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Dr. Y. Vasavada
Dr. Y. Vasavada, Pediatrician
Category: Paediatrics
Satisfied Customers: 3205
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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My 13 year old son has for the last year been suffering from

Resolved Question:

My 13 year old son has for the last year been suffering from nausea and abdo pains. He has now been diagnosed with Recurrent Abdo pain and oesophagitis. He initially responded well to amitriptyline and mebeverine but suddenly had a flare up of symptoms at Easter. A couple of weeks later the diagnosis of oesophagitis was confirmed by biopsy. He has been reducing the amitriptyline and is on 30 mg of Lansoprazole. He continues to have really severe symptoms and his school attendance which had been almost 100% Feb to March is now back to about 50%. His sleep, which the amitriptyiline had regulated is now really disrupted and he feels too uncomfortable to sleep. I am taking him to a CBT therapist - visualization and relaxation techniques only help in a very limited way. His consultant thinks he should see a psychologist as well. Although he is at a high pressured school with a long commute (I will have to move him to a closer school next term) he says he is not anxious about going to school. Even when he had problems at school as a younger child (he was diagnosed with Aspergers) at the age of 12) he never had more than the occasional slight stomach ache which never prevented school attendance. I really feel at a complete loss - he is now going backwards. He has had a number of blood tests done and an ultrasound scan - these all come back normal. Any ideas please?
Submitted: 3 years ago.
Category: Paediatrics
Expert:  Shantal-Mod replied 3 years ago.
Hello,

I'm Shantal and I'm a moderator for this topic.

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Customer: replied 3 years ago.


I would like to continue waiting . I would like some advice on how to help with sleep which is very impaired due to the symptoms of nausea and pain. He now gets to sleep in the early hours . Originally he was given amitriptyline which immediately helped sleep but consultant has said he can no longer have it - I am not sure why- but was taking it for about 4 months. Also what is likely prognosis given his history?


 


Thanks

Expert:  Shantal-Mod replied 3 years ago.
Hello,

Thank you for getting back to me and providing more information. We will continue to look for a Professional to assist you.

Thank you for your patience,

Shantal
Expert:  Dr. Y. Vasavada replied 3 years ago.
Hello, Sorry about this problem.
Short courses (4-5 weeks) of amitriptyline again may help, along with repeated dosing with antacid syrup like gelucil when in pain.
Hope the biopsy did not show eosinophilic esophagitis ever. If required, retesting and blood for serum specific immune assay may be ordered.
Bland diet with more fluids should be offered and his cot can have blocks at head end to raise that portion during sleep.
Customer: replied 3 years ago.


Thank you for your answer


Doct or won't give him anymore amitriptyline


Says he needs psychological support which he is getting as of next week.


Eosophilic eosophagitis not shown/ What is serum specific immune assay?


How likely is it that treatment of lansoprazole is exacerbating symptoms of pain and nausea? I raised this with the doctor who has now halved the dose.


He is already on a very bland diet. Any recommendation for how much fluid he should take? Thanks

Expert:  Dr. Y. Vasavada replied 3 years ago.
You are welcome
Serum specific immune assay detects any food allergy or similar issue.
Lansoprazole in once daily dosage may not be responsible. Positional sleep management (raised head end) may help.
Plain water about one to two liters and minimum or no soft drinks, colored or artificially flavored items may be given.
Dr. Y. Vasavada, Pediatrician
Category: Paediatrics
Satisfied Customers: 3205
Experience: M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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