magic.

Which part of the day the pain is more? Is it more before or after food? Does he describe this pain as burning sensation? What is his weight? Is there any weight loss recently?

From the description I have a very strong feeling that reflux esophagitis is responsible for his pain what ever the investigations may say.

H2 blockers or proton pump inhibitors and prokinetics prescribed by doctor would help in a case of reflux esophatis.

Weight reduction in obese is important. It is important that the child does not lie down immediately after a meal. A tight belt or pant may also be responsible for such a problem and the same should be avoided. Avoid fatty meal and large meal particularly in the evening. Avoid that ibuprofen that he is having regularly. Raising the head end of the bed may help. Try and avoid any passive smoking he may be exposed to.

Hope this helps.
Take care.
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