Discussions By Condition: I cannot get a diagnosis.

12-yr-old son chronically ill

Posted In: I cannot get a diagnosis. 3 Replies
  • Posted By: readingmom3boyz
  • September 28, 2008
  • 08:07 PM

Our 12-yr-old son has been dealing with illness since last November. It all started with a severe stomach virus. Since then he often experiences fatigue, tiredness, nausea, headaches, stomach aches, pallor, constipation and diarrhea. He has had bloodwork to check on mono and thyroid disorders which came back negative. I do need to get a copy of the lab tests to see exactly what was tested. We have a history of hashimotos and graves disease in our family. We also have a history of celiac/gluten sensitivity in our family. He has been tested for celiac by biopsy/bloodwork but it came back negative. A stool test showed a low positive. We had him gluten-free for several months but that did nothing for his symptoms. Currently he is not gluten-free, though, we are considering having him go GF once again.

His pediatric GI is convinced it is all caused by chronic constipation and has him on 20mg amitriptilyne a day, Prevacid 2 x's a day (for GERD), Miralax 1-2 x's a day and an anti-nausea as needed (though my son doesn't think it helps). We seem to be on top of the constipation right now, but he seems to be getting worse. He has been out of school for almost two weeks this time. I sent him one day last week but had to go pick him up--his teachers were shocked by how horrible he looked (very pale). He loves school and does well there so this is frustrating to him to not feel well enough to go. Even during the times where he seems to be doing better, he'll still have a day or two a week where he doesn't feel well.

We see his GI again tomorrow and I feel like more testing needs to be done, but I don't know what to push for. Any thoughts or suggestions would be greatly appreciated.

We do have a naturopath/md we'd like to see but he is out of state so we need to exhaust our options at home first. We can't really afford to travel right now, but grandparents may help if we feel it is needed.

thanks,
Carrie

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3 Replies:

  • this sounds similar to part of what happened to me All of the sudden I had runs one night that i couldnt control went to the emergany room they called it the flu hwoever it last 6 months and after that i was the never same, im also on mira lax for severe constipation ,and have the same nausea soemtimes to the point i cant walk without being ill, and sudden diarhea epsidoes that come out of nowhere, however because of the length of tiem ive been dealing with it, i havent been able to gain weighth and they just classified it as anorexia though it is not, i have found a couple things you can do to try to minimize it wont take it away but may him less nauseas and constipated, 1. i find as well as taking the laxative that yogourt with extra help for digestion such As activia or the stores own brand is helpful to keep my stools a little more regulated, i usually need 2 a day. the toehr thing is being careful what he drinks, water actually makes it ten times worse, ,flavored herbal teas, green tea with honey, and some juices such as apple or grape.
    Anonymous 42789 Replies
    • September 28, 2008
    • 10:25 PM
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  • Okay, well he's much too young for a thyroid disorder to be a consideration. Also, symptoms of this type that have persisted since November would generally require more in-depth evaluation at this point. Regarding his bowel habits, if the diarhhea always seems to follow the constipation episodes and he's experiencing abdominal pain, then I would be more concerned that something like intusucception may have occurred.Intusucception is where one part of the bowel or intestine has slipped over the other, sort of like the way a telescope works and it's not all that uncommon in children with considerable GI symptoms such as those your son is demonstrating, although it tends to be more acute in nature and if your son is experiencing periods of relief, then intusucception is less likely to be a consideration. A lower intestinal CT with contrast or colonoscopy may be of benefit since his symptoms have been persisting since November. In the absence of any positive findings, then it's important to note that chronic constipation can indeed induce general pallor, fatigue and nausea. He is also at the age where Irritable Bowel Syndrome could be the diagnosis of exclusion. Dysregulation of certain serotonin transmitters can alter the manner in which water re-uptake occurs at the bowel, causing constipation that may be predominant or alternate with diarhhea episodes in the case of your son. It is often linked to stress and if there have been any major life changes for him recently, ie parental divorce or separation, peer problems or similar circumstances, then IBS can certainly be a consideration and has been observed in adolescents as young as 12. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • September 28, 2008
    • 11:02 PM
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  • Thanks for your thoughts. We saw his GI today and she is beginning to think that this is not a GI issue. I don't think she knows, at this point, what else to look into. She did get some bloodwork and have another x-ray taken to see if he is really backed up. She upped his amitriptilyne to 30mg a day and prescribed a pain reliever.I've looked into Irritable Bowel Syndrome and have eliminated some triggers from his diet--I need to look into that further. There hasn't been a lot of stressors in his life--at least at the time this all started. His dad got laid off last week and I started working recently--that has been stressful on all of us. He had been home schooled his whole life and started public school last fall. He loves school and misses it when he's not well. We are going to back to part-time home schooling to see if that will help him. Though, he hasn't even been to school for almost two weeks and seems to be getting worse. For the first time in this whole thing, he is becoming very worried and is feeling worse by the day--even the hour. He's getting very upset about it. We had an appointment with his Pediatrician on Thursday but I may just take him in tomorrow and have the GI doc fax over test results. I need to do something to help him not be so worried about his health.I've been wondering about a CT or MRI--I will ask about it.Thanks,Carrie
    readingmom3boyz 1 Replies
    • September 30, 2008
    • 02:31 AM
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