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What Course Of Action Can Be Taken To Treat Epigastritis, Constant Stomach Burns And Pain In A 9-year-old?
Posted on
Fri, 23 Mar 2018
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 23 Mar 2018
Answered on
Mon, 17 Apr 2023
Last reviewed on
Question : My 9 year old son, approx 31 kg, 4 foot 8 inches, is currently suffering from acid reflux and what was diagnosed as epigastritis on Feb 03. he points to circular area around navel and says it pains on pressing.
It all started when he had a bout of flu in mid XXXXXXX 2018. It eventually ended up with wheezing with some crepts [LRTI], for which he was prescribed azithromycin 250mg 1-0-1 and cephalexin 250mg 1-1-1 for 5 days. Prior to this medicine he had to take a 5 day course of Amoxyxillin 375 1-1-1 and prednisolone 7mg 1-1-1 which proved ineffective. on the 4th day of the amoxycillin course, we switched over to azithromycin and cephalexin, 1 day previous to that, during the amoxy and predni course, he started complaining of stomach aches. it persisted thru azithro course. no vomiting during that phase
On the 5th day of the azithromycin+cephalexin dose he vomited green yellow liquid and we had him admitted in hospital for 2 days. he was give iv fluid glucose+ ranitidine+aluminum hydrox+magnesium hydrox.
He seemed better prior to discharge, had solid food and was walking on his own on feb 05. He was prescribed 10 day course of rabeprazole 20mg. After finishing the course, he seemed ok, complained of stomach aches around meals usually but burped and felt better. One day, after drinking a bit too much water and eating a little bit more than usual on March 10th, he seems to be back to frequent complaints of stomach burning, on waking up and lying down to sleep, some retching- no vomiting so far, and he points to a circular area around his navel and complains of pain.
Amylase and lipase are normal, esr 4/1 hour, bloodwork was examined by pediatrician and he didn't have any further thing to say, as of March 18th. He wants us to wait a bit before we do endoscopy etc.please suggest if any alternate course of action is needed to make the kid feel better.
Ultrasound on March 24th showed some mesentric lymphocytes.
He has lost about 7 lbs since feb 05. No prior complaints about stomach.
I meant ultrasound done on 24th Feb showed few mesenteric lymphocytes
It all started when he had a bout of flu in mid XXXXXXX 2018. It eventually ended up with wheezing with some crepts [LRTI], for which he was prescribed azithromycin 250mg 1-0-1 and cephalexin 250mg 1-1-1 for 5 days. Prior to this medicine he had to take a 5 day course of Amoxyxillin 375 1-1-1 and prednisolone 7mg 1-1-1 which proved ineffective. on the 4th day of the amoxycillin course, we switched over to azithromycin and cephalexin, 1 day previous to that, during the amoxy and predni course, he started complaining of stomach aches. it persisted thru azithro course. no vomiting during that phase
On the 5th day of the azithromycin+cephalexin dose he vomited green yellow liquid and we had him admitted in hospital for 2 days. he was give iv fluid glucose+ ranitidine+aluminum hydrox+magnesium hydrox.
He seemed better prior to discharge, had solid food and was walking on his own on feb 05. He was prescribed 10 day course of rabeprazole 20mg. After finishing the course, he seemed ok, complained of stomach aches around meals usually but burped and felt better. One day, after drinking a bit too much water and eating a little bit more than usual on March 10th, he seems to be back to frequent complaints of stomach burning, on waking up and lying down to sleep, some retching- no vomiting so far, and he points to a circular area around his navel and complains of pain.
Amylase and lipase are normal, esr 4/1 hour, bloodwork was examined by pediatrician and he didn't have any further thing to say, as of March 18th. He wants us to wait a bit before we do endoscopy etc.please suggest if any alternate course of action is needed to make the kid feel better.
Ultrasound on March 24th showed some mesentric lymphocytes.
He has lost about 7 lbs since feb 05. No prior complaints about stomach.
I meant ultrasound done on 24th Feb showed few mesenteric lymphocytes
Brief Answer:
GERD seems to be the cause
Detailed Answer:
Hi,
Your child's problem seems to be due to gastritis or GERD (acid reflux). A long gap between meals would essentially lead to accumulation of stomach acids (which are meant to help in digestion but the food simply does not come). The excess acids thereby collect and irritate the stomach walls which leads to throwing up.
In order to provide relief, you need to ask for the following:
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Give Lanzol Junior tablet (Lansoprazole)/Nexium (Esomeprazole) sachet once daily before breakfast. The mentioned preparations can be given as an alternative.
* Give plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like Isabgol / Psyllium husk or Senna. I would insist you to increase the dietary fiber intake.
* Regular playing or exercise for at least 1 hour a day to keep the bowel movements proper.
* Give curd or yogurt on a daily basis. It contains beneficial bacteria and should help.
Mesenteric lymph nodes can be found in children and is not a cause for concern. Since amylase is low, you need not be worried about pancreatitis. Give him ORS (Oral rehydration solution) to prevent dehydration.
Hope I have answered your query. Let me know if I can assist you further.
Thank you.
Regards,
Dr. Diptanshu Das
Pediatrician
GERD seems to be the cause
Detailed Answer:
Hi,
Your child's problem seems to be due to gastritis or GERD (acid reflux). A long gap between meals would essentially lead to accumulation of stomach acids (which are meant to help in digestion but the food simply does not come). The excess acids thereby collect and irritate the stomach walls which leads to throwing up.
In order to provide relief, you need to ask for the following:
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Give Lanzol Junior tablet (Lansoprazole)/Nexium (Esomeprazole) sachet once daily before breakfast. The mentioned preparations can be given as an alternative.
* Give plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like Isabgol / Psyllium husk or Senna. I would insist you to increase the dietary fiber intake.
* Regular playing or exercise for at least 1 hour a day to keep the bowel movements proper.
* Give curd or yogurt on a daily basis. It contains beneficial bacteria and should help.
Mesenteric lymph nodes can be found in children and is not a cause for concern. Since amylase is low, you need not be worried about pancreatitis. Give him ORS (Oral rehydration solution) to prevent dehydration.
Hope I have answered your query. Let me know if I can assist you further.
Thank you.
Regards,
Dr. Diptanshu Das
Pediatrician
Above answer was peer-reviewed by :
Dr. Raju A.T
thank you so much for your detailed response doctor. I have 1 followup question:
Since he has some difficulty eating regular amounts of food currently, can I give him 35 gm glucon D which is approximately 100 cals, 3 - 4 times a day for a week - which would be about 300 -400 extra calories per day? Only short term, while his food consumption is not normal.
He is currently having bowel movement daily. we gave him spinach dal and rice today for lunch, along with dahi chawal, oats with jaggery for breakfast and I ensure about 1 litre water consumption per day for him in small parts.
Since he has some difficulty eating regular amounts of food currently, can I give him 35 gm glucon D which is approximately 100 cals, 3 - 4 times a day for a week - which would be about 300 -400 extra calories per day? Only short term, while his food consumption is not normal.
He is currently having bowel movement daily. we gave him spinach dal and rice today for lunch, along with dahi chawal, oats with jaggery for breakfast and I ensure about 1 litre water consumption per day for him in small parts.
Brief Answer:
Bad proposition
Detailed Answer:
Hi,
What you suggested (Glucon D) is the exact reverse of what I suggested. Glucon D does not contain any fibers or any other nutrients and is practically worthless. It will only make things worse. Furthermore, 1 liter water is not sufficient and the amount needs to be increased.
Hope I have answered your query.
Thank you.
Regards,
Dr. Diptanshu Das
Pediatrician
Bad proposition
Detailed Answer:
Hi,
What you suggested (Glucon D) is the exact reverse of what I suggested. Glucon D does not contain any fibers or any other nutrients and is practically worthless. It will only make things worse. Furthermore, 1 liter water is not sufficient and the amount needs to be increased.
Hope I have answered your query.
Thank you.
Regards,
Dr. Diptanshu Das
Pediatrician
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
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