DD15 ongoing diarrhoea problem

[YourGladMember]

DD15 been suffering with stomach cramps and Diarrhoea. Been going on for more than two months now. Some days worse than others.

Been to see GP a couple times but they didn't seem at all too concerned and didn't really offer any advice or what could be the cause.

Eats a very clean diet so it's nothing to do with her food unless she has an intolerance to something.

Sounds like constipation

Try ruling out the common contenders and see if it improves, I'd start with dairy and then wheat.

Loose / frequent stools or actual diarrhoea?

So many possible causes at that age... IBS, food intolerance, stress, period related....

Keep a food / symptom / poop / feelings diary for a month and see if you can detect a pattern.

Any blood, mucus, dehydration them go back to GP sooner.

It's a mix sometimes just loose but sometimes full diarrhoea. Always frequent.

Yeah will try I mean she doesn't eat a lot of dairy or wheat very minimal amounts but worth trying.

That might be the culprit then, there was some research done and scientists found that some people with food intolerances naturally avoided them where possible despite not knowing that food was an issue for them. Maybe look for it in things where it is more hidden and not so obvious, like there is wheat in gravy granules etc

If it's daily then sounds more likely to be diet / gut than stress or period related but...

You said it started quite recently, any recent foreign travel, any big changes happened? Has she started taking any new meds? Pill etc? Is she otherwise happy/ well?

Had she got any issues about food or weight? Any chance she might be using laxatives for weight loss?

Lactose, dairy, wheat or gluten are the usual suspects to start with if you are trying an exclusion diet. Be careful if she has any issues around food as it can worsen any existing eating disorders.

At that age it might be easier to remove one at a time for a few weeks. A diet that is free of all of them is pretty unappealing! https://raisingchildren.net.au/toddlers/health-daily-care/allergy-intolerance/food-intolerances

If there is any blood or mucus in the stool I would return to the gp and ask for blood tests to check for anaemia and inflammatory markers. Stool tests like faecal cal protectin and Qfit may also be suggested to check for inflammation and blood respectively.
If IBD is excluded it may just be IBS

You say she eats a very clean diet, too much fruit causes diarrhoea. Try the BRAT approach, add banana, rice and toast and see if that improves it.

No recent travel or big changes at all really. No meds either and is generally happy overall yes although she does have some bad days especially when stomach cramps are really bad and toilet visits frequent, especially if its a school day.

No weight issues. Is a healthy weight.

Yes will try removing an item at a time from her diet.

Cut out dairy and gluten.

If it continues ask for her to be tested for coeliac and crohns. With coeliac she needs to be consuming gluten for the test to be effective, so only try this if eliminating the above foods brings no improvement.

Sounds like IBS and i've had very similar. I got referred to a dietician a few years ago and got told I ate too well!! Too much fibre apparently. I still eat well but have to watch the amount of fruit and veg I eat and I eat very little dairy as that is a definite trigger for me.

God sounds horrible. How frequent are her toilet visits? Must be a nightmare managing this at school? Has it caused any problems at school is her school aware? Any real sudden urges/accidents?

You say despite having some really tough days with this issue overall she is happy which is really excellent and a testament to her character.

Would definitely do the trial and error eliminating foods from her diet, however you say you bee docs and didn't seem concerned. Perhaps get a second opinion as this been going on a long time.

She goes several times a day. School are not officially aware, she avoids eating or drinking anything the entire day so as to not have to go at school, although there has been a couple of times where she's had no choice. It's not a really a case she gets very sudden urges, more a build up of stomach cramps. She has had one accident unfortunately on way home from school.

Will look to get second opinion

She needs to start making a food diary of what she's eaten and symptoms. It might be really obvious what's triggering it when she writes it down. Stress will also make IBS worse, which doesn't help when you're already worried about making it to the loo in time! Not eating all day at school might be counter-productive though, I find it I eat little and often my stomach copes better (probably because it can digest smaller amounts at a time easier) and if I get really hungry before I eat again I get bloated and stomach cramps more.

Does she often have days where she struggles badly through the school day? As in really bad stomach cramps from holding her poo to the point she can't concentrate and potential worry of an accident.

The fact she also is not eating or drinking in the day it's not really healthy to continue to go through her days like this. Even though it may be tough and embarrassing I think you may have to mention this to the school. Hopefully they are really good about it and can facilitate a solution where your child can be able to go number 2 during the school day.

It sounds like overflow constipation. Been going through this for years with my ten year old. In her case it’s constipation, despite going most days. At our gastro appointment two weeks ago they didn’t think she was constipated but on x ray she was literally full of poo high up. She’s had to do a disimpaction and now we’re juggling daily laxatives and stool softners. Your first step is gp for a stool test to check for chrons and infection. If it is constipation though GPs don’t usually know much about it but they will prescribe stool softeners and other laxative type meds. How you use them is a bit more complicated. These people are knowledgeable
eric.org.uk

Might sound random, but is she chewing gum lots? That can have a laxative affect. Or diet coke, anything with sweetners

This sounds like it’s really affecting her. I have severe bile acid malabsorption which causes diarrhoea and easily managed with medication. I really think the GP needs to at least arrange some bloods as things like crohns and colitis, coeliac etc need ruling out as a start.
Poor girl she shouldn’t have to be not eating and having poo accidents and they certainly need to take it more seriously.

Regarding constipation wouldn't that mean she is finding difficult to go, which is the opposite of what's described, or op does she having any pain when on the loo? Does she also have any leakage I.e poo stains on her underwear?

I second this, I had the same from childhood and only diagnosed it in my 30s. There are intolerance tests you can buy online, you'd be surprised what triggers it. Mine included lemons, dairy, wheat, cranberries and even broccoli.

Please make another GP appointment ASAP. She needs her calprotectin levels checked. Do not let them fob you off. If her levels come back raised then ask (demand) a referral to a gastroenterologist for a colonoscopy.

I'm not meaning to worry you but this was me at 16. They fobbed me off for months. By the time I'd got a referral to the hospital I was desperately ill. I eventually got a crohns diagnosis.

This was what I was like before I was diagnosed with coeliac disease. Ask the Gp to test her for it but do not cut out gluten or wheat first as the test won’t be accurate