### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
my daughter has had abdominal pain and severe nausea for a while..and has lost 30pnds over the past 6months.they removed her appendix due to a cat scan that showed inlamation on the tip of the appendix.Prior to the surgery,she had a sonogram,colonoscopy and an endoscopy done.All were normal,including her bllod urine and stool tests.The surgery was done 6weeks ago,and she is still having abdominal pain and severe nausea,I also noticed her legs,both..are covered in bruises.Do you have any suggestions on what to do next..the drs are stumped.

### output:

Hi ! Good morning. I am Chat Doctor answering your query. I am not aware if an intestinal mucosa biopsy was done during the endoscopy and colonoscopy or not, which was a must. If done, you did not mention the report of the biopsy. When all the tests mentioned by you came out to be normal, this compels me to think of possibility of celiac disease/gluten sensitivity which goes very often unsuspected and missed, specially if your daughter was used to eat fried, oily, and fast food from outside. This is not easy to diagnose, and the best way is to exclude all kinds of fast food you consume in outside eating joints. Gluten sensitivity could give rise to all the symptoms you have described including your weight loss, abdominal pain, nausea, and over and above, low platelet count which might have resulted in the bruises. A platelet count and clotting profile is indicated in this case. It is usually not thought of and is under diagnosed. Also, if you are from a developing country, tuberculosis not infrequently could give rise to such symptoms of your daughter. I suggest you to consult a gastroenterologist along with a dietician on this aspect of the diagnosis, which possibly might not have been considered until now. The gastroenterologist will be able to diagnose with few biochemical tests along with a possible repeat endoscopy with biopsy of the intestinal mucosal wall, while the dietician can guide you on your daughters' food that she can consume pleasantly. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor.