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Had diarrhea or vomiting. Taking dicyclomine and culterelle. What could be causing this? What tests should be done?

My 13 1/2 yr son had appendix removed nov 2011. For the past 4 months he has had diarrhea or vomiting upon awakening in morning at least once weekly. In past week it has been daily only in mornings after he gets out of bed. No fever. Has stomach cramps and pain in the belly button area. Bloodwork normal. Taking dicyclomine and culterelle for almost one week no improvement. Also immodium as needed. A couple hours of vomiting or diarrhea and feels better. Very strong appetite and drinks lot of fluids. Eating helps cramps but seems that after food has digested during night and upon awakening is when illness occurs most. What could be causing this? What tests should be done? Currently waiting for a gastro spec appt but cant get appt quick enough.
Asked On : Sat, 27 Apr 2013
Answers:  3 Views:  159
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General Surgeon 's  Response
Becuase of previous surgery of Appendicectomy,he might have developed mild Intestinal obstruction due to adhesions of bowel to the surgical scar site or between one another.
As it is not severe,he is having vomiting and diarrhoea on and off.
It may also be due to the food he is taking
He should get an X ray abdomen during pain,Ultrasound abdomen.
Give him Rabeprazole tablet and Pre and Probiotic capsule till investigations are done
Answered: Sat, 27 Apr 2013
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General Surgeon Dr. M Y Shareef's  Response
HI ! What is the dietary habit of your son. He must be going to school. Does he take junk food frequently from outside. You have to give proper attention to it and counsel him if he does. To me it seems like he has got simply collitis due to his possible irregular food habits. Get a routine stool test done for ova and cyst.
Please get him clinically examined by a general surgeon specially when he is getting the symptoms like cramps. Is his belly distended at that time ! After that does he passes a lot of air after which he gets relief. If this is so, he has to be examined to exclude a sub acute kind of intestinal obstruction which could be due to minor adhesions of intestines with the appendix scar. The surgeon may to for an X-ray abdomen in upright posture, and an ultrasound abdomen to investigate and if these do not help, may be a CECT abdomen.
I wish your son an early recovery.
Answered: Sat, 27 Apr 2013
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

Does he have Lactose intolerance?
Consultation by a gastro-enterologist is a must, in such situations.
He needs lower G I endoscopy (colonoscopy)
Stool will have to be examined several times...
In problem cases, some hormone assays and food allergies may need estimation

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Sun, 28 Apr 2013
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