<s>[INST]My 4 yrs old grandson has been having vomiting but only in the morning.  Has a high wbc. 13000. Has had u/s that was normal and has seen doctor 3 times.  Waiting for other bloodwork that will be back tomorrow. He c/o stomach pain around midabdomen.  He does not vomit after 10am only in the mornings.[/INST]Hi, Thanks for asking. Based on lab reports and clinical findings, my opinion is as follows:1. Vomiting early in the mornings could be due to gastritis. 2. Stomach pain around mid-abdomen also confirms a possibility of gastritis due to improper food habits.3. WBC of 13000 for 4 years age is normal. You are looking at it in comparison with adult values of 4-11 thousand. Its only gastritis, try to improve the diet. Any further queries, happy to help again.</s>