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What causes persistent vomiting in a teenager?

DOCTOR OF THE MONTH - Feb 2018
Feb 2018
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General Surgeon
Practicing since : 1984
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Question
My 14 year old daughter has been vomiting in the morning for the past 7 days. She said she awakens with a very sharp pain in her stomach, with nausea and it makes her vomit - please note, she in NOT pregnant. Our regular doctor will not refer us to a specialist even though we have explained that this has been progressive over the last 30 days to the point of the daily vomiting. Her appetite has decreased so she has also lost approximately 7+ pounds over the past 30 days.
Posted Sat, 30 Aug 2014 in Medicines and Side Effects
 
 
Answered by Dr. T Chandrakant 55 minutes later
Brief Answer:
Investigations and add-on treatment.

Detailed Answer:
Hi.

I can understand your plight.

To recapitulate: F-14- not pregnant- vomiting only in the morning after pain sharp pain in the stomach and nausea for 7 days - reduced appetite- weight loss over 30 days.

I would like to just get a clarification- your daughter is vomiting only for 7 days but you say the progression id for the last 30 days.

The possible cause is an inflammatory process either in the intestines, lymph nodes or may be an obstruction in the intestine.

The cause can be found only on detailed investigations :
-Upper GI Endoscopy to start with
-Ultrasonography of the abdomen to start with and Contrast enhanced CT scan if required.
-Tests of blood, urine and stool.

The possible add-on treatment would have been an antibiotic , metronidazole, for worms infestation, Domperidone exactly at 8 hourly interval. Continue with the medicines she has already been advised.

It is possible that as the daughter is just 14 your Doctor may be correctly thinking on the angle of psychological problem, common in this age group. I would think about this only if all the investigations are normal and the routine medical management fails to relieve the symptoms.

Request your Doctor to get her investigated as outlined.
Also ask about any problem at school or so.

Does she have any other associated symptoms like fever, altered stools, or anything you have noticed is normal for her age or routine.

Above answer was peer-reviewed by
 
Follow-up: What causes persistent vomiting in a teenager? 16 hours later
Dr. Chandrakant:
My daughter has woken up yet another day and vomited. This will be the 8th day now. To clarify, she has vomited episodically over the past 30 days prior to this last course of 8 days. Usually once she vomits, she tends to not have the pain in her stomach but still reports feelings of nausea. She has never had a fever at anytime since this has started. I had given her Prevecid before bedtime hoping to maybe control the possibility of excess stomach acid in the morning. What is really a mystery to all of us is that during course of the day she is able to eat, granted not her usual appetite, and keep it down. I also purposely made her eat a carbohydrate-filled dinner to see if there was a possibility of some ketotic hypoglycemia going on. I have researched parasitic infection symptoms, ulcer symptoms, hypoglycemia symptoms, cancer symptoms - she has maybe one or two similar symptoms of almost all of these things. It just doesn't make sense and it is very scary. This morning she did report that her bowel movements are getting easier possibly due to the reintroduction of the probiotics she is taking. Our regular MD has not done any tests on her, which also concerns me and they won't refer her to a specialist at this time.
 
 
Answered by Dr. T Chandrakant 52 minutes later
Brief Answer:
Investigations at the earliest

Detailed Answer:
In the days of evidence based practice the investigations should be done at the earliest, either to prove or disprove a possible cause.

Please insist for investigations, she is already loosing weight. The problem is more than a month now.

Prevecid alone may not help.
Above answer was peer-reviewed by
 
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