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Colorectal Diseases

Constipation, elevated WBC, vomiting

05/31/2006

Question:

I have a six year old son who has been diagnosed with "colonic inertia" and has been chronically constipated for about 3 years. The diagnosis was made after he was admitted to the hospital with severe, uncontrolled vomiting. They found that he had elevated white blood cells, dehydration and large amounts of stool present. He has been hospitalized 6 times in the last 3 years with these symptoms. Each admission to the hospital has resulted in a different diagnosis or an "unknown". Most often, we have been told that it "might be viral", but none of the tests for viruses have been positive. We were also told that constipation caused the vomiting. He is on a high-fiber diet and takes Miralax and Benefiber. He has has a barium enema which showed retained stool. The most recent hospitalization was two weeks ago. The vomiting was again severe and scary. It was difficult to keep him awake and he seemed unaware when he was awake. His WBC count was 17000. Suspecting apendicitis, they did a CT scan. The scan showed that the lymph nodes around the apendix were enlarged. Again, no real cause for the illness was discovered. Most recently, my son has experienced a few episodes of extremly rapid heartrate while at rest. His blood pressure and breathing were both normal. I am at a loss. He has seen several Gastro specialists and pediatricians. None of them agree about what the problem could be or what the treatment should be. What type of doctor should I seek help from, perhaps the constipation is a symptom of a larger problem? Surely 6 hospitalizations with the same symptoms is not normal. Any advice you can give me would be greatly appreciated. I`m a little scared and very desperate. Thanks in advance,

Answer:

You need to consult with a specialist in pediatric constipation, such as Dr. Mark Levitt at Children's Hospital in Cincinnati. There are not many such specialists who treat this problem, so I would recommend an e-mail or phone call to him to see what should be done. Good luck!

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati