2 yo vomitting for 5 days- ideas? - Mothering Forums
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#1 of 8 Old 06-10-2009, 02:43 PM - Thread Starter
 
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My dd has periods where she vomits for 4+ days and we are in one now. Occasionally it is a stomach bug that just won't quit but, sometimes, like this time, there is no illness around us and we can't find another cause.

When this happened last (sick in NOV, DEC and FEB) we saw a Gastroenterogist and an allergist. They did an upper GI study and tested for food allergies (blood draw and skin prick test)

Nothing showed up. No celiac, no reflux, no IGE allergies. There were some IGG responses (to wheat and soy) that, of course, the docs said to ignore. I also believe dairy is an issue for her.

Since Feb I started her on probiotics, got her constitutional homeopathic remedy, started epsom salt baths, used chiropractic and decreased wheat, soy and dairy from her diet and mine.

(I have not gone as far as removing foods with traces or hidden ingredients.)

The only things that are different that I can identify is:
1. she is teething
2. We didn't get grocery shopping and I got sloppy about keeping dairy out of my diet (ate some cereal with milk for lunch).

We have an appt with a different GI doc tomorrow but I'm not sure what I think they will help with.

Could small amounts of dairy in my diet set her off?
What else could it be that we havent' found?
ideas on what might help?

TIA!!
Wendy
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#2 of 8 Old 06-10-2009, 03:44 PM
 
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The most fundamental question is whether this is a primary GI process, or something else entirely (or both!).

Does she have fever or diarrhea assoicated with the vomiting? If so, this suggests that the problem is indeed gastrointestinal (could be related to infections, to inflammation or to food reactions).

But if she just has vomiting by itself, with no other symptoms, this makes me suspicious that it's not a primary GI problem. Sometimes random other infections (upper respiratory, urinary) can show up as isolated vomiting. And there's an interesting condition, probably vastly underdiagnosed, call Cyclic Vomiting Syndrome, which may be related to migraines. Kids with this classically have stereotyped episodes in which they're fine one minute, then start puking repeatedly for a few days straight, then are fine again. The key to this condition is that the episodes are always the same, and there are no other symptoms that suggest an infection (no fever, no diarrhea). Your daughter would be a little young for it, but it's possible.
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#3 of 8 Old 06-10-2009, 05:06 PM - Thread Starter
 
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Usually there is no fever. this time she had one day where she went up to 100.1 but that's it. Diarrhea only shows up after she's had a few doses of zofran (used to stop her from dehydrating.) and then it's not really full diarrhea (loose stool but not frequent throughout the day).

in the past there hasn't been a connection to ear infection, or lungs or throat but this usually DOES follow a chest cold. I've wondered if it could be sinus drainage that starts it and then her body just can't stop vomitting?

I also hear a LOT of mucus in the back of her throat when she breathes at night.

It doesn't seem to have the same pattern in terms of what time of day it starts etc.
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#4 of 8 Old 06-10-2009, 08:57 PM
 
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Is the vomiting mainly in the morning? Swallowing mucus can often make a person nauseous, and you mentioned you could hear mucus in the back of her throat at night.
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#5 of 8 Old 06-11-2009, 01:39 AM
 
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We're fairly certain that our daughter has cyclic vomiting syndrome http://digestive.niddk.nih.gov/ddise.../cvs/index.htm

We haven't completed all of the testing yet but she completely fits the profile. She cycles approximately every three months. Sometimes it's preceded by either a happy or stressful event, sometimes a virus. I am also fairly sure that she's getting migraines too.

It's awful. I keep Zofran in the house. If I don't give it to her she ends up vomiting every fifteen minutes or so at the cycle's zenith and we end up in the ER for rehydration. I give her the meds as soon as we think she's starting to cycle or she gets very dehydrated fast. She still vomits every hour or so but most of the time we're able to get enough fluids in her to keep her home. (she REALLY hates the ER and all the ivs and bloodwork)
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#6 of 8 Old 06-11-2009, 08:11 AM - Thread Starter
 
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With cyclical vomiting syndrome- how many days does it last? We've used Zofran sporadically over the course of the illness- when I worry about her hydration. It works pretty well but I worry about using a drug so continually.

We're now on day 6 of vomiting. The Zofran wore off at 1:15am and by 5am she was vomiting again.

Thank GOD she is still nursing because she seems to keep BM down better than water or food.

I'm so worried, so tired and frankly so sick of this all!
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#7 of 8 Old 06-11-2009, 09:36 AM
 
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Quote:
Originally Posted by Seawen View Post
Nothing showed up. No celiac, no reflux, no IGE allergies. There were some IGG responses (to wheat and soy) that, of course, the docs said to ignore.I also believe dairy is an issue for her.

Since Feb I started her on probiotics, got her constitutional homeopathic remedy, started epsom salt baths, used chiropractic and decreased wheat, soy and dairy from her diet and mine.

(I have not gone as far as removing foods with traces or hidden ingredients.)

The only things that are different that I can identify is:
1. she is teething
2. We didn't get grocery shopping and I got sloppy about keeping dairy out of my diet (ate some cereal with milk for lunch).
You have your answers already. Please remove all the foods with traces or hidden ingredients. Do it for two weeks and see if you have your answers. My son can react for up to 10 days with foods. I can't believe the doctor would say to ignore the findings when there are obvious symptoms. And start keeping a food journal to see if you need to identify any remaining culprits. The IgG tests aren't always that accurate. Dairy, gluten, soy, and corn are the top 4 intolerances.

Kathy, mother of 3, wife of 1. My new recipe blog: www.kathysrecipebox.wordpress.com (no longer searchable by allergen, but at least it doesn't have a virus!)
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#8 of 8 Old 06-11-2009, 02:39 PM - Thread Starter
 
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Well the gastro guy we saw today said he thinks she has "post viral gastroparesis" since she has been vomiting with every virus she gets for the past year. I didn't see the pattern myself until he pointed it out. Every time she gets a chest cold it turns into a vomiting episode of days.

What happens is when you get a virus (like she did in Jan 2008 when she had RSV) a side effect is that the virus can paralise the stomach muscles that pump food out of the stomach and into the small intestine. This results in intermittent vomiting when the stomach becomes too full from delayed stomach emptying.

If she were having problems with food in between episodes he'd worry more about her intolerances or even do an endoscopy for esophiliic esophagitis but because she is so "well" overall he thinks it's unlikely.

He trusted me on the dairy issue and said to continue to not offer dairy and did suggest she might do better off all dairy (including traces) but that if her slight excema is her only symptom it was our call.

The down side is that treatment for post viral gastroparesis is erythromycin in low doses to increase stomach motility. I'm not sure I like the idea of low dose of antibiotics but I like the idea of frequent Zofran a lot less.

The plan would be to use the erythromycin every time she gets a virus to keep her stomach contents moving to see if we could avoid the vomiting next virus she gets.
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