Stomach Pain for 3 Weeks

[SandIsMyGlitterRN, BSN, RN]

Advice to see if I am missing something. Student with abdominal pain for 3 weeks following a diagnosis of flu. No vomiting and no diarrhea. Not a frequent flyer. Cries in pain and because missing class. No distension, soft belly. Bowel sounds present. No radiation of pain. No increase in pain with movement. Having regular BMs. What are we missing?????? I am not trying to diagnose (well.....) but there has to be something that we are missing. Student has been to doc but they are stumped also.

[mainecoonRN92, BSN, RN]

I am assuming you are talking about influenza, not a stomach virus, correct?

I think you've done a very thorough assessment. Were they prescribed any anti-virals such as tamiflu?

[SandIsMyGlitterRN, BSN, RN]

Correct. Dx with Flu A prior to this occurring and took Tamiflu.

[ruby_jane, BSN, RN]

2 hours ago, mainecoonRN92 said:

I am assuming you are talking about influenza, not a stomach virus, correct?

I think you've done a very thorough assessment. Were they prescribed any anti-virals such as tamiflu?

Tamiflu may produce transient diarrhea and stomach upset, but this seems like a long time for this to go on.

What's the age of the student? And what is mom/dad prepared to do?

[SaltineQueen]

If the doc is stumped he needs to refer to a GI.

[SandIsMyGlitterRN, BSN, RN]

15 hours ago, ruby_jane said:

Tamiflu may produce transient diarrhea and stomach upset, but this seems like a long time for this to go on.

What's the age of the student? And what is mom/dad prepared to do?

No diarrhea and no vomiting. Just pain.

Looks like the doc is testing for celiac disease now. Crazy timing.

[Flare, ASN, BSN]

So the Tamiflu can cause gastritis (Anovadiya, A. P., Barvaliya, M. J., Shah, R. A., Ghori, V. M., Sanmukhani, J. J., Patel, T. K., & Tripathi, C. B. (2011). Adverse drug reaction profile of oseltamivir in Indian population: A prospective observational study. Indian journal of pharmacology, 43(3), 258–261. doi:10.4103/0253-7613.81509). Wondering if the child's diet or some other factor may be contributing to the s/s going on this long. A follow up with a GI would be a great idea - maybe even an abdominal ultrasound.

[bluebonnetrn, BSN, RN]

I agree that the GI doc is the next stop.

But you can have regular BMs and still be constipated. A look at the good ol' Bristol stool chart can help with that.

http://pediatricsurgery.stanford.edu/Conditions/BowelManagement/bristol-stool-form-scale.html

[SaltineQueen]

16 minutes ago, bluebonnetrn said:

I agree that the GI doc is the next stop.

But you can have regular BMs and still be constipated. A look at the good ol' Bristol stool chart can help with that.

http://pediatricsurgery.stanford.edu/Conditions/BowelManagement/bristol-stool-form-scale.html

Oh I've gotta bookmark this. People always laugh about me questioning kids about poop.

[bluebonnetrn, BSN, RN]

I also really like what Dr. Hodges has to say on this topic. He is a pediatric urologist and got into this topic because he determined that most often the cause of bedwetting and daytime accidents was not the GU system but constipation. If you read through his materials what he says really makes A LOT of sense. I have had some kids who had issues with daytime stool accidents and his info really helped the parents understand the problem. Many pediatricians don't understand this which is really sad.
https://www.bedwettingandaccidents.com/

[NutmeggeRN, BSN]

How old?

[SandIsMyGlitterRN, BSN, RN]

2 minutes ago, NutmeggeRN said:

How old?

3rd grade