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Suggest Treatment For Abdominal Pain And Nausea

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Posted on Fri, 5 Sep 2014
Question: My 15 year old daughter has had severe upper abdominal pain along with nausea (and vomiting) and diarrhea for the past week... BUT only in the morning. It passes by about 10 am and she is absolutely fine the rest of the day!! This morning she was doubled over in pain and complaining of dizziness but did not vomit. She said the pain is in her upper abdomen and travels down around the left side to her lower abdomen. Her pediatrician said viral maybe, but we are not sure. She is getting quite depressed that every morning starts like this. Help!!
doctor
Answered by Dr. Eric Goldstein (25 minutes later)
Brief Answer:
Abdominal pain

Detailed Answer:
Hello. I just read through your question. I am sorry your daughter is not feeling well.
Stomach virus is the most common diagnosis for these symptoms at this age. This is what your pediatrician is thinking. However, a few points in your description are not consistent with this diagnosis. Specifically, I am referring to the upper (vs. lower) abdominal pain, and that fact that it resolves in the AM hours and doesn't come back until the next morning. This makes me think about something related to her laying down. When she is upright, her symptoms seem to resolve.
Because of this, I would consider reflux as a possible diagnosis. This doesn't mean anything needs to be done just yet, like starting medication for reflux. However, it is something to keep in mind, especially if the symptoms persist or worsen. It would be worth a conversation now with your pediatrician to get an opinion.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Eric Goldstein (49 minutes later)
hmmm... that wasn't even mentioned by her pediatrician. Does reflux cause stomach cramps, diarrhea, and vomiting? If so, is there something I can do or try to help her wake up in less misery?
doctor
Answered by Dr. Eric Goldstein (25 minutes later)
Brief Answer:
Follow Up

Detailed Answer:
Thank you for the follow up question.
Reflux would explain why the pain tends to be in the upper abdomen versus lower. It would also explain why the pain seems to resolve at around 10AM and not return again in the morning. Meaning, while laying down, a small amount of stomach content can work it's way up in the GI tract. When we stand, gravity helps it down again.
Keep in mind, many illnesses can trigger a short lived reflux. So this could be a stomach virus that triggered a reflux. This would explain the nausea and diarrhea.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Eric Goldstein (4 minutes later)
Ok, thank you. Is there something I can try over the counter to help her? She has missed the first week of Spanish and Math classes at school and is falling behind already.
doctor
Answered by Dr. Eric Goldstein (12 minutes later)
Brief Answer:
Follow Up

Detailed Answer:
You are very welcome.
At this point she should concentrate on remaining well-hydrated, and avoiding reflux triggers such as, sodas, chocolate, spicy foods. Also, dairy can sometimes worsen the pain, so it should be limited.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Eric Goldstein (43 minutes later)
Ok, I will try that. This may be a random thought, but any chance it is gallbladder? I just remembered that I woke up every single day with pain where my ribs meet. It's not as severe as my daughters pain and I had no nausea or diarrhea, but I ended up with my gallbladder removed in my 20's. Only then did I realize that that pain I had for so many years was related to it and not "normal"...
doctor
Answered by Dr. Eric Goldstein (16 minutes later)
Brief Answer:
Follow Up

Detailed Answer:
It's a good thought when we consider that in pediatrics, anything can happen. However, if she were to vomit green material, it would be a much more convincing argument. In the absence of that, it is far less likely.
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. Eric Goldstein

Pediatrician

Practicing since :1999

Answered : 1303 Questions

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Suggest Treatment For Abdominal Pain And Nausea

Brief Answer: Abdominal pain Detailed Answer: Hello. I just read through your question. I am sorry your daughter is not feeling well. Stomach virus is the most common diagnosis for these symptoms at this age. This is what your pediatrician is thinking. However, a few points in your description are not consistent with this diagnosis. Specifically, I am referring to the upper (vs. lower) abdominal pain, and that fact that it resolves in the AM hours and doesn't come back until the next morning. This makes me think about something related to her laying down. When she is upright, her symptoms seem to resolve. Because of this, I would consider reflux as a possible diagnosis. This doesn't mean anything needs to be done just yet, like starting medication for reflux. However, it is something to keep in mind, especially if the symptoms persist or worsen. It would be worth a conversation now with your pediatrician to get an opinion.