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What Causes Severe Abdominal Pain In A Teenager?

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Posted on Wed, 21 Dec 2016
Twitter Wed, 21 Dec 2016 Answered on
Twitter Thu, 12 Jan 2017 Last reviewed on
Question : My son (14 years old) has severe abdominal pain - almost constantly, day and night. It has kept him out of school for 9 weeks now. He has burning pain, but also achy pain - not appendicitis. Pain is in central belly around belly button. He tested negative for celiac; has no blood; cal protective (sp?) is negative, so Crohn's, ulcerative colitis, and diverticulitis are not likely. Not losing much weight. He was scoped last spring (he had same problem then and after a few months - and we took him off of Concerta - the problems subsided) and they only found a slight abnormality with the esonophiles (sp?) so he has slight GERD. He had a lactose test - very slight lactose response - but barely. He had an MRI - nothing. Tested for parasites - nothing. Was off of gluten and dairy for about 3 weeks - no improvement. I just got a call that the plumber will be here early - in 20 minutes

I forgot to write that my son has started Nexium 22.5 mg, 2ce/day, and amitryptalene at night, and sucralfate as needed. So far, I have not received any emails to my first question sent 54 minutes ago.

In the original message, I meant to write, "he has no blood in his stools", instead of, "he has no blood". I was interrupted while writing and forgot to finish the thought. The doctor (Pediatric GI) thinks that it is a "brain-gut" problem, meaning that his brain is firing signals for pain for no real reason. They also are recommending biofeedback. He had ultrasound of the abdomen back in March. He had endoscopy in April. They told me if he had had a peptic ulcer, and even if it had healed by the time of the endoscopy, months later, they still would have seen remnants of it.
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Answered by Dr. Sumanth Amperayani (8 hours later)
Brief Answer:
Could be abdominal migraine or functional pain abdomen

Detailed Answer:
Hi... I have just read through your question. Whatever you are describing is called Chronic Pain Abdomen in medical terms.

The differential diagnosis of abdominal pain in children varies with age, gender, genetic predisposition, nutritional exposure and many environmental factors. The causes are many including - constipation / acid peptic disorders / inflammatory bowel disorders / irritable bowel syndrome / worm infestation etc.

But you have ruled out everything.

The only other possibilities that remains are a functional pain abdomen or an abdominal migraine.

I suggest get an EEG done. If it's showing seizure activity then anti epilepsy medication like Valproate will help.

But I can assure you one thing. Though he's having pain abdomen, since long, there are no red flag signs like - blood in motion, weight loss, recurrent unexplained vomiting etc. So he's not having anything serious.

If it's only a functional pain abdomen, I suggest you talk to him and find out if he's having any problems at school which is making him avoid school.

Regards - Dr. Sumanth
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8338 Questions

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What Causes Severe Abdominal Pain In A Teenager?

Brief Answer: Could be abdominal migraine or functional pain abdomen Detailed Answer: Hi... I have just read through your question. Whatever you are describing is called Chronic Pain Abdomen in medical terms. The differential diagnosis of abdominal pain in children varies with age, gender, genetic predisposition, nutritional exposure and many environmental factors. The causes are many including - constipation / acid peptic disorders / inflammatory bowel disorders / irritable bowel syndrome / worm infestation etc. But you have ruled out everything. The only other possibilities that remains are a functional pain abdomen or an abdominal migraine. I suggest get an EEG done. If it's showing seizure activity then anti epilepsy medication like Valproate will help. But I can assure you one thing. Though he's having pain abdomen, since long, there are no red flag signs like - blood in motion, weight loss, recurrent unexplained vomiting etc. So he's not having anything serious. If it's only a functional pain abdomen, I suggest you talk to him and find out if he's having any problems at school which is making him avoid school. Regards - Dr. Sumanth