question about 3 year old son

[jusshell]

I guess I will start with a little history of what has been going on. Everything started the middle of Sept. My son (3yrs old) started sleeping a lot, had no energy and just didn't act like himself. The dr originally, thinking he was very pale, tested for anemia (neg). Another dr said he thought he had mono but wouldn't test because by now it had been a while and he should be getting better. He seemed ok for a while and then started with not being able to get throught the day without a nap, which cont to today. He will climb on the couch and go to sleep on his own. Other symptoms include: daily belly aches that sometime he will just climb on the couch for a while and others he will be bent over for a few and then it will go away, mouth sores on and off looking like little white dots in his mouth and red dots on his lips, floating, greasy stools (even when they are not greasy, they always float, about 6-7 episodes of vomiting since the middle of Sept (he will wake up throwing up and within a few hours is fine), he drools all the time and in the last couple weeks constantly has his hands in his mouth, complains his legs hurt, very sweaty especially at night, stomach looks bloated especially after eating. He has had like 8-10 just virus like colds since Sept. Other than the symptoms he looks healthy; is growing fine (35 lbs about 36-37 ins), but just doesn't act like he feels well a lot of the time.
When he was 5 mths old he had a cystic fibrosis test which came back neg. He had an acid reflux as an infant. The dr orderd stool tests yesterday. I am just concerned at what this can be> I know the dr is going to start running tests, but I was just wondering if there is anything specific I can ask for him to be tested for. I appreciate the help ahead of time. Thank you.

[Kevin Pho, MD]

Tough to say without examination.  A floating stool can be caused by pancreatitis as well as malabsorption.  A blood test looking for pancreatic disease as well as sending the stool off for a fecal fat analysis can be more specialized tests that you can consider.  A lower endoscopy can be considered to evaluate for colitis or inflammatory bowel disease.

Regarding the stomach pain - things like refractory reflux as well as inflammation of the upper digestive tract can lead to the symptoms.  An upper endoscopy or upper GI series would be reasonable first tests to evaluate this.

These options can be discussed with your personal physician.

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

[ozark]

has your son been checked for malabsorption, or lactose intolerance or allergies such as wheat etc...?

[jusshell]

I am supposed to be getting stool samples and bring them in. The dr said she was going to check it for infection, malabsorption and parasites and go from there whatever the results are. But now that she did a rectal exam and he knows we need to keep the poo, he doesn't want to go even though he has to.

[yoshi]

i recall you said once you are in Japan.
have you folks been eating sushi and sashimi??
If the tests do not yield any results,consider seeing a local doctor.

[yoshi]

did you check out his gall bladder?is he allergic to fat??

[MLWTR]

Fatty, voluminous stools are often found in people with celiac disease (an inability to digest gluten). Fatigue, GI problems, and some other extraintestinal symptoms may also be found in children/adults with inflammatory bowel disease. If you would like more information about either condition, reliable sources include www.celiac.org for celiac disease, and www.ccfa.org for inflammatory bowel disease.

I hope your son feels better soon.

[jusshell]

Yes, we are in Japan. I had posted a question to a different forum. I finally found a really nice dr who said she will run tests until we find out what is going on. If she comes up with nothing, I will take him to a local dr. I did ask about celiac and she said it could be. She wants to run all the stool tests and go from there. I am writing a log of what he eats and how he acts and how often his stomach hurts. We do not eat out in town much and when we do, the kids won't eat (they are very picky eaters). I appreciate the comments because maybe I can suggest something the dr didn't think about.