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What Could Cause Horrible Stomach Pain With Nausea And Vomiting Every Morning In A Teenager Diagnosed With Mild Gastritis?
Posted on
Thu, 10 May 2018
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Thu, 10 May 2018
Answered on
Wed, 18 Oct 2023
Last reviewed on
Question : My 14 year old grandson has horrible stomach pain with nausea and vomiting in the mornings. He recently had a colonoscopy which was clear and endoscopy that showed mild gastritis. He has had this problem since last November. Treatments have been omeprazole for a couple of weeks with some relief and antibiotic for H pylori which gave him relief until the course of treatment was completed. His symptoms are acute in the morning and completely resolve by noon or 1:00 pm. He has been out of school for a week, but has kept up with his homework and good grades. He had an MRI last fall with no abnormalities seen. He has been seen by a FP and now a gastroenterologist who scoped him a few weeks ago. Any thoughts on his symptoms and why they present only in the morning?
Brief Answer:
Gastritis is the cause.
Detailed Answer:
Hello and thanks fir query,
Characterstic Pain of gastritis often comes several hours after a meal when the stomach is empty.The pain is often worse at night and early morning.These are characterstic feature of pain due to gastritis.Omeprazole alone is not sufficient to deal with cases of gastritis much better and specific PPI's are available which are far more effective in treating acid peptic disorders.
Treatment consist of two parts-
1)Control production of acid-For which he was given omeprazole however much better and more specific antacids like Rabeprazole are now available.
2)To prevent the acid formed inside stomach to reflux back into esophagus-(This part of treatment is not covered by your doctor)-I would suggest you to add Levosulpiride or itopiride or domeridome(as per availability) all are prescription medicines. It is a prokinetic drug and is very effective in controlling reflux of acid back into esophagus.Acid peptic disorder may involve mild reflux of acid in esophagus also which may cause the symptoms to persist.A better way is to take it with Rabeprazole trials have shown that its very effective when combined with Rabeprazole.So you can switch over to Rabeprazole from omeprazole and start a prokinetic.
An antacid like Gaviscon can be taken twice daily.
Breath test should be done to see if H.pylori has been eradicated or not.
Basically Triple antibiotic regimen is followed for 21 days to erradicate H.pylori which includes-
Amoxycillin 1000 mg twice daily
Metronidazole 400 mg daily with claritromycin 500 twice daily.
Early in morning after an overnight fasting secretion of acid juices by parietal cells are high and secondly when ever we eat and drink things they form a coating around layer of stomach which prevents it from its own acid.So i would sugggest him to take something like a cup of chilled milk at midnight or early in morning to neutralise the excessive acid formed.Fasting period should not exceed 4,5 hours.He can keep milk by his bed side and can take it.
lets see how he responds to above therapy and medications.
Hope i was helpful.
follow ups are welcome.
Gastritis is the cause.
Detailed Answer:
Hello and thanks fir query,
Characterstic Pain of gastritis often comes several hours after a meal when the stomach is empty.The pain is often worse at night and early morning.These are characterstic feature of pain due to gastritis.Omeprazole alone is not sufficient to deal with cases of gastritis much better and specific PPI's are available which are far more effective in treating acid peptic disorders.
Treatment consist of two parts-
1)Control production of acid-For which he was given omeprazole however much better and more specific antacids like Rabeprazole are now available.
2)To prevent the acid formed inside stomach to reflux back into esophagus-(This part of treatment is not covered by your doctor)-I would suggest you to add Levosulpiride or itopiride or domeridome(as per availability) all are prescription medicines. It is a prokinetic drug and is very effective in controlling reflux of acid back into esophagus.Acid peptic disorder may involve mild reflux of acid in esophagus also which may cause the symptoms to persist.A better way is to take it with Rabeprazole trials have shown that its very effective when combined with Rabeprazole.So you can switch over to Rabeprazole from omeprazole and start a prokinetic.
An antacid like Gaviscon can be taken twice daily.
Breath test should be done to see if H.pylori has been eradicated or not.
Basically Triple antibiotic regimen is followed for 21 days to erradicate H.pylori which includes-
Amoxycillin 1000 mg twice daily
Metronidazole 400 mg daily with claritromycin 500 twice daily.
Early in morning after an overnight fasting secretion of acid juices by parietal cells are high and secondly when ever we eat and drink things they form a coating around layer of stomach which prevents it from its own acid.So i would sugggest him to take something like a cup of chilled milk at midnight or early in morning to neutralise the excessive acid formed.Fasting period should not exceed 4,5 hours.He can keep milk by his bed side and can take it.
lets see how he responds to above therapy and medications.
Hope i was helpful.
follow ups are welcome.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you so much for your thoughtful and thorough response to my query regarding my grandson's gastritis. If OK with Dr. XXXXXXX I would like to keep this question open for a few days while I await a response from his current physician. I will say that, based on Dr. Kumar's response, I have much more confidence in his assessment and recommendations than on my grandson's physician.
As a retired nurse and a volunteer patient advocate, I appreciate Dr. Kumar's approach in addressing (and hopefully solving) our problem.
Again, Thank you!
As a retired nurse and a volunteer patient advocate, I appreciate Dr. Kumar's approach in addressing (and hopefully solving) our problem.
Again, Thank you!
Brief Answer:
follow up.
Detailed Answer:
Thanks for appreciation my dear,
This query is either closed by you or by this forum.
However you can reach me directly any time when ever you want at this link http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660.
Hope he gets well soon.
Hope to hear from you soon.
Regards and best wishes for your grandson.
follow up.
Detailed Answer:
Thanks for appreciation my dear,
This query is either closed by you or by this forum.
However you can reach me directly any time when ever you want at this link http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660.
Hope he gets well soon.
Hope to hear from you soon.
Regards and best wishes for your grandson.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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