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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18199
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My daughter is nine years old and has been having terrible

Resolved Question:

My daughter is nine years old and has been having terrible cramping upper abdominal pains and random stabbing pains in upper abdominial area occurring on an off for periods between ten to thirty mins typically but sometimes all day for the last six weeks every day. In addition to this she has a constant headache and feels very sick although she has not been sick. She is going to the toilet regularly and it is not runny but is sometimes sticky/oily looking and brown/dark brown or orange. She is totally exhausted, very pale and has aching legs also and red eyes.
She has suffered with stomach aches and head aches on and off for five years but this is the worst episode and she looks terribly ill and in pain. We have tried buscopan, ranitadine and gaviscon to no effect.
She has had a full blood count which is normal and coeliac which is normal we are still awaiting a inflammatory bowl disease blood test to come back but the GP thinks this will be normal as her inflammatory markers were normal. She is getting booked in for an ultra sound but there seems to be no course of action and I am so worried as I know there is something very wrong now.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you could provide some further information:
Has she had a consultation with a Gastroenterologist or consideration of an endoscopy of the stomach?
If not, has her GP discussed such a consultation?

Customer: replied 3 years ago.

No she has only been seen by a GP so far and then referred to the local childrens day unit at the local hospital to be assessed there where they did the basic bloods. I then took her back through A&E when she had more intense pain this week hoping to speed things up and they have only booked her for an ultrasound so far although I did speak to the surgeon on the childrens day ward and we discussed a biopsy via endoscopy at some point, but no one seems to be in any great hurry!!!


 

Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

Certainly, an ultrasound is appropriate, but I would also typically have referred a child with this history of abdominal pain for consideration of an endoscopy. With both the symptoms that she has had intermittently for years and this more significant symptoms for the past 6 weeks, it would be appropriate to pursue a complete evaluation.

In addition to the endoscopy to assess the oesophagus, stomach, and small intestine, there may need to be an assessment of whether a germ is present in the stomach, H. pylori. If there is a persistent acid irritation problem, this germ may be contributing to the problem.

The only other consideration until further evaluation can be done would be whether to use a stronger medicine to suppress stomach acid, such as Prilosec. I usually am hesitant to use this medicine until a definitive diagnosis has been made, but I also usually am able to get an evaluation done in a timely manner. In a situation in which someone is having significant symptoms and an evaluation cannot be done in a reasonable time frame, it is an option to try the medicine empirically. For children, if the weight is more than 20 kg, which would be expected for a 9 year old, then the recommended dose is 20 mg once daily.

If you have any further questions or need clarification, please let me know.

Customer: replied 3 years ago.

Many thanks for your response, could I just ask, would an MRI give a good and valuable picture of what is happing in her stomach area? For example anything unusual looking, or swollen/inflamed?

Expert:  Dr. D. Love replied 3 years ago.
Well, yes and no. An MRI (or CT scan) are not good at picturing the stomach. Since the stomach is continually churning, these imaging studies do not typically provide good information about the stomach. An endoscopy is a far better test at detecting problems within the stomach. On the other hand, there are certain problems that can be detected by these advanced imaging studies, so these may be done if no problem is identified with the ultrasound and endoscopy.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18199
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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