Dr. Hive- Continuous tummy aches

[BlsdMama]

Background: DD(9) had cellulitis in her eye in November. Fairly serious - no surgery but a few days hospitalized and it was antibiotic resistant so two heavy IV antibiotics. 

I can’t say “since then” but pretty close, she has had tummy aches. We assumed upset gut bacteria. We did serious probiotics during and after her hospitalization. We’ve done raw sauerkraut, kefir, yogurt, and kombucha since then. There isn’t a day or two that goes by before this child has a stomach ache. She can be playing happily or absorbed into something and it hurts. Not associated with diarrhea or constipation.

We went to Urgent Care and we were prescribed antacid. It did not help. Was told it was probably an after effect of her gut trying to recolonize. Ya’all it has been SIX months. This is not a child who can be sick. She is so thin it’s alarming. Good appetite but has been thin all her life. My girls tend to run small. My 17yo is 5’4” and 109. My 15yo is 5’2” and isn’t 100 yet. (My sister in law was 103 when she got married and she was too big for my mother in law’s-dress. They both now struggle with weight and have diabetes.) But Ella is, by far, the thinnest of all of them. I’m average sized and like to see healthy bodies - Ella’s alarms me. It doesn’t say “healthy” to me.  We have three meals and pretty liberal, albeit healthy snacking. Snacks are usually grain free and veggies or fruit, but we don’t believe in low fat and use coconut oil and butter predominantly & liberally.)

I really believe there is something: a) genetic and b) particular hard hitting for Daniella.

What do we want to test for? My oldest DS tested positive for celiac when he was two. A second opinion (at the University) said he didn’t have it so I believed them.  I’m now wondering if it was right the first time.

Thoughts?

Other tests you would ask for?

 

 

 

[hornblower]

lactose intolerance would be the most likely thing
I'd stop all dairy for a couple weeks and see how things are then. 

[J-rap]

Two of my kids randomly had cellulitis of the eye (para-orbital) when young.  It was unusual, but I don't think it was really related to anything that happened after that.  Several of my children have weird food sensitivities.  I don't at all, and neither does my dh, so it's kind of unusual that several of our children do.  It must be recessive genes or something!  They're very sensitive to gluten (although the one dd who actually had the celiac biopsy tested negative).  Two other children had quite severe stomach aches all their growing up years.  Now, finally, they don't, after avoiding gluten and sticking with a very healthy diet.  They avoid all processed foods, most sugars, all gluten products.  Their diets are very simple.  If they stick with a strict, very clean diet, and mostly GF, they avoid the stomach aches they used to get.  They also sleep better!  We never really had it tested for more compete explanations, but this is what works for my kids.

[Ellie]

My dd cannot tolerate dairy. Yogurt doubles her over almost immediately. Now that she is all grown up, she can decide to risk the stomach pain for a pizza night with friends, but yogurt...not ever.

[AurieD]

My daughter had mesenteric adenitis after a virus, inflamed lymph nodes in the abdomen.  I can't remember what the initial virus was but I don't think it was stomach related. It was extremely painful at first, she could barely walk for a couple of days, after that it was a lot better but she would often seemly randomly complain of stomach pain. Thankfully it only lasted a a few weeks but our GP said it could last a lot longer and it could flare up on occasion. She did get stomach aches more often than typical in the months after but not severe ones.

Edited April 23, 2019 by AurieD

[displace]

Maybe lactose intolerance, if you eat dairy products?  The timing with the antibiotics could be a red herring.  

Frequent abdominal pain can be a variety, ranging from infection (like H pylori), allergies, celiac, etc.  Idk about systemic antibiotics and abdominal pain causes.  Girls at that age can sometimes develop ovarian cysts and such as well as they develop, but it would depend on location of pain and her development.  Abdominal migraines are also a very painful disease.

I will caution an urgent care diagnoses as they tend to just make sure it’s not an emergency.  If this has been going on for six months, the pediatrician could screen for a lot of allergies and infections, and send you to a pediatric gastroenterologist.

Unfortunately, abdominal pain can have so many causes that it tends to be a step wise approach in going through a long list of what is most common, seeing if it’s that, then checking for next most coming, seeing if it’s that, etc.  

Edited April 23, 2019 by displace

[JFSinIL2.0]

My dd got frequent tummy aches...after a very bad year the pediatrician had a brain wave and ordered an abdominal ultrasound...she had a malformed gall bladder, full of stones!   It was removed laparoscopically about age 15, but should have come out earlier, poor kid.   

Just something to check for.  Folks don't think of the gall bladder in kids, but it can happen.    At least get it ruled out, an ultrasound is noninvasive.

Edited April 23, 2019 by JFSinIL2.0

[JFSinIL2.0]

Of course, we have a famous family photo of my kid sister, about 13, drooped over the top of the stairs clutching the pink bottle of Pepto, before the doctor figured out it was lactose intolerance.   No one else in our family ever had this.  Of course, I married into a family that is totally lactose intolerant, and only one of my four kids escaped it.   

Dd has it along with, now, a missing gall bladder.   Recently, age 25, she has had tummy troubles again, as part of developing food allergies to eggs, peanuts, soy, etc..  

[Meriwether]

9 hours ago, BlsdMama said:

But Ella is, by far, the thinnest of all of them. I’m average sized and like to see healthy bodies - Ella’s alarms me. It doesn’t say “healthy” to me.  We have three meals and pretty liberal, albeit healthy snacking. Snacks are usually grain free and veggies or fruit, but we don’t believe in low fat and use coconut oil and butter predominantly & liberally.)

Thoughts?

Other tests you would ask for?

I don't have a guess about what is causing the stomach pains, but it may not have anything to do with weight. My Ds14 is 5'8" and weighs 90 lbs. His BMI is somewhere around 13 or 14. Honestly, it scares me. I cannot put weight on him. The doctor mentioned it to me a year or two ago for the first time. I was a little worried and started telling him that he does eat as much as the rest of the kids. The doctor said they've always noted it, but that year was the first year they had to mention it to me by law. So, the doctor wasn't concerned enough about it to tell me until he had to by law. My husband was very thin at that age. Not, I think, as thin as Ds14. As far as we can tell, it doesn't have a root in anything but slim genetics. He doesn't have trouble with food intolerances or allergies at all.

[BlsdMama]

22 minutes ago, Meriwether said:

I don't have a guess about what is causing the stomach pains, but it may not have anything to do with weight. My Ds14 is 5'8" and weighs 90 lbs. His BMI is somewhere around 13 or 14. Honestly, it scares me. I cannot put weight on him. The doctor mentioned it to me a year or two ago for the first time. I was a little worried and started telling him that he does eat as much as the rest of the kids. The doctor said they've always noted it, but that year was the first year they had to mention it to me by law. So, the doctor wasn't concerned enough about it to tell me until he had to by law. My husband was very thin at that age. Not, I think, as thin as Ds14. As far as we can tell, it doesn't have a root in anything but slim genetics. He doesn't have trouble with food intolerances or allergies at all.

 

Wow! That height/weight would alarm me too! 

 

Its funny/odd though the number of people who don’t know until they do. (Not saying this is your case) But a friend didn’t find out until her thirties that she was celiac. Then her mom got tested -yep.  We don’t have any allergies other than food intolerances but we did test one child for intolerances and it was soy, eggs, gluten. 😞 

 

i do wonder if the antibiotics were coincidental. Or if they maybe disrupted her coping ability and flared inflammation. Sigh.  I really don’t want to do specialty diets for kids. I’m barely managing Level 1 Wahl for me.  Bummer.  I suspected this is what everyone would say. I’ll call her pediatrician this morning. 

[Monica_in_Switzerland]

I would test for gluten and other food intolerances/allergies.  

Gluten intolerance is auto-immune related, and so fighting off that eye infection or being weakened from the antibiotics could have triggered a genetic predisposition for gluten issues into intolerance.  My son's gluten issues arose after a particularly horrible stomach flu ran through the family.  

For your other child, who had a positive blood test but negative second opinion... you might still have an intolerance going on.  You can re-run the blood test maybe.  It IS possible to get a positive blood test and negative biopsy- this is called Non-Celiac Gluten Intolerance and is being recognized more and more as a legitimate diagnosis.  This is what my son had at the time we tested-  positive blood, negative biopsy.  They told us that meant no issues, but we took him off gluten and literally he became like another child within 48 hours.  

[cintinative]

I would definitely retest (or test) for Celiac if you never have for this child.  My celiac kid presented with tummy aches for months before other symptoms showed up. It was a similar situation where he was getting sick with strep or ear infections and receiving a lot of antibiotics and we thought that had killed his intestinal flora, but it was really the Celiac driving it. They didn't suspect Celiac until he started losing weight. He had been tiny for a long time. 

ETA: I just re-read your post. What sort of test did the child have at age 2 for Celiac? Just the blood test or the endoscopy? While it is possible to have a false positive on the blood test for Celiac, I am surprised they would have told you to disregard it.

Edited April 23, 2019 by cintinative

[Jean in Newcastle]

Non celiac gluten intolerance is also a real thing. 

[ktgrok]

Has the one that tested positive been retested? Had an endoscopy? 

Either way, have this one checked over by a pediatric gastroenterologist, please. That's who you need to see.