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My, otherwise healthy, 14 y/o son went to the ER early morning with severe abdominal cramping above his navel area. The area was also sore and he had diarrhea. He wasn’t running a fever and had no other symptoms. The ER did a complete CBC, rectal exam ( for blood in stool) and urinalysis. All were normal. They did a abdominal x-ray which was normal with the exception of lots of “gas” and possible edema which could suggest Inflammatory bowel disease of some type. A abdominal CT with contrast was complete and it was normal with the exception of the gas. He was given some medication for the pain associated with the cramps. He is still having these fleeting cramps 24 hours later. They come and go. He has no other symptoms, no fever, no blood in stool and has had one solid bowel movement since. The ER discharge stated that if the cramps had not subsided in 72 hours to see his PCP. Any ideas on what could cause this colicky pain with but there are no serious issues after tests?

Answer
Hi, SLayde,

It is always interesting to read questions carefully, for the wording can sometimes give me clues as to the background of the writer.  I may be wrong, but the term "colicky" is not common in the lay vernacular and I suspect you have some medical background.

He had an extensive and appropriate workup that has eliminated acute medical emergencies like gall stones, kidney stones (to a large extent) and especially appendicitis.  Did they do a test for inflammation, like an ESR or CRP?  This sometimes is helpful to rule out inflammatory bowel disease like Crohns or ulcerative colitis.  A lipase is sometimes helpful to lessen the chance of an pancreatitis.  

This may have been a weird GI virus or a food poisoning.  These things can be sneaky, self limited, and can't generally be detected by conventional tests.  

If he is generally improving with less crampy pain and having good bowel movements, I would chalk this up to an unexplained "thing" and just be sure this is not a recurring event.  If he is better, in my mind no further stuff needs to be done.

Hope he is better, good luck, Dr. Olson

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David Olson, MD

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I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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