abdominal pain and vomiting

My 14 year old son Matt, has been vomiting almost nightly since January 2, 2004. He has constant pain in his stomach area just below his rib cage. The pain is always there but he tells me that it goes up and down. He also has a slight head ache in the back of his head. So far the vomiting is only at night. He has no fever. He has no history of medical problems nor has he had an injury. He is a very athletic child who is tired of feelig this way. He has a few hours during the day that he doesn't feel too bad but he has not been back to school since Chrismas break. We have been to the doctor may times and have had may tests. They include a brain scan which came back negative. Blood work that shows that he had mononucliosis, but nothing else so far. We are still waiting for hepititus results. He also had a sonagram that showed that there were some fatty deposits on his liver possibly from recent infection.We have been told that this might be the reason for the nightly vomiting and that the inflamation (inflammation) of the liver is possibly caused from the mono. We have been told he needs to rest and eat a bland diet until we can see the specialist next week. In the mean time, I feel that there is more to this than what I am being told. Matt is an honor student who has gotten attendance awards. Could there be another reason for the mild headache and vomiting? This is just not my son.

[Kevin Pho, MD]

Headache and vomiting raises the suspicion of possible diseases of the central nervous system (infection or a mass effect in the brain), but these are obvious causes that should have been considered by your personal physician.  With a negative brain scan, this would be less likely.  

Less serious causes would include the various causes of dyspepsia - for instance, GERD, inflammation of the esophagus or stomach, or an ulcer.  An upper GI series and/or upper endoscopy and tests for H Pylori (a bacteria associated with ulcers) is suggested.  Viral causes (such as mono) can be associated with these non-specific symptoms.  The referral to a specialist (preferable a GI specialist) is a reasonable course of action.

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.

Thanks,
Kevin, M.D.