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Having grunting, loss of breath and pain. Took Tylenol. Having pain in navel. Should I be worried?

Feb 2013
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Practicing since : 2002
Answered : 3176 Questions
First of all, what is your specialty in?

My 5 year old came home from school on Friday sounding like he was gagging every few seconds. I kept asking him if he was going to throw up and he said no. After watching him, I realized that he was in pain, and holding his breath, then grunting when he had to breathe out because it hurt to do so. I went through the ordinary questions...he did not fall, he was not hit, he drank plenty of water on his field trip, he urinated normally with no pain, he said he ate his lunch but was starving. I took him to get food, and he barely ate, saying it made him hurt to move and try to eat. I gave him children's Tums, and this did not help. I gave him Tylenol and after a half hour he began to relax and grunt less, stating it felt much better, but still had no apetite. Every 4 hours around the clock he woke up screaming in pain with the grunting breathing, and I gave him more medicine, which had him back asleep within 30 minutes. The pain started on his right side, about navel level. It moved up to right under his ribs on the right side, and then eventually down to center around his navel. Then after 36 hours he spiked a fever of 103.2 (he normally runs very high fevers, even when not typical). Coupled with the intense, moving pain, I got concerned it could be the beginning of appendicitis, even though the pain had not localized yet. I took him in, of course after he had Tylenol, so he could move around fine, his breathing was nearly normal and he wasn't hurting too bad. He has no other symptoms. The doctor said he had normal bowel sounds, his abdomen was tender, his throat looked good, his urine looked good, his lungs sounded good, and even though he could palpate and find the tenderness, it was not localized so he told me not to worry too much, YET. He told me he thought it was either the precursor to appendicitis like I was worried about, or "hopefully just an odd virus XXXXXXX We are now another 24 hours past that, and the fever is very low now (if at all). The pain was gone most of the day today; however, right before bed, he said that it was hurting under his rib cage on the right side again. What should I be concerned about? How soon should I have him seen again?

Other things to take into consideration: He has asthma, which has not been acting up at all. He got 3 large "bug bites" at school the day the issues began. He has ADHD and takes Adderall XR each morning. He was diagnosed with mono in October 2012, and had "super strep" causing him to have strep infections repeatedly from September until February, when he had his tonsils and adenoids removed.
Posted Sun, 2 Jun 2013 in Child Health
Answered by Dr. E Venkata Ramana 4 hours later

Thank you for your query on Healthcare Magic.

My specialty is pediatrics which deals with children health.

As the child presented with pain in the abdomen and fever, it is looking like an infection of gut.

As there is pain on the right side of abdomen below the ribcage, some times viral infections of the liver will present this type fever and pain.

And some times infection of the lung, especially lower lobe infections will present with fever, grunting, and referred pain abdomen.

Gastroenteritis will present with fever, pain abdomen, followed by loose stools after some time.

I advise you to observe for any worsening in the pain and fever, development of new symptoms like vomitings or loose stools or abdominal distention.

Continue the medication as advised by your doctor. And physical examination and reevaluation within 24 hours may be required if the symptoms are worsening.

If the child is continuing to have pain abdomen, or develops any new symptoms consult the doctor again for re-examination and for investigations like ultrasound abdomen and pelvis if required depending on the examination findings.

Hope I have answered your query.

I wish your child a speedy recovery.

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