For about nine months, just about every day, my 14 year old son, who has type�1 diabetes, has been complaining of abdominal pain which he says feels like something is exploding in his right side to both his family doctor and endocrinologist. They did a ultrasound of the gallbladder, an upper GI (which were normal), and a CBC which was also okay, except for elevated eosinophils. They have this kid thinking it is in his head. His endocrinologist said if he keeps complaining, they will do an ultrasound of his liver. My son has a problem with high blood sugars and currently is using the continuous glucose monitoring system for 72 hours to see what’s going on. What other tests can I request for the abdominal pain?

It’s impossible to make any diagnosis without a complete history and exam, and it sounds like they have already done a lot of tests. Large swings in blood glucose levels can sometimes produce such symptoms as can nonspecific constipation.

Occasionally, celiac disease presents like this, and celiac disease can be subtle but co-exists with type�1 diabetes in about 5-8% of kids in our practice. The best test would be a tissue transglutaminase antibody.

Lactose intolerance sometimes causes such problems as excess gas is produced. Avoiding all milk products for three to five days — if the pains stop and resume when milk is reintroduced, then this is a likely culprit. Go back and check with your son’s doctors; perhaps get a GI consultation as well.

SB

[Editor’s comment: If your son’s blood sugars are continually high, and he has ketones, this could account for the pain. If this is the case, improvement in control should alleviate it.

SS]