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teenage stomach problems
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teenage stomach problems

My daughter 17, (does not have a history of eating fried/spicy foods with the exception of an occasion french fry/pizza)started vomiting approx. 30 minutes after each meal about 6 weeks ago. There was no pain or nausea asociated. After the purging, she felt fine. Went to her regular doctor that knows her history of diaphram hernia (left side) at birth, ECMO and bowel obstruction 12 years ago, all surgically repaired. He gave her zofran and reglan. We tried for 1 week. Still having bowel movements. Vomiting/heaving started to hurt but no stomach pain at this time. We were referred to a pediatric gastro. 3 weeks have passed by now and she is having pain in the center just under rib cage. Vomiting is more violent still no nausea. Cat scan on abdomen area, with barium, x-rays, head CT, chest x-ray, digestion study (25% first hour, but caught up in the second hour), endoscope (results were erosions said to not be the worse he has ever seen).He gave carafate, acid blocker in addition. Stomach pain at a 4 out of 5. Periactin was given in addition. This made her so hungry that she ate more thus vomited more bowel movements stopped at this time. We were at a feeding/vomiting frenzy she gained about 7 pounds so far. Was hospitalized for 3 days with IV to give abdomen a rest. The pain subsided with no food on stomach. 2 days following discharge, the pain returned.  Monitoring close bland diet.  So we at over 6 weeks now, the pain has also started in the lower ab. and back. No vomiting for about 5 days, but the feeling of having to is there. She has only attended school for 3 days in the last 5 weeks. The pain has taken over her life. Our gastro speicalist said to return to him in 1 month, which is about 2 1/2 more weeks.  Took her to my doctor, he thought it might be adhesions pulling causing the pain, which no test would show only exploratory which we are not against but doesnt seem to be an option. Anything further we can do?
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The workup has been comprehensive with the imaging, endoscopy and digestive study (I assume this was a gastric emptying scan to exclude gastroparesis).  

One last test would be a 24-hr pH study as well as esophageal motility study.  This can be arranged via a gastroenterologist, preferably at a major academic medical center.  

If the GI tests remain negative, neurological causes of the vomiting may be investigated - starting with brain imaging with a CT scan or MRI study.  

These options can be discussed with your personal physician.

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 Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd
4 Comments
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The neuro MRI was already done, actually in the first 2 weeks from the onset of vomiting.  Normal. On the most recent visit to the doctor, it was explained about the gall bladder and pancreas pain. The center pain seems to go straight through to her back and down, almost to where the kidneys are as well as her entire abs. now. Although in the 2nd week, we also had CT and xray of that to rule that out as well. Dr. explained that until there is infection, abnormal gall bladder conditions will not show.  Lortab was given for the pain to get us thru the weekend. We finally have a surgical consult on Monday.
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Surgical consultation was on Monday. He re-did the upper GI. He found that her stomach is not in the normal position, from being a diaphramic hernia or from the liver pushing or being pulled into the stomach, not sure. (from adhesions?) Should explain the pain in the middle under rib cage and left mid area (where image would show where the stomach is) but didn't get any relieft from pain or vomiting.  Gave a muscle relaxer to try to a few days, we havent seen any relief yet. She threw up before 30 minutes of taking, so I am not sure if any of it is being absorbed. Our Children's Hospital is 3 hours away, we have been doing alot of traveling and time is not helping it get any better. I wonder if we are not giving clear symptoms or is there really nothing that can be done to help her?
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Hi kiki - sorry to hear of your daughter's problems. As  a long time user of the gastro, and particularly Crohn's community forum here at Medhelp, my experience has been that Dr. Pho does not answer supplementary questions, unless you post a new question and pay the fee. Don't know why that is, it just is.
Take care and I hope you get some answers soon as to your daughter's symptoms, and appropriate treatment.
Liz.
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