I wasn't sure where to post this but I need as many responses as possible as soon as possible because I have to know if I should cancel our appointment by this afternoon.
This is the background: Mid-December, dd gets prescribed a z-pack antibiotic to help clear up an upper respiratory infection. On Christmas Day, dd (6) came down with a terrible stomach flu thing--vomiting, diarrhea, could not keep even water down. Thankfully, it lasted only 12 hours. 2 days later, dh comes down with the same thing, so we definitely think it was a virus. Well, fast forward 1 week and dd starts vomiting out of the blue--no diarrhea, just constant gagging and vomiting with mild fever. We took her immediately to an urgent care clinic and were then sent to the ER at a local children's hospital to check for appendicitis. The took a blood sample and did an ultrasound of her abdomen, all of which were fine, and we were sent home with the diagnosis of another stomach bug. After that, however, she would sleep 10 hours, wake, and then feel queasy for the first hour. Usually, she's very chipper, hops right out of bed, but after that virus on January 4th she would wake and feel queasy. Honestly, at first I thought it was just because she had gotten a little paranoid (and for good reason!) after her last 2 stomach viruses in a week and half. I'm also pregnant and she had seen me having some morning sickness, so I thought maybe that might have aggravated her paranoia. Well, 3 weeks of queasiness each morning (and then being fine the rest of the day) she woke up and threw up. We were planning to go on vacation to Disney World that weekend so we thought we'd just watch her and see if anything else happened. She was fine the rest of the day and for the next 2 days she would wake with queasiness again but no vomiting. We flew to Orlando and starting the morning after she would wake at 6 am (very unusual for her not to sleep until 8 or later!) and need to poop and then vomit. She's pretty much been the same every morning since--waking early, needing to poop, and then vomiting. As soon as we got back from vacation I took her to the pediatrician who put her on OTC Prevacid and told us to see a pediatric gastro-enterologist. We also did a CT scan of her head to make sure there wasn't a tumor, and that was negative. I made an appt. that very afternoon and the earliest they had was 3 weeks later. Meanwhile, the pediatrician said if she got worse, take her to the ER. Last Thursday we did that because she was still very sick every morning and getting more frequent spells of queasiness throughout the day. They did a lot of bloodwork and all of that came back negative for anything--checked white blood cell count, celiac disease, etc. We were given a higher dosage of Zofran to try out (4 mg) and that has been working in the morning to keep her from vomiting. This is the only thing that has helped at all. We saw the pediatric GI dr. yesterday (actually she ended up being a physician's asst. if that matters) and were given orders to continue the Zofran, the Prevacid, and add an anti-histamine at night called cyproheptadine. She checked for blood in her stools and that was negative. The dr. ordered a series of stool tests that we're going to do soon, and she also ordered a barium x-ray of her lower GI tract to make sure there wasn't a blockage. We were also prescribed Florastor, a probiotic, to take twice a day.
My question is this: Would you do the barium x-ray given that dd has recently had a CT scan of her head? I'm really worried about radiation exposure, and according to the information I've been looking at online, this x-ray technique (it's like a real-time video x-ray until the barium is digested) is like 3 years of environmental exposure to radiation. That seems like a lot to me. So far, the Zofran seems to help in the morning, and last night dd slept better having taken the cyproheptadine. I'm giving her DanActive as well as the Florastor but we've just started these so I don't know if or how fast they will help. My instinct is that her GI tract just really got torn up from those viruses in late December/early January. She had had an infection before then which took a Z-pack antibiotic to clear up, so her gut was already very vulnerable when she got those 2 stomach bugs. I feel like she just needs time to heal, and I'm worried that this barium x-ray will do nothing to help and expose her to significant amounts of radiation.
What would you do? Please help!!!
I feel so bad for your dd (and you) . . . this sounds like it's been a terrible ordeal.
Are you talking about a barium enema, or a small bowel follow-through? Unfortunately, those symptoms definitely need to be investigated. If the doctor's concerned about blockage, or inflammatory bowel disease (which can be triggered by a stomach virus), I would ask if my DD could have an MRE first . . . no radiation (but owing to her age she might have to be sedated). If not, I would assume a small bowel follow-through would be appropriate (despite the radiation . . . if it's a blockage or Crohn's, those absolutely need to be treated ASAP, and neither would show up on any of the tests she's had so far). I would do a colonoscopy over a barium enema (again, sedation, but bno radiation). And the radiation is to a different part of her body, so I wouldn't worry about the head CT.
Good luck, mama, I hope it's nothing and your dd feels better soon!
Thanks for the reply. Yes, it's a small bowel follow-through. So, then, it matters about where the radiation is done? I wish I could ask about the other tests you mentioned but it is SO hard to speak to a dr. here. Thanks!
Yes, the radiation affects the cells in its path, not the whole body, as far as I understand it . . . so brain CT and abdominal CT would be affecting different cells.
An MRE is an MRI of the digestive tract. It's an expensive test and takes a long time to perform, so doctors will almost always recommend the x-ray type tests first, but it images the small intestine. I don't know if it will show the same things your doctor is looking for, and the SBFT shows the digestive tract working, which the MRE won't, so it may not be adequate. But I think it's worth it to ask, if you're able to. The worst the doctor can say is no, right?
I'm surprised they haven't done a colonoscopy already. Living in a chron's family we've all gone though a lot of this (I'm one of the few that actually doesn't have it, but still have a weak stomach). I'd think they would do that first barium really really sucks! I would ask about doing it.
Thanks so much for the replies. We've opted to wait on the testing. We're doing some stool sampling now, but she's really responding to probiotics and zofran, and is pretty much back to her normal self right now. I honestly think it's just gastritis, and I'm not going to put her through a barium x-ray for a very slight chance of something that no one in our family has and it's very unlikely that she has. All of this started after antibiotics and 2 bouts of stomach flu (she was fine before then and had never had an issue) so I think those things aggravated her gut. Again, thanks for the input.