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3 year old vomiting
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3 year old vomiting

I have a 3 year old daughter who started waking in the middle of the night coughing desperately and ended up vomiting. This has happened aproximately since 2003 and the vomiting episodes have become more frequent ever since.

I have taken her to several doctors, pediatricians, allergy specialist, gastroenterologist, othorhinolaryngologist, etc. We found no specific allergy. The nose specialist did an endoscopy of the larynx which said she has reflux and posterior sinusitis. The sinusitis was treated with antibiotics and two weeks later, after he did a second ensdoscopy of the larynx, it was gone. The reflux still shows and she has been given medicine (lanzoprasol and mosapride) for it, but I feel it is still the same. I just know she has reflux but I do not know the origin of it. The doctor recomends we do a endoscopy of the stomach to search further, but I am afraid because she still coughs (could alter the situation), she is too small, and will be given anesthesia.

Sometimes I don't how to differentiate between a flu cough or reflux cough. Lately my daughter has gotten worse and now this is happening every other day. I just feel helpless and love my daughter too much. Could you please reccomend what steps should I take and all the possible problems and tests I should do from 1 to 10.

Thanks,

Jorge Colindes
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Tough to say without examination.  You clearly have had a comprehensive evaluation with several specialists.  

If the endoscopy was non-revealing, there are several more specialized tests that you can consider to evaluate the vomiting.

Other tests to consider would be to do an upper GI series with small bowel follow-through.  This can evaluate for any blockages or obstruction all the way up to the small intestine.

I would also consider a CT scan to evaluate for any organ abnormality.

If the GI tests remain negative, you can consider any lesion in the brain - which can lead to nausea or vomiting.  A CT scan or MRI can be considered to evaluate this possibility.

You can discuss these options with your personal physician or in conjunction with a gastroenterologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b
10 Comments
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I am not a doctor,but have you been paying attention to what she is eating??
google acid reflux,gastritis etc and find out what food can lead to acid reflux,-nuts,dairy,fatty food,spicy food,peppermint,chocolate,caffeine,soda.
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Yoshi, my daughter has three 8 0z bottles of milk with strawberry Nesquick per day(late morning, early afternoon and early night). She also has banana soda during the day. She almost never has chocolate, nuts, peppermint or spicy food.
What do you recommend on milk ?? Could the Strawberry Nesquick be affecting her too ? Thanks,

Jorge

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Avatar_n_tn
i dont know what is nesquick,why dont you read the label and see what it contains?
banana soda is soda drink?
for adults,we try not to eat three hours before we go to bed.
is that all she eats?i would think a three years old would be eating solid food??If you suspect milk and soda are the culprits,why dont you withdraw them and see what happens?
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Avatar_n_tn
I found the safest food to eat is rice and white bread,but then where is the fun??
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i had years of contants coughing from excess mucous going from my sinus down my throat. I would sometimes cough so much I vomited, especially when I got up and a large amoung of goo seems to sit up there until I stood up - then it came down. Eventually tracked this down to food allergies. In my case SOY, wheat and gluten. It's gone away completely now. more recently I found my evening meal set me off for several hours and eventually went away by about midnight- i suppose the allergen was all used up. Then I'd be fine until the morning. I was eating a lot of wheat based pasta for dinner. i used to go to sleep and wake up choking because of mucous going down my throat and triggering some reflex.

Does you child have mucous problems during the day? Does she cough or clear her throat a lot?
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Avatar_n_tn
i had a similar mystery happen with my daughter.
every night between 3 and 5 she would wake up coughing and then vomitted, and we took her to see doctors and specialists who said she might have asthma, allergies etc. we were frantic, everybody said something different! hospitals, doctors!!!we went to see her doctor who believes a bit in natural medicine who told us that the hours she was waking up at were, in chinese medicine, the same hours that affect the lungs and to see an accupuncturist. this did not help, but the accupuncturist said it was some kind of allergy to something that she was taking in through her lungs. we have a dog and thought this might be it, but most of all we had black mold growing on the windows and all over the inside of the walls of our appartment.
children are very sensitive to things we may not be affected by.
im convinced this was what the problem was because once we moved, she was ok and is still ok!and we still have the dog.
i hope this helps a bit, good luck!
tessie
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Avatar_n_tn
were there broken pipes inside the wall??
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Avatar_n_tn
I can relate to your frustrations, I have a four year old daughter who was diagnosised in November 2002 with Cyclic Vomiting. This wasn't until she was hospitalized three times and diagnosised with Abdominal Seizures, Reflux and allergies. infact this morning she had an episode where she woke up and came in my room telling me her tummy hurt and she was going to be sick. I had her get into bed with us, as in the past she becomes very lethargic and doesn't respond well to us during these episodes of severe vomiting. In the past we can tell when she is about to start, like with your daughter she coughs once or a few times then retches and gags as she vomits. It is very tough to tell if she has the flu or another episode. The only way we have been able to confirm an episode or the flu is to take her into her doctor and have blood drawn to see if she has the flu. I have been reading allot on the Cyclic Vomiting Syndrome website to get some more info on it, as we were told she would eventually have episodes of migraine headaches and possibly vomiting with them. As far as the CVS you cannot tell she has any disorder, she is over the charts for height and weight, and is very smart for her age, if we hadn't persisted with the doctors we would have never found the cause behind her episodes, because she was so healthy they had no idea what tests to do. This all started when she was 10 months old. We haven't had an actual episode since 11/2003, so they are few and longer in between. Have patience and just research all avenues.
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Avatar_n_tn
To the original poster.  Milk allergies are often a cause of vomiting.  Has she been tested for IGg and IGe milk and or dairy allergies?  That would definitely be something to check into.  If you don't want to jump into the testing, you could do an elimination diet for a month of all milk and dairy (read labels carefully) to see if it improves.

For the mom of the four year old with the chronic vomiting cycles.  Have they done anything to check for malrotation of the intestines?  In older children with cycles of vomiting like you describe, it can be very difficult to diagnose.  But, the symptoms, severe stomachache, and periods of vomiting, can be an indication that the intestines are twisting and untwisting.  

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The birthing process is very tough on babies. Many are born with vertebral subuxations. This means that the vertebrae is out of place and is sitting on a nerve that makes our bodies function normally. If Thoracic vertebraes 3-8 are subluxated, then it is possible the reflux and vomiting are symptoms of what is an easily treatable problem. I would suggest finding a reputable chiroprator who works with children and getting your child a comprehensive evaluation and treatment.
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