My 9 year old working on an ulcer!?!?

Home Health Columnist / Guide · May 23, 2001

He has been a little constipated, has had a few small BMs, nothing exciting, no diarrhea, no fever. This is not the first time this has happened. Tommy has actually complained of stomach pain ever since I can remember

What advice has your pediatrician given you re this ongoing stomach pain?
Sounds like he needs a workup by a pediatric gastrologist since long term problem. Misdiagnose can lead to costly, nonwarented treatment.
I have learned that in about 10-15 % boys, rapid growth spurts indicating hormonal changes can starting as young as age ,9 can cause a multitude of problems.
Starting at age 12, my oldest son kept c/o off and on of vague stomach aches, bone aches and constant headache. Dr Maddy, our pediatrican finally decided that after 6 months tx with Tylenol, pecpid, TLC, and negative labs it was time to send to specialists. He had gained 30 lbs over this time-prior was at 25%levels on growth charts, now at 90%. Pediatric neulogist DX migraines after 2 visits, & negative CAT Scan. She stated 10-12% boys develop migraines. Went on Diet: no caffiene,no chocolate, high carbohydrates every 3 hrs, fatty snack at bedtime, juicebox to bed to drink upon awakening prior to getting OOB due to hypoglycemia from cortisol producion; and Tylenol qid, Benadryl at HS,some improvemnt then added AMdose as migraines continued. Within a month migranes resolved and weaned off benedrylover next 6 weeks. He has learned that rare chocolate treatis ok, but caffiene triggers migrane within few hrs.
Stomach ache, "racing strip" in underwear continued along with c/o stomach constantly upset. Grandmom had hiatal hernia. Saw pediatric gastrologist: stool cultures negative, review of diet, no problems with milk products. DX: gastritis--otc Pepcid changed to RX BID--1 year still problematic everytime weaned off med. Endoscopy showed chronic gastritis. Added slant pillow and RX now Prilosec---symptom free within one month.
Last Nov,now age 15, calls me at work that he lost color in vision "room went to black and white when he stood up." Told him to push fluids, probably dehydrated from gym class. Happened 2 more times that week, Stat opthmologist consult: DX-occular migranes! Next week neurologist visit found him hypotenssive, + tilt test:hypovolemic from another growth spurt. Increased salt intake, Gatorade every 3 hours, carbo snack mid afternoon. Symptom free within 2 weeks. I am not an overactive person, tend to brush off most kid complains,but knew that something just wasn't right. Son self regulates diet,checks food labels and is back to no complaints most days. Brother turned 12 in August, and is going through rapid wt gain, minor aches "growing pains" and has had a few headaches but nothing like the year long conplaint of "I'm just not feeling well" of oldest.
Both are happy, well ajusted, active in sports and community activities.
I'm telling you this for despite 20 years of nursing,mostly adults, caring for kids seven years atsummer camps,and having 4 older nephews, I never realized how much growth spurts/hormones can affect boys!
Let us know how things turn out.

MQ Edna · May 23, 2001

Thanks, Karen, for all the info! We just moved to this area, so are going to have to start all over with docs. As for his last pediatrician, the last time I had him in for this, after doing a CBC, he attributed it to a virus. This was a little less than a year ago. I can't remember if I mentioned Tommy had had a flare up about a month or so ago and it eventually went away. I have been trying to avoid doctors until my insurance kicks in. Sounds horrible, but I am trying to be realistic.

My husband has been telling me for a couple of days that he thought this was growing pains. I am not totally counting this out, but this has been a complaint for as long as I can remember!

When I get insurance, the first thing I am going to do is take Tommy to whomever I pick as his doc and we are getting a THOROUGH physical, work up, you name it, I'm asking for it. I want to find out what the heck is going on and get working on it now before it gets any worse or causes other problems!

Thanks again, it makes me feel better to hear similar stories! :)

Laura

Zee_RN, BSN, RN · May 23, 2001

I had a peptic ulcer when I was in second grade (so I was about 7 or 8 years old, I guess). Don't have much advice to give you as that was SO LONG AGO :) everything they did then is outdated (I had to go to the school's cafeteria three times during the day to drink a carton milk--which was usually lukewarm, YUCK--didn't drink milk again for YEARS).

I'd certainly be interested in the prilosec/prevacid regime of medications if I were diagnosed with a peptic ulcer these days.

MandM · May 23, 2001

My textbook says NOT to put patients on a bland diet because it increases the stimulation of gastric juices by increasing the pH level.

Mary (student nurse)

MQ Edna · May 23, 2001

I know, Mary, I've read that too, but I've also read just the opposite as well, which is why I am confused!

Laura

mustangsheba · May 23, 2001

Parasites can cause all these problems. May I suggest consulting a good naturopath. There are several OTC remedies to be found at health food stores. It couldn't hurt and it might help. We are exposed to parasites other than pinworms all the time - swimming, walking barefoot, living with animals, contaminated food. I treat myself every six months with herbal remedies; you wouldn't believe the difference it makes. Good luck.

GInurse · May 24, 2001

As a Gi nurse, I feel that there are several ohter things you need to know. From his symptoms,

having abdominal cramping since Saturday, exacerbated whenever he eats anything. He has been a little constipated, has had a few small BMs, nothing exciting, no diarrhea, no fever. This is not the first time this has happened. Tommy has actually complained of stomach pain ever since I can remember.

It could be several things: gastritis, ulceration, IBS, crohn's, dysmotility, pseudo-obstruction,etc..... The only way to a definitive diagnosis is through endoscopy and biopsy.

My 9 year old daughter had similar symptoms, and after several years of thinking it was "normal childhood abdominal pain", I took her to see our pediatric gastroenterologist, who did an EGD and found bile gastritis, gastric dysmotility, and chronic esophagitis caused by GERD. She does well on BID reglan and prevacid. See a ped. gastro. and get him scoped!

nurs4kids · May 24, 2001

I agree completely with GINurse. Let me caution you against home remedies with herbs. In six years of pediatric nursing, we've nearly lost two kids because of their parents treating them with herbal remedies(one of which is a frequent patient d/t appropriate care not being allowed in a timely manner). Let a pediatric gastroenterologist determine what's best for your child.

MQ Edna · May 24, 2001

GInurse and nurs4kids, thanks for the advice. I am definitely going to be taking him to a specialist, the only thing is I must wait for insurance to kick in, which will be in the beginning of July. Until then, I am going to be taking him to the local clinic which is staffed by nurse practitioners (yea!) and will just have to manage his symptoms until July. I feel awful saying that, but it is the reality of the situation right now.

Thanks again,

Laura

mustangsheba · May 24, 2001

I'd like to clarify my post. I wasn't suggesting you not continue with your PCP, just that it might be helpful to consult a naturopath in CONJUNCTION with your regular medical care. The reason I mentioned the OTC medication is that you have insurance considerations. Just something to keep in mind for the future. Good luck.

MQ Edna · May 24, 2001

Thanks, mustangsheba. I am looking for information on vitamin U. Do you know anything about it?