Q: My 8-year-old son's severe stomach pain isn't getting better after two weeks and multiple diagnoses. What should I do next?

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Question:

Hello, I'm writing out of frustration and concern. My 8-year-old son suddenly developed abdominal pain and chills about two weeks ago. An X-ray at a local clinic showed a lot of gas, so we gave him medicine for that.

A couple of days later, he woke up crying from the pain, and a pediatrician diagnosed him with gastroenteritis. That afternoon, the stomach pain and a headache got worse. He received an IV drip for a suspected norovirus infection and seemed to improve slightly. However, the severe abdominal and head pain returned early the next morning.

We had him admitted to a local pediatric hospital. Blood tests showed mild anemia and a mild case of type A influenza, for which he received a Peramifluir IV. Despite this and painkillers, the intense pain continued, and he wouldn't eat. The next day, we went to a university hospital. An MRI revealed sinusitis, which was thought to be the cause of his headaches. He was treated with antibiotics for five days and then discharged.

It has now been a week since he was discharged, but he still complains of stomach pain. We saw our pediatrician again last Thursday, who said it was still gastroenteritis and prescribed more medication. Just a little while ago, he cried from stomach pain after eating and then fell asleep. I feel so helpless. I'm sorry for asking a question that isn't related to fever.

Answer:

It must be incredibly worrying and frustrating that the abdominal pain has continued for nearly two weeks.

【Summary of Events So Far】

• About two weeks ago: Abdominal pain + chills → Diagnosed with gas.

• Worsened after two days → Diagnosed with gastroenteritis, received IV for suspected norovirus.

• During hospitalization: Confirmed Type A influenza + anemia, treated with Peramifluir.

• At university hospital: MRI revealed sinusitis → treated with antibiotics for 5 days.

• One week post-discharge: Abdominal pain persists, re-diagnosed with "still gastroenteritis" on Thursday.

【Red Flag Symptoms—If you see any of these → Go to the university hospital ER or see a pediatric surgeon today】

• He continuously clutches a specific area of his belly (especially the lower right side or around the navel) or has difficulty walking.

• Vomit is green or yellow, or he is vomiting repeatedly.

• He passes bloody stools (dark red or bright red) or jelly-like mucus stools.

• His abdomen is hard and swollen, or he experiences severe pain when it's touched.

• A sharp decrease in urine output (no urination for over 8 hours) or dry lips/tongue.

• He is lethargic, only wants to lie down, or is difficult to wake up.

If the above symptoms are absent, and your child is drinking water, urinating, and occasionally shows interest in playing or watching TV → you can proceed with the steps below.

【What You Can Do at Home Now】

1. Keep an Abdominal Pain Diary (for 3 days)

- When: Before/after meals, at dawn/in the morning, etc.

- Where: Around the navel, right side, left side, or all over.

- Severity: On a scale of 1-10, does he cry, or just pause during play?

- Accompanying Symptoms: Vomiting, diarrhea, headache, fever.

- What and how much he ate.

2. Dietary Adjustments

- Avoid greasy foods, dairy products, fruit juices, and carbonated drinks.

- Offer small, frequent meals of bland foods like white porridge, bananas, boiled potatoes, or toast.

- Instead of large amounts of water at once, offer a few sips every 5-10 minutes.

3. Check Bowel Patterns

- If stools are hard or he hasn't had a bowel movement in over 3 days → possibility of constipation.

- If loose diarrhea continues more than 5 times a day → possibility of persistent gastroenteritis.

4. Sinusitis Follow-up Care

- Confirm if the prescribed course of antibiotics is finished.

- If nasal congestion or yellow nasal discharge persists → needs re-evaluation by an ENT specialist.

【Questions to Ask Your Current Pediatrician】

• "Since the abdominal pain has lasted for two weeks, should we consider other causes besides gastroenteritis (e.g., constipation, lactose intolerance, mesenteric adenitis, or rarely, early appendicitis)?"

• "Is an abdominal ultrasound or additional blood work (like inflammation markers) necessary at this point? Could the results change our treatment plan?"

• "Would dietary changes or adding a probiotic supplement be helpful?"

• "At what point, if there's no improvement, would you consider a referral to a pediatric gastroenterologist or a pediatric surgeon?"

【Regarding Referrals and Specialist Consultations】

Based on your current pediatrician's judgment, a stepwise referral to a Pediatric Gastroenterologist (to rule out chronic abdominal pain, inflammatory bowel disease) or a Pediatric Surgeon (to rule out structural issues) may be possible.

Since he was admitted to the university hospital, a consultation within the same hospital system would be advantageous for sharing medical records.

【Final Thoughts】

It is perfectly fine to ask questions unrelated to fever—abdominal pain is a very important symptom.

For today, please start by keeping the pain diary mentioned above, and if you notice any of the red flag symptoms, please seek immediate care.

Share any new changes or the results from your diary, and we can figure out the next steps together.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us