DEAR DR. GOTT: My 15-year-old daughter has been suffering from chronic abdominal pain for about a year. She has had multiple blood tests to rule out diabetes, Crohn’s disease, ulcers and a host of other possibilities. She has also had a barium X-ray and an upper endoscopy. The only result has been that she does have mild damage to her esophagus from acid reflux, along with some minor isolated areas of swelling in her stomach lining. She’s otherwise healthy, physically fit and an excellent student with many friends.
Her only complaint is the nonstop abdominal pain. She’s currently taking 300 milligrams of gabapentin three times a day and 20 milligrams of omeprazole twice a day. She says the only difference she notices is that when the pain is really bad, the gabapentin gets her back to base quickly, but she doesn’t get any better.
I would appreciate your thoughts on her condition. You always have thoughtful and helpful advice. Thank you.
DEAR READER: It appears you have taken a great deal of time and expended a great deal of effort in seeking relief for your daughter. I’m not sure that I can add too much more, but I’ll try.
Possibilities include irritable bowel syndrome, abdominal migraines, lactose intolerance and the use of aspirin or ibuprofen taken for the pain. I’m reluctant to mention stress, peer pressure, poor diet or lack of support because your note is so supportive, and your daughter appears well-rounded; however, if she has dark or bloody stools, a change in bowel habits or constipation she hasn’t mentioned, we might have a basis from which to begin. You might ask her physician whether he or she believes a CT scan or MRI might shed some light onto the problem. You also might consider a second opinion with another specialist. This is no reflection on her physician, but sometimes different views help. Keep me posted.
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