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Friday, April 18, 2014
Child with Abdominal Pain
My 10yr daughter has been having sereve consistant abdominal pain for several weeks. Her pain is "cramping" in the epigastric region and gets worse after eating anything or during bowel movements. The pain wakes her at night. Doctors have done CT-abd, US-abd & pelvic, hida scan, colonoscopy, endoscopy and even a capsule endoscopy,lab work and everything is normal, but she is having such severe pain and nothing helps it. What are they missing?
The pain your daughter is experiencing may be function in nature and not related to a serious organic (one related to serious pathology) cause. Gastroenterologists see children with the complaints on a regular basis. Their pain is of variable severity and may respond to amitriptyline (Elavil). Some children require behavioral interventions for pain relief. The pain she is having is real and most likely relates to movement of her stomach, intestine and colon without an identifiable cause by the exams you described. To help her resume her normal activities, it would wise to consider consultation with an expert in pain management for children in collaboration with your doctor.
James E Heubi, MD
Professor and Associate Chair of Pediatrics
College of Medicine
University of Cincinnati