What causes diarrhea with vomiting?
Irritable bowel or inflammatory bowel disease
Hi...thank you for consulting on Health Care Magic. I appreciate your concern regarding the vague symptoms of your kid. With his stature & good built, as you have rightly pointed out I too think this is not an eating disorder. But putting one and one together, 2 possibilities come to my mind -
1. Irritable bowel syndrome
2. Inflammatory bowel disease (Crohns or Ulcerative colitis)
I would not think of GERD when he's having diarrhea along with vomiting...isolated vomiting & heartburn I agree..but not when diarrhea is there. Coming to the possibilities I suggested, these two can start at any age and are notorious to be diagnosed very late as there should be a high index of suspicion when considering these. As you suggested gluten free diet, I assume you are considering celiac disease but its rare presenting this far (15years) that too in a well built child. But for confirmation you can get a tissue transglutaminase antibodies done. Inflammatory bowel disease requires early endoscopy and colonoscopy along with a biopsy. The only thing which is not fitting in is occasional blackouts. I suggest, even if your physician is mad, kindly approach him & discuss about the possibilities I put forth, for kid's sake. I wish your 15 year old good health & speedy recovery. Hope my answer was helpful for you. Happy to help anytime. Further clarifications and consultations on Health Care Magic are welcome.
Dr. Sumanth MBBS., DCH., DNB (Paed).
Ruling out treatable conditions shoud come first
I thank you for your trust in me. I agree with you that food related is a probability. But one logical train of thought is that if food is the only cause then, he should be having the same food ingredients since long and he is well built kid, which rules out conditions like malabsorption. Keeping a diary of 24hour or weekly dietary recall is a very good idea. But my concern is the same as you.
The vagueness of the symptoms are the ones which are worrying me too and in my experience I have seen till now 5 cases of Inflammatory bowel disease presenting vaguely and being diagnosed after endoscopy and biopsy. When I went through the literature, I stumbled upon innumerable references in medical literature saying the lack of high index of suspicion is what is the main cause of late diagnosis and complications is such cases.
I again humbly suggest you to consider this possibility and discuss with your pediatricians about the possibility of probing in these lines.
I wish your son a very bright future and speedy recovery. I also request you one thing....I am really interested to know as a physician what is the final outcome and diagnosis after which your son got better. I request you to share this with me so that this experience will help some other kid whom I see with same symptomatology.
With kind regards - Dr. Sumanth MBBS., DCH., DNB (Paed).
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