<s>[INST] My son has been sick on and off for 6 weeks, with stomach pain, loose stool, low energy and very pale. No fever, but looks weak and pale. In the last two weeks he woke up screaming with stomach pain and we took him to the emergency twice. They thought he had a viral infection first time and sent us on our way. Didn't even see us the second time. The pain is acute and only lasts at that intensity for few hours at the most, so he presents fine at emergency, eating, drinking, no fever etc. Walk in clinic ordered an ultrasound (came back normal, thought he might have intestinal swelling) and blood work. Blood work came back with high hemoglobin, hematocrit, red blood cell count and platelet count. Most others were close to being high too. What could this mean? [/INST] This is the classical case of polycythemia vera. it is a abnormal increase in RBC, Platelets, granulocytes. This increase leads to abrnormal high hematocrit. many a time it will cause blockade in the small blood vessels like Gastro Intestinal Tract in your case. and leads to ischemia and resulting in pain. consult hematologist near you and start the treatment accordingly. thnx </s>