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What Treatment Can Be Taken For Severe Persistent Abdominal Pain With Vomiting ?

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Posted on Sun, 6 May 2012
Question: Friends child, boy 13 yrs old, severe abdominal pain (child screams and cries unconsolably) with and without vomiting. Recurrent for 3 months. ER visits, CT scan, Upper & lover GIs, biopsies reveal nothing. Morphine does not relieve the pain. Doctors are stumped. Any ideas? Where to go for more help? Mayo?
doctor
Answered by Dr. Sunil.N (4 hours later)
Hi,

Thanks for your query.

History of recurrent episodes of severe abdominal pain, with and without vomiting over 3 months in a 13 year old indicates the following the possibilities :
1) Intestinal obstruction due to Intussusception
2) Henoch scholein purpura
3) Inflammatory bowel disorders
4) Fungal infections.

Since certain tests and biopsies have already been done and most of the above can be ruled out like Intestinal obstruction due to Intussusception, Inflammatory bowel disorders and Fungal infections.

The remaining causes can be ruled out only after taking a detailed history and clinical examination.

Mayo clinic is a well renowned hospital you can approach them for better management, I don't know about the clinic personally but according to the health survey it is considered as best hospital .

Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sunil.N (7 hours later)
The child is back in hospital today for same ailment. It just goes on and on. He is getting very weak. The docs have said they do not believe it is Abdominal Migraine because it doesn't follow the course exactly. Q: Is Abd Migraine the same thing as Cyclical Vomiting Syndrome? AND can Abdominal Epilepsy be present with NO history of seizures? Thank you. I'm terribly concerned about this child. I am an RN and have worked in Children's hospital many years ago but have not ever seen this course of illness. Thank you so much.
doctor
Answered by Dr. Sunil.N (1 hour later)
Hi Again ,

Thanks for your follow up query.

Abdominal migraine and cyclical vomiting syndrome are used to describe symptoms in the child having Abdominal pain, vomiting, etc, though they were considered different,clinically it is very difficult to differentiate.

Yes, Abdominal epilepsy can present without overt seizures ,an EEG will detect the abnormal wave pattern of the brain activity can be helpful in detecting in such cases.

I hope this answers your query.

Wish him a speedy recovery.

Regards.
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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Answered by
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Dr. Sunil.N

General & Family Physician

Practicing since :2010

Answered : 157 Questions

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What Treatment Can Be Taken For Severe Persistent Abdominal Pain With Vomiting ?

Hi,

Thanks for your query.

History of recurrent episodes of severe abdominal pain, with and without vomiting over 3 months in a 13 year old indicates the following the possibilities :
1) Intestinal obstruction due to Intussusception
2) Henoch scholein purpura
3) Inflammatory bowel disorders
4) Fungal infections.

Since certain tests and biopsies have already been done and most of the above can be ruled out like Intestinal obstruction due to Intussusception, Inflammatory bowel disorders and Fungal infections.

The remaining causes can be ruled out only after taking a detailed history and clinical examination.

Mayo clinic is a well renowned hospital you can approach them for better management, I don't know about the clinic personally but according to the health survey it is considered as best hospital .

Hope I have answered your query. If you have any follow up queries I will be available to answer them.