<human>: My 13 year old daughter has been having stomach pain often for years.  We have always thought this was lactose intolerate and that she should avoid milk products as much as posible we use moderation.  This has worked but recently(2-3) they are getting worse.  These are the things I have been thinking Reflux, Food Allergies  She does have cramping at her period time but controlled with pain relivers.  We are going to her doctor today any suggestions on bloodwork labs testing to recommend to her.  I cant handle it anymore I have kept telling her for the longest time youll be ok but maybe something really isnt ok.
<bot>: Hello. Thank you for asking at Chat Doctor. I went through your daughters' history. From your history, I would first think of chronic gastritis or gastroesophageal reflux disease. I would like to make suggestions to you as follows:1. If she has never been tested for food allergies, I would suggest testing for food allergies, especially, milk, peanut, wheat, soy, eggs, tree nuts, fish, shell fish. She needs not to be tested for all the foods above, choose the foods she is normally/frequently eating. Food allergies, especially milk protein allergy, can cause chronic gastritis. It important to know that milk protein allergy is not same as lactose intolerance. One has to avoid milk and all milk products in milk protein allergy.2. For treatment, I would suggest her a 6-8 weeks course of antacids like omeprazole or pantoprazole before each meal. It is important to remember that she should take continuously for minimum 6 weeks even she is free of symptoms as complete healing of inner lining of stomach/esophagus takes 4-6 weeks.3. If she has to take frequent pain relievers, I would suggest preferring paracetamol to all other pain medications. All other medications like ibuprofen, diclofenac, mafenamic are notorious to cause gastritis. Paracetamol is considered the safest among pain medications in terms of gastritis.4. I would also suggest her to avoid hot & spicy foods as well as caffeinated beverages. A soft, bland diet is would be the best.  5. If she does not improve with above measures, I would think of H.pylori infection and treat her with appropriate antibiotics after necessary tests. Hope above point will be useful to you. Wish your daughter a quick recovery and the best of the health. Should you have any further query, please feel free to ask at Chat Doctor. Thank you & Regards.