What are the recommended diagnostic next steps and potential differential diagnoses for a pediatric patient experiencing severe, episodic abdominal pain that has shown only temporary response to empirical antibiotic and analgesic therapies, despite completely normal findings on multiple abdominal ultrasounds, complete blood count, C-reactive protein, serum amylase, urinalysis, and stool tests?
Since his ultrasounds and blood tests are normal, which is very reassuring, we can look into other possibilities. This episodic pain might be related to functional abdominal pain, abdominal migraines, or food sensitivities like celiac disease. As a next step, I highly recommend consulting a pediatric gastroenterologist. They may suggest further specialized evaluations, such as celiac serology, a stool calprotectin test, or a food diary.