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Stomach Pain for 3 Weeks

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SandIsMyGlitterRN has 20 years experience as a BSN, RN and specializes in School Nursing.

404 Profile Views; 94 Posts

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.  

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mainecoonRN92 has 5 years experience as a BSN, RN and specializes in School Nursing.

39 Posts; 511 Profile Views

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?

Edited by mainecoonRN92
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SandIsMyGlitterRN has 20 years experience as a BSN, RN and specializes in School Nursing.

94 Posts; 404 Profile Views

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

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ruby_jane has 10 years experience as a BSN, RN and specializes in ICU/community health/school nursing.

5 Followers; 2,789 Posts; 11,591 Profile Views

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?

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SaltineQueen specializes in School Nurse, past Med Surge.

1 Follower; 881 Posts; 6,378 Profile Views

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

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SandIsMyGlitterRN has 20 years experience as a BSN, RN and specializes in School Nursing.

94 Posts; 404 Profile Views

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. 

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Flare is a ASN, BSN and specializes in school nursing, ortho, trauma.

2 Followers; 5 Articles; 4,202 Posts; 35,667 Profile Views

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.  

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SaltineQueen specializes in School Nurse, past Med Surge.

1 Follower; 881 Posts; 6,378 Profile Views

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.

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bluebonnetrn has 18 years experience as a BSN, RN and specializes in School nurse.

133 Posts; 5,369 Profile Views

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/

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NutmeggeRN has 25 years experience as a BSN and specializes in kids.

2 Followers; 6 Articles; 3,998 Posts; 43,286 Profile Views

How old?

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SandIsMyGlitterRN has 20 years experience as a BSN, RN and specializes in School Nursing.

94 Posts; 404 Profile Views

2 minutes ago, NutmeggeRN said:

How old?

3rd grade

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