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Gastroenterology (Expert Forum)
5 year old - Stomach Cramps and Dry Cough
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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5 year old - Stomach Cramps and Dry Cough
by sathya, Nov 13, 2003 12:00AM
Hi,
My son is 5 and a half years old. He has been
suffering from dry unproductive cough for little more
than 2 yrs now. He has been diagnosed for allergy and
has been taking allergy medications (cetrizine
citrate). He had to be on medication almost everyday
for the past 2 yrs. Sometimes a small dosage would
work and other times (during cold season) he had to
take the full recommended dosage. Now for a yr a half
he has also been complaining about stomach cramps
every now and then. We are not sure if this cramp is
medication induced or the cough itself was induced by
acid reflux. We found out that the cough worsens if
he takes milk, cheese, apple, banana or nuts. He
sweats a lot, more than normal, during activity and
during sleep hours. He coughs mainly during waking
hours. He says that he feels like clearing something
that pricks his throat. During the early mornings
(2-5) occasionaly he gets productive cough which
sometimes stays for just a few minutes and goes away
without any medication.
He complains of cramps as soon as he wakes up, during
a long car ride (which we assumed is due to boredom),
right after meal or if the meal time gets postponed.
He refused to drink cow's milk until he was little
more than 2 yrs. He was on breast milk until he was
little more than 3. After he turned 2 we started to
force him to drink milk and he would take only very
cold milk. Just couple of months before the cough
episode he started to drink milk regularly. Currently
he has stopped taking milk for th epast 1 yr but
takes yogurt.
My husband's family has a strong history of acidity
related problems and my husband himself suffers from
hyper acidity. My family and myself have a strong
history of respiratory related problems.
He has been tested for primary complex, esnophilis,
liver, kidney functions (stomach scan). Everything
has been negative so far. We circumcised him 6 months
ago as he developed UTI and was told that this could
be a reason for the cramps. But the surgery didn't
help either.
We would really appreciate if you could diagnose this
illness as it is hard for us as parents to feel
helpless. Also please advice us on any other tests
that needs to be taken in this regard.
PS: He was given a dose of Hetrazan tablet 18 months ago.. and we feel that the stomach related problems started surfacing after that, though may be a coincidence.
Sathya
My son is 5 and a half years old. He has been
suffering from dry unproductive cough for little more
than 2 yrs now. He has been diagnosed for allergy and
has been taking allergy medications (cetrizine
citrate). He had to be on medication almost everyday
for the past 2 yrs. Sometimes a small dosage would
work and other times (during cold season) he had to
take the full recommended dosage. Now for a yr a half
he has also been complaining about stomach cramps
every now and then. We are not sure if this cramp is
medication induced or the cough itself was induced by
acid reflux. We found out that the cough worsens if
he takes milk, cheese, apple, banana or nuts. He
sweats a lot, more than normal, during activity and
during sleep hours. He coughs mainly during waking
hours. He says that he feels like clearing something
that pricks his throat. During the early mornings
(2-5) occasionaly he gets productive cough which
sometimes stays for just a few minutes and goes away
without any medication.
He complains of cramps as soon as he wakes up, during
a long car ride (which we assumed is due to boredom),
right after meal or if the meal time gets postponed.
He refused to drink cow's milk until he was little
more than 2 yrs. He was on breast milk until he was
little more than 3. After he turned 2 we started to
force him to drink milk and he would take only very
cold milk. Just couple of months before the cough
episode he started to drink milk regularly. Currently
he has stopped taking milk for th epast 1 yr but
takes yogurt.
My husband's family has a strong history of acidity
related problems and my husband himself suffers from
hyper acidity. My family and myself have a strong
history of respiratory related problems.
He has been tested for primary complex, esnophilis,
liver, kidney functions (stomach scan). Everything
has been negative so far. We circumcised him 6 months
ago as he developed UTI and was told that this could
be a reason for the cramps. But the surgery didn't
help either.
We would really appreciate if you could diagnose this
illness as it is hard for us as parents to feel
helpless. Also please advice us on any other tests
that needs to be taken in this regard.
PS: He was given a dose of Hetrazan tablet 18 months ago.. and we feel that the stomach related problems started surfacing after that, though may be a coincidence.
Sathya
Doctor's Answer
by Kevin Pho, MD, Nov 14, 2003 12:00AM
, Nov 14, 2003 12:00AM
First a quite note, this service cannot diagnose over the internet - that is something that should be done by your personal physician. However, here are some thoughts.
There are several reasons for abdominal discomfort in children. This can include constipation, carbohydrate malabsorption, musculoskeletal pain, parasitic infection, dysmenorrhea, and peptic disorders (eg, reflux esophagitis, gastritis, gastric and duodenal ulcers, and H. pylori infection). Less common causes include urinary tract infections, inflammatory bowel disease, endometriosis, and pelvic inflammatory disease.
A complete blood count with differential and erythrocyte sedimentation rate are helpful for confirming the presence of an infectious or inflammatory process or anemia.
Stool tests for culture, ova/parasites, and Giardia antigen if a bacterial, parasitic, or protozoal cause of abdominal pain is suspected. Giardiasis can cause abdominal pain without diarrhea.
Serum electrolytes, glucose, creatinine, and blood urea nitrogen to evaluate metabolic causes and consequences of abdominal pain. Liver function tests and amylase, particularly in patients with upper abdominal pain.
Abdominal ultrasound and CT scan are the imaging tests of choice to evaluate any mass or other pathology that can cause the discomfort.
Finally, if the tests remain inconclusive, upper and lower endoscopy can also be considered to evaluate the bowels as well as the upper GI system.
I would suggest a referral to a pediatric gastroenterologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Fishman et al. Evaluation of the child and adolescent with chronic abdominal pain. UptoDate, 2003.
There are several reasons for abdominal discomfort in children. This can include constipation, carbohydrate malabsorption, musculoskeletal pain, parasitic infection, dysmenorrhea, and peptic disorders (eg, reflux esophagitis, gastritis, gastric and duodenal ulcers, and H. pylori infection). Less common causes include urinary tract infections, inflammatory bowel disease, endometriosis, and pelvic inflammatory disease.
A complete blood count with differential and erythrocyte sedimentation rate are helpful for confirming the presence of an infectious or inflammatory process or anemia.
Stool tests for culture, ova/parasites, and Giardia antigen if a bacterial, parasitic, or protozoal cause of abdominal pain is suspected. Giardiasis can cause abdominal pain without diarrhea.
Serum electrolytes, glucose, creatinine, and blood urea nitrogen to evaluate metabolic causes and consequences of abdominal pain. Liver function tests and amylase, particularly in patients with upper abdominal pain.
Abdominal ultrasound and CT scan are the imaging tests of choice to evaluate any mass or other pathology that can cause the discomfort.
Finally, if the tests remain inconclusive, upper and lower endoscopy can also be considered to evaluate the bowels as well as the upper GI system.
I would suggest a referral to a pediatric gastroenterologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Fishman et al. Evaluation of the child and adolescent with chronic abdominal pain. UptoDate, 2003.
