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Intellectually disabled. Having headache and stomach pain. Stomach looks abnormal in shape. Previously diagnosed with gastritis. Help?

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Practicing since : 2000
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My sister who is intellectually disabled has been having this problem for 5+ years now with no diagnosis.

Her symptoms almost always begin with a headache then she complains of stomach pain located approximately 2 inches above her navel & about 2 inches to her left side. When she's experiencing an episode, I will touch the area described above and it seem harder than her right side. She will spend most of the day laying down looking drained with no visible energy. She will cry of pain and then eventually throws up. Her stomach seems abnormal in size as if she was 6 months pregnant.

It is until then that all symptoms subside. My concern at this time is that these episodes are occurring more frequently (every 2 wks), when it used to be at least every month and at the most, every 2-3 months. I am really puzzled at the fact that it seems so difficult to diagnose her condition after just about every exam/procedure has been performed. Unfortunately, with her not being able to describe as anyone else would normally be able to, it makes this matter a bit more frustrating.

She had been previously diagnosed with gastritis however that was discarded on 2 recent endoscopy procedures.

Please help me ease this ongoing frustration and hopefully come up with a diagnosis.

Thank You,

Posted Mon, 9 Sep 2013 in Digestion and Bowels
Answered by Dr. Amit Jain 1 hour later
Brief Answer:
Please upload investigations and drugs she is on

Detailed Answer:
Hello! Thanks for putting query in XXXXXXX

I can understand the problem she is facing. Please upload all the investigations and medicine she is on if you don't mind as I want to know which investigations she has undergone. It may be drug induced or may be neuropathic or intestinal colic arising from partial intestinal obstruction or may be a vascular disease. I also want to know whether she is having any other symptoms like her bowel habits or vomiting especially during pain, whether she is able to take orally at that time or any other systemic symptoms like joint pain, rash over body, any seizure etc. please provide me these details, I hope you will not mind because these details are necessary as symptoms are persisting since last 5 years. Waiting for the response.
Above answer was peer-reviewed by
Follow-up: Intellectually disabled. Having headache and stomach pain. Stomach looks abnormal in shape. Previously diagnosed with gastritis. Help? 7 hours later
Dr. Jain:

Thank you for following up on this query. Sorry for the delayed response but I just came back from the emergency room at our local hospital. My sister was not feeling good and so I decided to have checked out. She was given Pepsid & an anti-nausea medication intravenously which brought her back to normal. Blood & urine samples were normal. She was prescribed Omeprazole for a month as the attending doctor suspects Gastric Acid build up as the culprit.

In response to your request, 2 endoscopies have been performed where in one of them, a sample of tissue was taken to test for possible Celiac disease. Blood test follow up, discarded that possibility. 2 ultrasounds have been performed which presented cysts in both her kidneys and liver. I was told these were of such small size that it was of no concern.

2 Cat Scans of her head performed which were normal. 1 Cat Scan of her stomach which confirmed the previous findings of the ultrasounds. Another finding was Diverticulosis.

Amoebas were present in her latest stool sample and treated with Flagyl, antibiotic.

In a stereoscopic exam of her stomach, a doctor did mention he heard more than the normal number of movements in her intestines.

She was not taking any medication until the one prescribed today. Hopefully this information will assist.

Look forward to hearing from you soon.

Thank you,

Follow-up: Intellectually disabled. Having headache and stomach pain. Stomach looks abnormal in shape. Previously diagnosed with gastritis. Help? 12 hours later
Hi Dr. Jain:

Was following up with my response of 12 hours ago and was wondering if you had an update?

Answered by Dr. Amit Jain 4 hours later
Brief Answer:
Continue with omeprazole

Detailed Answer:
Hello! Sorry for delay. Thanks for giving all the details I required.

Your doctor is right over there that She is having acid peptic disease as her symptoms were relieved with pepsid and antinauseating medicine. So continue with omeprazole. Also take some prokinetic agent like domperidone. Omeprazole and domperidone also comes in combination like Capsule Ocid-dsr which can be taken once only for better compliance.

All investigation are normal except one endoscopy report which is suggestive of gastritis, for which omeprazole is appropriate medicine.

Hope She will become well soon
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