Teen daughter's chronic abdominal pain and nausea
Seeking a recommendation for a gastroenterologist who can think outside the box. Our teen daughter has been experiencing long term chronic abdominal pain and nausea that seems to be triggered by food. We saw a traditional gastroenterologist who did a battery of tests and ruled out all the obvious major medical causes, and then told us they didn't have an answer for us. I am open to suggestions at this point. Thanks, BPN!
Apr 27, 2021
Parent Replies
Have you considered a gluten intolerance? That is the most likely thing. If it is triggered by food, then an elimination diet may help you find out what food it is. Find two foods she rarely eats, such as amaranth and olives. See how she feels after a day or two on this diet. I know that can be hard to maintain. If that works, slowly add foods back in. If it doesn't try a different combination of two food that she rarely eats. You might want to try an allergist to get an idea of her allergy situation.
Has your daughter tried a low FODMAP diet? Although I agree with you that she should see another doctor, this might help while she is waiting to figure out the problem. I have been experiencing similar symptoms to your daughter and am waiting for a colonoscopy appointment. This diet has allowed me to get my life back. It is a very restrictive diet and if she tries it, I would recommend she also take a multi-vitamin and a probiotic.
I don’t have a good answer for a GI for you. I did have similar symptoms however and after months and months of looking for a diagnosis it turned out to be a pancreas problem. I am on rx pancreas enzyme replacement and the pain has mostly gone away. You can get not as regulated, but worth trying, pancreas enzymes from a health food store (proteasas, amylase, lipase). Take 10 minutes before a meal and you should know within 1 to 2 meals if it works. You can then take that information to your doctor.
You might look at the Abascal diet, it's an elimination diet to find what foods you are sensitive/allergic to. Sounds like cutting out gluten would be a good place to start. Good luck! I've been gluten free for 2 years and I feel so much better!
My daughter had the same from 10 yrs old on (now she is 17). We discovered she has POTS (postural orthostatic tachycardia syndrome). It is a problem with the autonomic nervous system and regulation of blood flow. She is nauseous almost all the time, but worse with food. Electrolytes and salt help. No quick fix, but hopefully she will grow out of it. Kaiser has a POTS clinic but they just do symptom management through lifestyle changes and nothing seems to help with the nausea. Oh and anxiety makes everything worse.
My college age daughter had similar symptoms over the last 1.5 years. My first attempt to help her was to send her to a GI doctor, who was not able to diagnose the problem. I later sent her to an internal medicine doctor who did food allergy testing (IGG?) and found out she had celiac disease, which also seems to cause something called "leaky gut syndrome". I then had her go to a functional medicine (naturopathic doctor), and she went on a special diet gluten free Ketogenic diet and supplement program for about 3 months to heal her intestines. Aside from all the abdominal pain and vomiting, I believe she was quite malnourished and that resulted in some mental health issues, partly because of the toll that being so sick took on her school work and self-esteem because of always feeling sick. It took about a year for her to fully recover and she is finally back to feeling pretty good. If Celiac disease is the culprit, check out the book "Jennifer's Way: My Journey with Celiac Disease--What Doctors Don't Tell You and How You Can Learn to Live Again". We both read it and it was motivational to help her overcome the problem. I probably helps that I am gluten free also because it causes severe eczema for me.
Our daughters see GI Dr. Yvette Wild at UCSF, and we love her. Both of our girls have GI diagnoses, one with Eosinophilic Esophagitis (EoE) and the other with IBS, SIBO (at one time) and possible EoE. We've done lots of elimination diets and low FODMAP, very well directed by Dr. Wild and her team. She's extremely knowledgable and really listens to what the family needs/what works for the child. Our kids (17 & 19) have almost outgrown her but we're hanging on to her as long as possible! Feel free to contact me with any questions, we've been on this road for 12+ years. emily [at] emilyadesigns.com