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Wafaa

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Hello I Am wafaa my son 14 years old was perfectly fine until Jan 31 when a dr prescribed him klacid xl for his upper respiratory infection. Though there was no fever . Then after 3 days from the start of this medicine he started vomiting . We took him to ER where he took antiemetic and iv drips . This went on for a week daily in ER. Welll he didn’t improve. Then we went to see a gastro dr where he did upper endoscopy and said he has oseophegitis and have him motilum and Risek . It didn’t work either. And we had to admit him because he was dehydrated. He stayed a week in hospital and the vomiting wouldn’t stop by even iv zaforan . He vomited everything even water . Nothing stayed in his stomach. He vomits one and half hour after food . He lost 10 kg over this two weeks period . They did again upper and lower endoscopy and were normal. No celiac disease no salmonella no IBD . Ct scan with contrast for abdomine was normal and mri brain normal. His bilirubin was 40 and direct bilirubin was 6. His wbc 3.4 Hb 149 urea 1.4 creatinine 49 . Na 139 k 4 CRP normal . But he was still vomiting and with severe constipation . He didn’t pass until they cleaned his bowels for endoscopy. He discharged and stayed few days at home and readmitted for dehydration. His prolactin was 665 . He stayed for a 2 week and still vomits everything even water . He got slightly better interns of the frequency of vomit . But it became like stereotypic. It starts at night 11 pm and he keeps vomiting every half and hour each lasting 2 minutes . He sleeps at 12:30 am or 1 am . Plus constipation is still on . He doesn’t pass even gas like something is blocking down . He pass stool only when we put dulcolax suppository. And strangely he vomits air like big bouts of air until he gets it all and sleep . We did plain Xray normal . Gastric emptying study normal and barium meal normal . He recently lose consciousness for 6 minutes after attacks . He fella down and he likes disconnect from world . His eyes open but he’s unaware. He doesn’t respond to us . And while this he’s absent he  gets severe abdominal pain and puts his hands on tummy hurting , he can’t see or talk . He’s unaware of this attack at all when he return to reality. Sometimes he faints before vomiting. But the vomiting is daily daily since 31 Jan . Non stop . No free day . He’s not been to school since then . And we are 24 hours around because of the faint we are afraid he might hurt himself if fell . So our life’s is a hell now . The dr says it might be abdominal epilepsy or CVS , he didn’t start treatment yet . But I don’t know why he’s vomiting air and the severe constipation even though he’s taking twice a day loxidol. I need help. 
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wynnak

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Reply with quote  #2 
Has he had any Vomiting struggles earlier on in life? Did they take him off the med that he started initially?
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Blynda
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Wafaa

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Reply with quote  #3 
He was totally ok . And yes we stopped the klacid on the third day .
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ginny

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Reply with quote  #4 

This does not seem to be CVS to me (CVS is a functional problem and not a disease).  It does seem to be somehow connected to a reaction to the antibiotic.

Keep watch on the blood tests and compare to see which ones are normalizing.

Lack of bowel sounds can be serious.  He cannot digest his food if his bowels are not working and unless something has changed, the doctors usually rest the bowel until function returns.  He might need IV support until the issue with the bowels has resolved.  This can take time.  Sometimes warm water enemas can be tried to encourage some bowel action.  

Are you at a teaching hospital?  If not I would try to get him admitted to a children's medical center.  You can also do a virtual consult with a US teaching hospital such as Mass General or Boston Childrens.  That might be a good approach.  How are his copper levels?

Please let us know how he is doing.


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Wafaa

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Reply with quote  #5 
Today I did blood test which is all normal . He’s not in hospital now . He’s eating fine but gets the attack at night . Where he vomits air only . And I didn’t do the copper though . I don’t know why he’s not passing stool or flatus . Tomorrow we have MRI enterography. And hopes are up . The dr mentioned that it might be abdominal epilepsy. ?? And he was on iv fluids for 4 weeks . But even that didn’t help. I am so sad .
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wynnak

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Reply with quote  #6 
Let us know what comes back on the MRI. 

Lack of bowel sounds and movement can be a variety of issues. If he is completely backed up.. then even air has only one way to go. Flatulence would indicate bowel movement. but only if it was moving through. 

Have they done an Ultrasound? 

You are doing the blood tests? What kind of blood test are you administering? 

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ginny

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Reply with quote  #7 

One of my kids had an ileus which resulted in violent vomiting including vlomiting up an NG tube.  The NG tube was to relieve pressure but it did need to be reinserted from time to time.  This child also developed SMS (Superior Mesenteric Artery Syndrome).  

Nothing at all by mouth for the duration so IVs including TPN for nutrition when there was a dramatic weight loss.
  
It took quite a long time inpatient to resolve these issues and some problems did remain longer. 

Can you have his doctors conduct a remote consult?  Sounds like lots of testing but no true help for him yet.







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Wafaa

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Reply with quote  #8 
ultrasound was normal . i am did smac 20 all normal 
cbc normal
here in kuwait we don't have a family dr unfortunately so we have multiple drs .
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ginny

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Reply with quote  #9 
No bowel sounds but u/s is normal?

I think at this point with your son so sick, he needs a teaching hospital and hopefully your doctor will consult with either a CVS Medical Advisor or with a major teaching hospital in the US.  There are also programs to take kids to the US for difficult cases. Your sons doctors should be able to access the programs.

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