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  • 4.5 Yr. Old - Constipation/Encopresis/Vomiting Since Sept ! (m)..

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    Old 01-13-2007, 10:44 AM   #1
    greenacres
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    4.5 Yr. Old - Constipation/Encopresis/Vomiting Since Sept ! (m)..

    we go see a Peds Gastro on Monday. We've been dealing w/this since September. 2 trips to the ER in and 3 trips to his peds. I rcvd med records yesterday and 2nd time to ER they took blood/urine (this was within 3 days apart) and urine showed crystals inhis urine, a moderate amount. His blood showed trace ketones. YES, they told me everything was normal. IS that normal? I am so peed right now, cause if it isn't.....GRRRR! Anyway, his x-rays showed severe constipation and he was vomiting. Over and over he got better. But during this whole time at least 2-3x a day he still complains that his tummy hurts and he vomits I would say every 1-2 weeks for a whole day when it gets real bad. They did a barium x-ray and everything unremarkable. They ruled out appendicits, cause they felt no lumps or anything in abdomen. They also ruled out "supposedly" with the barium any kinks or folds in the bowels (Intussusseception) or malroitation of the bowels. I'm just wondering if anyone has any ideas what this might be? ALso, he had a lot of times he soiled in his underwear because he had such bad feecal impaction, the loose stuff was going around the hard stuff and leaking out.

    His HGB is a bit out of whack and they did find a few WBC's in urine - but again, they told me these tests all came out normal at that time. Oh and when he says his tummy hurts, he's always grabbing the middle, by belly button but sometimes he points to the right side (he has a language disorder - verbal apraxia). THen, yesterday AM, he said "owie" when he peed. Oh and his glucose on the test was 95, which seems to be normal. (I was worried about diabetes too).


    Any ideas? THANKS
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    Old 01-13-2007, 06:26 PM   #2
    Mom22greatkids
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    Re: 4.5 Yr. Old - Constipation/Encopresis/Vomiting Since Sept ! (m)..

    I don't have any answers for you but I feel your pain. My 4.5 year old daughter has constipation issues also and I know how frustrating it can be. She went through a period of 3 or 4 weeks that she did not eat solid foods. Only pediasure and yogurt. During this time she said she hurt in the middle also, pointing to her belly button. When her doctor felt her abdomen he could feel all the stool in her abdomen and said it was all the way over by her appendix (I guess the intestines can stretch quite a lot). He should not have felt it that far over but she was soooo constipated. Maybe that is why your son points to his right side? She did vomit a couple of times too and she was always feeling nauseous. Probably from being so backed up. She is now on the maximum dosage of Miralax every day . If she misses a dose she will get constipated again. Good luck on Monday. Let me know how it goes.

     
    Old 01-13-2007, 09:34 PM   #3
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    Re: 4.5 Yr. Old - Constipation/Encopresis/Vomiting Since Sept ! (m)..

    hi, I was reading your post and i can understand how upset you are. My 6 yr old has severe constipation. He has been taking miralax since he was about 1 and a half. I still tells me his tummy hurts, and he will tell me he needs his medicine. I have been able to cut down on it though. He use to drink it everyday, he now takes it for 3-4 days and will stop for about 1week, then we start all over. I have been fighting with his dr about sending him to another ped gastro. Have they done a biopsy on your son? I know they said it can show something, i cant remember Matt had one done when he was 11months. Matt has had hemmeroids and bleeds when going to the bathroom. He has also passed out while sitting on the toilet trying to go. You should be careful. Sorry i can't give you any better advice, and i hope your son feels better. God bless you

     
    Old 01-14-2007, 07:20 AM   #4
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    Re: 4.5 Yr. Old - Constipation/Encopresis/Vomiting Since Sept ! (m)..

    Greenacres-
    Oh sweetie, I am so so sorry you are having to deal with this. I know when our children are suffering we just want to be able to make it all ok. That's what we've been trained to thing after all- that mommie can always make it better.

    You are doing the right thing by continuing to look for answers. Dont' stop!

    I only glanced at all of the posts, and didn't see mention of this, but have any of these doctors tested for chrons? What you desribed about being so clogged and constipated and then soiling his paints from the loose excriment is called "overflow diarrhea". Chrons can either be diarrhea dominant or constipation dominant. So can IBS. I have constipation dominant IBS and have never in my life been regular with bowel movements. I'm either so constipated that I have to force a bowel movement, or am having extremely explosive and excuciating bowel movements.

    Deffinately seek the opinion of a pediatric GI specialist. You might also consider having your son tested for certain food allergies such as wheat, gluten, milk, peanuts, etc. There are so many things that can cause the symptoms your son is exhibiting. There are some absorption disorders that can cause this as well. I know my cousin went for years before being diagnosed with Chrons. Most of the doctors out right told her mom that children just do not get chrons! She had suffered from childhood, yet none of the doctors would even consider chrons. They kept telling her it was stress.

    I finally told her mom to please, PLEASE find a pediatric GI specialist and have her tested for chrons. She did, and they finally got their answer.

    I wish you the very best of luck in finding a doctor that can diagnose your son and thus, begin treating him so he can be more comfortable. Please do keep us posted. I'm sending positive thoughts your way!

     
    Old 01-17-2007, 09:07 AM   #5
    Thread79
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    Re: 4.5 Yr. Old - Constipation/Encopresis/Vomiting Since Sept ! (m)..

    I read this post and just had to respond. I am not very medically literate but my advice is to demand appoints with specialists. Keep seeing different ones until someone has an idea of what to do. My experience is that doctors will listen to your problem and either have a good idea of what is going on, or just be at a loss as to what could possibly be wrong. They are all very smart and good at what they do. It just takes a doctor who has seen this before or has a creative idea to solve it. Your description does not sound normal and I feel there must be a cause to the problem.

     
    Old 01-17-2007, 10:33 AM   #6
    greenacres
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    Re: 4.5 Yr. Old - Constipation/Encopresis/Vomiting Since Sept ! (m)..

    Hi there. This is a followup....we went to see a peds gastroenterologist on Monday. We were there 2.5 hrs. We went through a lot of information. They asked us A LOT of questions. He ruled out Cyclic Vomiting Syndrome because he doesn't vomit A LOT at one time to the point he gets dehydrated. He even wanted our input as to what it "might" be. He wants to start w/the least invasive testing, that being bloodwork (which he gave on Monday), we have an ultrasound scheduled for the 29th. In between that, he is having us get a sample of his stool and also breathe into some bags for some "gas" test in his gut. By the time the 29th rolls around, they should have all results back for all the tests (except the u/s of course). Now, since Monday, he vomited Monday night, then he vomited once again yesterday (that being because he was upset and crying? cause Daddy dropped him off at G and Grandpa's?). Today he is fine so far. It's 12:20 and I've gotten no phone call from school yet (yay!). This is the 2nd day he has taken his Prevacid (this being a drug we are trying to rule out reflux). So, that's where we're at. One thing that concerned me was looking at his urine testing from September and comparing it to 1/10/07. He had trace ketones on both tests and on the 1/10/07 one had 4mg/dl of urobilinogen which is not good. I e-mailed his regular ped (who referred us) about it and this was his response. I will speak to his peds gastro though abou tthis as well. This is his response 1st, and my actual questions below:

    Good questions. Although both tests flagged as abnormal, in isolation, with
    other tests normal, I wasn't concerned.
    For the urine ketones, it is common to see these positive in children who
    have been vomiting. Most individuals will use sugar as their primary source
    of fuel. If you don't eat, even briefly, your body then will start breaking
    down fat, which creates the ketones. With the results being trace, it more
    likely the vomiting causing the ketones than the ketones causing the
    vomiting. It would be different, for example, if we saw him spilling sugar
    in his urine, with large ketones. That's the presentation for diabetic
    ketoacidosis.
    The positive urobilinogen is also something I have seen many times in kids
    who have been vomiting. If you have slower gut transit time, you have
    bilirubin that can be absorbed from the gut and excreted in the urine
    (increased enterohepatic circulation). With excessive RBC breakdown, we
    would see subsequent anemia. Dawson's hemoglobin is normal. The large
    hematoma or bruise would be seen clinically. The liver problems would be
    seen in the liver function tests - his bilirubin in the blood was .5, and
    his liver function tests were normal.

    Although you have a few abnormal tests elevated, they are nonspecific, and
    it is often a pattern of tests that show something is wrong. That's why I
    wasn't concerned, or thought they meant too much. I still think is a good
    idea to point those out to Dr ((((( - two heads are better than one.


    Subject: Dawson's Urinalysis

    Hi, question for you. I was wondering looking at Dawson's lab reports
    comparing from September to the one your ordered on 1/10/07.

    It showed Trace Ketones on both - is this a concern? Also, the Sept. report
    showed negative urobilinogen and the one on 1/10/07 showed 4 mg/dl - which
    is an increase and from what I find indicates a problem. Is this a concern
    and something I should point out to Dr. ****next time I see him? I didn't
    notice it until today and we saw Dr. *****yesterday so I did not mention it.
    According the normal level of the hospital's results are supposed to be
    0-1mg/dl. I found this info on the net on what abnormal levels "might"
    indicate. We go for more testing on 1/29 and in between stool and h.pylori
    testing. Thanks again.

    Abnormal urobilinogen values may indicative of
    Increased values

    overburdening of the liver

    excessive RBC breakdown

    increased urobilinogen production

    re-absorption - a large hematoma

    restricted liver function

    hepatic infection

    poisoning

    liver cirrhosis



    Thank you.
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