Abdominal pain with coughing or movement

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my little penguin

my little penguin

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First I did call DS's GI this am.
Waiting for a call back

Ds normally has abdominal pain. He pain has been mild since last week.
This morning woke up saying his stomach hurt when he coughs( he has a cold).
It also hurts when he walks or jumps or pulls his knees to his chest .
The pain gets better if he lays down.
Pain is only a 3-4 ( tears are 5-6 and he was panting last week at a 8)

He said this pain that hurts when he moves is different .
Google has horror stories - if it was worse I would have him in the ER already but since it's slightly above mild to moderate I am ok with waiting for the GI to call for now
Ideas???
 
Could it be that his abdominal muscles are sore from coughing? It took A a while to learn the difference between sore abdominal muscles from dance and a true tummy ache.
 
Not from coughing since his cough is extremely mild and only a few brief times a day.
He has abdominal pain from swimming but this is different .
 
Chest infection only because one dd er visits for stomach pain prior dx resulted in a chest xray.
 
Muscular would spring to mind due to the worsening with activity…movement coughing.

If you can rule this out though and the pain reduces on laying down but remains present then it is difficult not to go down the path of inflammation being the cause as movement/coughing will aggravate the inflamed area further. :(

I hope you hear back from the GI soon. :ghug:

Dusty. xxx
 
Gi just called
Worried about stricture /narrowing or something with the bowel loops
He ordered an mre -can't evel talk to the scheduler till Monday .
Hoping to avoid ct scan .
Mre could take a while but hopes to get him in sooner rather than later
Wants him in the ER if it gets worse or fever , vomiting etc....
Pain isn't too bad 3-4 with movement
But the concerning part for the gi is it goes away with laying down and increases with eating /moving /coughing /jumping
I hate waiting
Fingers crossed things don't get worse
 
:ghug:

I hope things stabilise for your lad mlp until testing can be done, bless him. :heart:

Sending much luck and well wishes your way!

Dusty. xxx
 
METHODS: A single-center, cross-sectional study of 153 pediatric patients with CD and control subjects undergoing diagnostic CTE or MRE. Examinations were evaluated for disease activity using a novel scoring system and for the presence of LN, stricture, intra-abdominal abscess, or fistulae. Dichotomous outcomes were compared with respect to antibody status (high or low) using Fisher's exact test and logistic regression, whereas continuous outcomes were evaluated using unpaired t test.

RESULTS: GM-CSF Ab were elevated in CD patients (n = 114) with a median (interquartile range) GM-CSF Ab level of 2.3 μg/mL (0.5-6.6 μg/mL) compared with 0.6 μg/mL (0.3-1.3 μg/mL) in healthy and disease control subjects (n = 39) (P = 0.001). Ileal disease location was more common in CD patients with high GM-CSF Ab (P < 0.001). LN increased from 39% in CD patients with low GM-CSF Ab to 71% in those with high levels (P = 0.004) and remained significantly associated with high GM-CSF Ab in a multivariate logistic model, which included age, gender, small bowel location, and duration of disease. Stricturing prevalence on CTE or MRE examination increased from 4% in CD patients with low GM-CSF Ab to 19% in those with high GM-CSF Ab (P = 0.03).

CONCLUSIONS: Pediatric CD patients with high GM-CSF Ab levels have a higher prevalence of LN on CTE or MRE. Further study will be needed to determine whether medical therapy will reduce progression to stricturing behavior in these patients.
Click to expand...


From
http://www.ncbi.nlm.nih.gov/m/pubmed/23893081/



Increased prevalence of luminal narrowing and stricturing identified by enterography in pediatric Crohn's disease patients with elevated granulocyte-macrophage colony stimulating factor autoantibodies.

Authors
Dykes DM1, Towbin AJ, Bonkowski E, Chalk C, Bezold R, Lake K, Kim MO, Heubi JE, Trapnell BC, Podberesky DJ, Denson LA.

 
Nor I !! :D

MLP, I'm sorry he's still not feeling well. :( I'm also hoping it settles before testing! I have no advice to offer but just thinking of you. :ghug:
 
The big issue is Ds is not typical at all in how he presents ever
So Gi is being very cautious given the blip last week.
Just wish I knew when it was scheduled at least .
 
Now MLP! You aren't playing the game right. Wait means wait. Do not pass go, do not google!

But I do like your style...if you don't like the rules change the game to one we are really good at...Outguess the GI!

Waiting totally sucks! Especially when you have a child in pain. I hope the weekend passes without much drama and that you get that call first thing Monday and the appointment is an early one!
 
If you have to take him to ER, do you think you'd be able to get an MRE done? Or would they schedule a CT?
 
If he was at the ER
Things are really bad and they won't wait for the mre
I was only told at that point they would take care if things "in the hospital " if that was what he needed.
So I am not sure and didn't ask
Typically Er just does ct scans unless it's a brain thing .
Again not sure .
So far so good
 
Hasn't gotten worse
Still the same gets worse with movement/eating but reduces quickly
And lessens to next to nothing when he lays down
 
Spoke too soon pain up to 4-5 ( still ok to be home )
Bowel movement attempts , eating as well as other movements still increase pain
Gets better with heat but worse within minutes of removing the hot packs .

Assume it's still something crohns related .
Any theory's on guessing ????
 
Any chance it is back pain? My girl had a kidney stone a week after diagnosis. She was only comfortable lying down with heating pad. No pain on urination.
 
Thanks for the thought
Not his back or kidneys -due to arthritis and kidney issues he is good at pointing out those issues.
His pain is around the belly button.
 
My understanding is the belly button area is the TI area. My son has most of his pain there.

Hugs
 
:ghug:

Sarah: Atypical presentation. Ileal CD but pain for the vast majority of the time located in the epigastric region.

Matt: Classic presentation. Ileal CD with pain in the umbilical region that radiated down the RLQ. Described as a pulling/burning type pain. Always worse on movement.

Dusty. xxx
 
Any fevers MLP? For Johnny he would run low grade fevers along with the abdominal pain.

Any chance it's appendix related? That usually starts in the belly button area.
 
So far pain has stayed at 4-5
No fever -any sign of that we are to bring him in to the hospital .
Still eating and playing so far
 
I had this. I remember I had a mild cough for about a week, which wouldn't have been bad except every cough caused a stab of pain in my lower right. Sudden movements would do it too. Worse thing was driving as every bump would cause me pain (having a silly sportscar didn't help).

Hope you get some answers soon.
 
Comment about 'bumps while driving' reminded me of S's constipation pain. When he was about your DS's age, S had issues with constipation. When this happened, he was in quite a bit of pain, any movement caused pain, lying still alleviated pain. Don't remember if it hurt around belly button, but did hurt around LRQ. Initially, dr thought it was his appendix. Dr suggested glycerin suppositories and if that didn't help, or pain worsened, to go to hospital. We tried suppository, waited recommended time, S had BM and pain resolved immediately. Could constipation be the problem? And, not sure if there are any issues with using gylcerin suppository with crohns??

Hugs... :ghug: :ghug:
 
Thanks Tess for the thoughts
He has constipation as part of crohns but is on daily miralax and probiotics to keep from getting constipation.
BM are bristol 5-6 plus no pain relief with BM .typical 2-3 a day .

Funny about the car rides though ;)
 
Appendicitis , intuscession , obstruction , structures and just plain active crohns thickening are on the Gi's short list .

Add in Ds tests weird which then leads to more testing we have learned to test with caution .
 
Quite list to choose from...is there a none of the above choice? Forced to choose I choose appendicitis. How is he doing? Monday can't get here fast enough!
 
Still playing eating etc...
He has a high pain tolerance
Levels are steady at a 3-4 sometimes 4-5 so I am ok with the watchful wait for Ds.
List was just what we were told to watch out for .
Gi thinks it's crohns narrowing at the top of the list .
:(
 
BLECH! I don't like that choice! :voodoo: Can the GI pull some strings with the MRE schedulers to get you in super quick?
 
Will see on Monday ...
Once I have a date from the schedulers then I notify the GI to see if the docs ok with the date.
In the past the Gi office has worked their magic if they don't like the date .
Hopefully within a week to two weeks tops .
 
Mre scheduled jan 14th abdomen
Mri of pelvis -jan 19th
Gi appt 13th

After I begged for a sooner date original first available was jan 22nd
Fingers crossed thing remain the same or better until then
 
So good to hear you were able to move things forward mlp. :ghug: Well done!

Fingers crossed here…and toes, eyes, arms and legs! And hoping with all my heart your lad remains stable until then. :heart:

Good luck!

Dusty. xxx
 
So he still has pain
That gets better with rest -worse with sitting or standing etc.,
When laying down the pain is the same as standing up if he lays on his back
But drastically decreased if he is on his side or tummy

Any ideas why ????
Can't wait - see Gi and mre next week
 
This may have been already discussed... but I think ntussusception would be very painful in any position. Don't you think? During my son's surgery last march they video taped it and we watched it with the surgeon afterwards. He showed us that they happened to catch my son's small bowel doing the intussusception thing. They used the tool to pull lightly and it un-telescoped. (not a word I know! :)) They said it may have been a one time thing and because they were inching along his whole bowel feeling for thickness, etc. (they saw it on the way back down) They didn't think it'd do it again because they checked that area really good to see if there was something causing it. It was kinda confusing. Sorry I'm not explaining it better. They did say it would be painful.
 
MLP,
Did they check him for appendicitis? Any fever? do you think it warrants a call to the GI? Does he seem worse?
 
He has been at the same level of pain for a week .
So far the highest level of pain (5-6 )has been the same as last Sunday daily.
Pain decreases with position or rest .
Still watching for appendicitis - no fever and heel strike does not elicite exteme pain.
Also told if there is any signs of fever or worsening pain = Er


Gi was watching for intussception on Christmas eve since he had severe pain (7-8) with panting . It hasn't gotten that bad again - if it does we are intructed to just take him straight to the hospital and call on the way - don't wait for a call back

He is still functioning so not as concerned since its been over a week.

It's just not like the last time when he had visceral sensitivity after the inflammation was treated .
So that does have the Gi and I concerned.
 
Glad the pain has not worsened. Keep us posted. Praying he feels better and this is just a bump in the road.
 
Thought of you the other day when I was at school. A mom came in with her daughter who had a burst appendix for a week and no one knew. Crazy.

Glad to hear things aren't necessarily worse, but sure hope he feels better soon.
 
I'm relieved to hear it hasn't gotten worse but I sure do hope he finds some relief soon. HUGS
 
For those playing the home game
Pain worsens if he pulls his belly button in as far as he can or out as far as he can
Laying in his stomach or back have a higher level than on his side

He sees gi in the am
And mre weds
 
Appt done
Gi was very concerned and ordered more tests.
Including bloodwork
Once we have the resuls then next steps will be discussed .
Very long list of could be 's for Ds
Hoping testing will shorten the list quickly
 
Hello, i have similar symptoms for a month now, but since last week I cant even walk, every movement gives me pain, every cough and every move, only lying down helps. Waiting for MRI now.
Did the pain stopped in ur situaton? What doctors found?
 

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my little penguin
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