I have an 8 year old daughter who has been generally healthy. She had some issues with seasonal allergies and had her adenoids removed at age 3. As an infant she had reflux and milk sensitivity which she outgrew She has no known food allergies and has been a relatively good eater. While she is small for her age she has always been on the same curve on the growth chart and the doctor has done a variety of lab work (including chromosomal testing) along with bone age X-ray to rule out any concerns. She grows over two inches each year and is proportioned. At the start of this school year (and last year too) she started complaining of stomach aches mostly in the morning at breakfast. She looks like she forces herself to eat and at times(not often) will vomit a small amount of what she just ate. Occasionally this will happen at dinner time as well. She has not lost weight and is generally happy though she has been very anxious and worried about school this year. She is in a new building, new teacher, new friends and is very vocal about her anxieties about school. Her bowel movements were pretty regular though I notice now she may not go every day and when she does, she strains and will sometimes only evacuate a small amount. The pediatrician suspected reflux and we had a referral to a Pediatric GI. The GI didn't think the issue was reflux instead said that on exam he could feel she was constipated. He did a fecal occult test and found trace of blood in her stool. He seemed a bit surprised by this even though the morning of the appt she strained really hard to go and said it hurt badly. He wants her to do a miralax clean out and follow up in two weeks. He said if there is still sign of blood he would like to do a colonoscopy. I should note that the pediatrician ordered lab work including abdominal panel, CBC. ESR, celiac, food allergies etc and everything was normal. I do not want to see my child in discomfort and want to get to the bottom of all of this but concerns me to think about doing something so invasive on a child. He said it could be polyps or IBD. How likely could that be given all her lab work and symptoms. I would have guessed the issue is more reflux given the vomiting, and frequent belching etc. Any advice would be greatly appreciated!
Most likely the blood was from a hard stool and not from any other source. However, anything is possible. I think that the GI doctor is right on track. A cleanout, followed by stool testing for blood is an excellent idea. If the blood is negative, then she will probably be continued on daily Miralax for a while. If the blood is positive, then the further tests need to be done.
If one suspects reflux and everything else is fine, we often do a trial of an antiacid med for a month or so to see if this works.
Good luck, Dr. Olson