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Ask Dr. Yogindra Vasavada Your Own Question
Dr. Yogindra Vasavada
Dr. Yogindra Vasavada, Pediatrician
Category: Pediatrics
Satisfied Customers: 3104
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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I have an 8 year old child that has suffered from chronic

Customer Question

I have an 8 year old child that has suffered from chronic stomach pain that radiates to the back and leads to forceful vomiting. This started at age 3 with just daily back pain that was mild. I suspected scoliosis since it runs in the family. The doctor
checked it out and told us not to worry unless she started limping or losing coordination. Around age 4 things progressively got worse. She started having daily burning/stabbing in her umbilicus area that would radiate into the back causing forceful vomiting
until dry heaving. This pain would occur daily with vomiting every 7-10 days. The pain would start of mild and build up until relieved by vomiting. Her GI specialist performed an endoscopy and saw reflux which she was already being treated for and gastritis.
He prescribed carafate to go along with her daily nexium. When things didn't resolve he ordered an abdominal ultrasound, gastric emptying test, and hida scan. The hida scan showed a low ejection fraction of 19% and referred her to a surgeon to have the gallbladder
removed. The surgeon refused to remove the gallbladder due to her age and said he rather use the wait and see approach. The GI specialist decided to put her on a gluten free/dairy free diet and prescribed miralax for constioation issues. The gluten free/dairy
free diet cut the vomiting attacks down to every 2 weeks -4 weeks. Even vomiting attacks have been reduced greatly she continued to have stomach pain that would sometimes be relieved by going number 2. At age 6 she started to suffer from dysuria that was ignored
and blamed on constipation. After battling that and her other daily struggles she was referred to a urologist whom diagnosed her with bladder soasms and prescribed Oxybutnin which relieved urinary pain. While all of this was occuring my daughter developed
horrible dark circles under her eyes which doesn't run in our family and she started to complain of horrible sore throats. After going back to the GI specialist they decided this pissibly was caused by stomach migraines and the sore throat was allergies not
her reflux. They prescribed cyproheptadine. This medication is the first thing that has ever worked. She went 6 weeks without vomiting, dark circles resolved, and sore throats disappeared. But, the medicine caused her to be uncontrollable and moody and angry.
So we had to stop the medication. I'm assuming thus occured since they say this medication stops the secretion or seritonin. Now i don't believe my daughter suffers from stomach migranes and i'm starting to think this has all been undiagnosed food allergies.
Is this pissible based on these symptoms? How do i get her properly diagnosed? Are there other medications that will help her that won't cause mood changes? Do you have any insight on what might be causing all these symptoms? Thanks
Submitted: 2 years ago.
Category: Pediatrics
Expert:  Dr. Yogindra Vasavada replied 2 years ago.


Sorry about this extensive medical history. Surely she may be having some food allergy but blood test may decide about that. Elimination of offending item may help greatly. Cyproheptadine may be given in 10-12 day courses with gap of a week or two, repeatedly.

Expert:  Dr. Yogindra Vasavada replied 2 years ago.

If the problem persists, please visit GI surgeon again for gall-bladder procedure, like laparoscopic excision.

Customer: replied 2 years ago.
They did have me cut her down to every other day on the cyproheptadine. She would show less moodiness on the days she wasn't taking it but extreme on the days she was. Then she started to claw herself in a rage. So i stopped the medication since i didn't want her to hurt herself. It's been 4 days and the mood swings have stopped. I will discuss the 10-12 day course with her specialist and hopefully that will stop the mood swings. Thank you for all your advice!
Expert:  Dr. Yogindra Vasavada replied 2 years ago.

Another drug helping gastric emptying is erythromycin.