<s>[INST] I have a 5 year old daughter who has been having chronic stomach pain for the last two years.  They come and go.  Usually in the middle of the night.  they last for an hour or so.  She throws up and then she is fine.  Done all the test and eliminated suspected food.  Nothing has helped.  Any suggestions? [/INST] Hi.Thanks for your query and proper history. I can understand the plight the child and you must be going through.Your daughter is just 5 years old and hence the causes of pain in the abdomen for the past 2 years can be as follows. The most probable cause of pain in a child -Tummy tonsils- meaning enlargement of the lymph nodes of the abdomen.-Appendicitis- by default this has to be ruled out in every case of pain in -abdomen of a child.-Worms.The best diagnosis is a high resolution ultrasonography. some blood, urine and stool tests.A therapeutic trial with a course of an antibiotic, metronidazole and probiotics under the guidance of a pediatrician / Surgeon always helps to solve the problem and to get a diagnosis.Also given is a dose of medicines active against worms in intestine.I hope a consultation with a Pediatric Surgeon, investigations and a course of an antibiotic and metronidazole should solve the problem.If this is indicative of appendicitis , please go for the surgery of appendectomy. </s>