Upper Abdominal Pain

[Momdoc]

I have a 14 year old son with sudden onset of upper abdominal pain.  This has lasted constantly at a high pain level for nearly 6 months, taking him out of school and all activities.  His pain is worse after eating and drinking, he never experiences hunger pangs, he is tender to the touch on his upper abdomen, jostling, driving on bumpy roads, exercise, makes the pain worse.  He describes it at times as acid burning, knife stabbing, tightening and about to explode.  He has had xrays, ultrasound (no gallbladder stones detected), been scoped twice with biopsies of esophagus, stomach and small intestine.  He's had MRI,  Meckels scan, HIDA scan, various blood and urine tests, all coming up virtually negative or with unremarkable results.  The HIDA scan was very painful and caused a lot of nausea.  He has been dealing with nausea on a daily basis off and on, but it has been really bad lately.  The pain is usually at a 7 or above, with "spikes" of pain throughout the day, particularly after eating or drinking.  I have heard the gallbladder can be problematic even with negative test results.  His gallbladder is functioning at 91%.  Do we need to pursue the gallbladder?  Is there a specialist in California that deals with gallbladders that are bad without conclusive test results?  Other symptoms...occassionally a bubbling sensation, pain in the esophagus, pain radiating down into his stomach, but always there in the upper abdomen.  We have exhausted our resources.  Suggestions?

[Momdoc]

thanks much, everyone!  We have had a test for celiac, which didn't show anything, but I don't know what kind of test it was.  I'll have to check the file.  We have tried stomach relaxers like Busperone (sp?) and he's currently trying Citalopram HBR, which is probably a generic name, but so far nothing.  We've had weeks of acupuncture and finally have a biofeedback appointment, but I must admit I'm not real hopeful on this.  I doubt it is growing pains, as it is way severe, constant, and came on suddenly.  No diahrea or throwing up.  Lots of nausea but mostly the constant pain.  He's a well-balanced kid, and really I think he's handling it well most of the time.  But after 6 months, he's tired and discouraged.  Mornings are worse...lots of nausea and pain.  By evenings his spirits lift a bit, and we try to keep him engaged in activities (books, games).  Oh, and no celiacs in the family.  I'll check into the bentyl, etc.  Thanks so much.

[CalGal]

Part of the problem may be that your son's gallbladder is working TOO well. He's having extreme contractions which mean that he could be dumping fairly large amounts of bile into the duodenum and it could be irritating the whole of the small and large intestine. The problem with the gallbladder is that when it's either working too well or not well enough and it's removed it may not change the problem, and other problems can crop up.

Has he tried antispasm meds in higher doses? Something like bentyl might be effective. Or there are some calcium channel blockers that might be tried to see if they can cut the discomfort.

Do check out the celiac possibility, however. It can produce some very strange symptoms. The blood test IMO is worthless. But look into the use of a fecal antibody test and a genetic test (allele). Read up on it at enterolab. If you decide to try it, make sure you also test for cross-reactivity to casein, the major protein in dairy. Many celiacs are cross-reactive. Check to see if any family members are celiac - you never know where it will show up.

[dts413]

Yes, I would definitely check out the possibility of celiac disease (gluten intolerance) as this is commonly not considered (if this has not been ruled out as of yet).

[crambone]

not the gullbladder,too young,and function was good.
bad would be like 18% or something like that!
being so young,i hate to say,but possible "growing" pains could cause disconfort,and his pain tolerance might be low,and the more he dwells on this pain,,the worse his mind will make it out to be.
if everything checks out fine,and he is young and youthfull,,,i dont think its anything to worry about,,now if he didnt have all the tests he has,id say check it out!!
does he have diahrea alot?,,throw up alot?
alot of gas?
id suggerst possible food alergy at his young age.
you know how kids eat alot of ****.
he might do best to have food alergys checked into.
also google colitis,crohns,and cealiics,,see if any of those three sounds familiar to you both.