Concerned Mom, looking for advice

[Tummyhurts]

Hi, I wasn’t sure whether to post in undiagnosed or in here, I myself have had crohns for many years but my 9 year old daughter is the one I have questions about. She had a bad respiratory cold a month ago, but has continued to be extremely nauseated on and off since then. The bouts of nausea can come on suddenly, and randomly. She is struggling to eat, low appetite and has lost some weight. She lightly plays when she feels well but not like she usually does. She naps and sleeps in later which is new for her. No pain or bowel issues currently.

She had blood work done, CBC, CMP, CRP it was normal except slight elevated bilirubin. We are currently waiting on GI referral so we can schedule appt.

Last year after another virus she had mild diarrhea that kept going on, or would come and go for a while after but eventually went away altogether.

Of course my question is could this be crohns without pain, and only current symptom being the nausea?

Also does anyone know if there is a connection between crohns being “activated” (in a genetically susceptible person) by a viral infection? I feel like I read this before somewhere?

Do you think the bilirubin (it was 1.1) has any significance?

Lastly, any recommendations for what we can do while we wait? Is there an over the counter nausea med?

Currently doing mild meals, with pediasure to fill in with the eating struggles, lots of rest and fluids, and ginger chews (I don’t think they help much though).


Thanks you guys

 

[Scipio]

Also does anyone know if there is a connection between crohns being “activated” (in a genetically susceptible person) by a viral infection? I feel like I read this before somewhere?

Just about every sort of microorganism has been implicated in one study or another in triggering Crohn's disease, including viruses: cytomegalovirus, Epstein-Barr Virus, and measles virus, Plus I'm sure there are more too, plus a host of bacteria and even fungi.

None of them have been proven as the definite cause/trigger of Crohn's.

 

[Pangolin]

I don't really have any suggestions on nausea or what the cause might be, but odds are good that this isn't Crohn's.

Classic Crohn's symptoms would include abdominal pain and diarrhea 3+ times per day persisting for a long time, and labs would usually show low hemoglobin and signs of inflammation such as high crp. Nausea can happen with Crohn's but isn't really characteristic of it.

 

[Maya142]

One thing I've learned over the years is that kids do not always present "classically." My daughter's symptoms were abdominal pain, weight loss and some constipation. No diarrhea before diagnosis and she had ulcers in her colon and a very inflamed and friable terminal ileum (the last part of the small bowel) when she was scoped. I do remember nausea being one of her symptoms.

Some kids do present with the classic diarrhea and abdominal pain. Others have no GI symptoms at all and are referred to GI because they've stopped growing and gaining weight. I know one child who presented with joint pain and fever and weight loss - no abdominal symptoms at all. It really varies.

It's a good sign that her inflammatory markers are normal and that she's not anemic. It could certainly be something else - reflux can cause nausea, as can motility disorders like Gastroparesis. Gastroparesis is delayed gastric emptying (so food leaves the stomach extremely slowly) and symptoms are nausea, feeling full after eating only a little, vomiting, abdominal pain and weight loss. Not all kids have every symptoms. My daughter has Gastroparesis in addition to Crohn's and her main symptoms were extreme nausea, particularly after eating and being unable to eat much (which of course led to weight loss). I'm mentioning Gastroparesis specifically because it can be triggered by a virus (as can Crohn's). The treatment is motility medications, small but frequent meals and supplementing with formula like Boost or Pediasure if necessary for weight gain.