If I give you the symptoms will you diagnose?

[BeeEm]

So perhaps i'm clutching at straws or being a mad paranoid overprotective mother - BUT -
here's the symptoms
9.5 yr old DD.
constant nausea
depressed
clingy
tummy pains
behaviour 'issues' temper tantrums school refusal
poor diet - v picky eater
constipation
strange pale poo sometimes
behaviour always better after being persuaded to eat something
not anaemic, thyroid and liver function normal
v skinny
GP has referred to Paediatrician and CAMHS (school nurse thinks is all depression)
Now i know you lot can't tell me definitively that A B or C is the matter but would anyone think i am barking up the right tree or just barkin?

Honestly couldn't tell you (obviously) BUT nothing on your list screams allergy or intolerance at me. The symptoms you describe (such as nausea, tummy pains, constipation) that can be allergy related could simply (!) be down to not eating enough/ eating a wide enough range of foods. Esp. as she often feels/behaves better after eating something (if it was an allergy/intolerance you'd expect it to sometimes go the other way).

Depression, combined with a poor diet, could I think account for pretty much everything on your list. Or I guess the depression plus everything else could be the symptoms of some unknown illness.

Sorry - I'm not much help, am I ?

I don't think you're mad, or overprotective, by the way. Something obviously is wrong - will be interested to hear what others think.

I hate the way the medical profession label eevrything depresion! If you had stomach pains and nausea you'd be depressed and a picky eater too!

First what does she drink? Constipation and nausea can be symptoms of dehydration. If you can get hold of the detailed results of her blood tests it is something doctors don't check on - and they should. If you can persuade her to drink water or smoothies some of her problems may disappear. She may be less of a picky eater when she doesn't associate food with pain.

It doesn't really sound like allergy/intolerance more like food aversion caused by the stomach pains. However if getting more liquid into her doesn't help I would probably try eliminating wheat or ideally gluten. There are plenty of gluten free foods she can have for a couple of weeks.

If you can get a fish oil supplement into her that is helpful for depression and behaviour issues. If she'll eat nuts walnuts are high in fatty acids.

Keep a detailed food diary - and I mean list all the ingredients of her food and everythign she drinks - to see if you can match up problems to food.

Has she had the blood test for coeliac disease? Quite often GPs think that you can only be coeliac if you have diarrhoea but constipation can also be a symptom. The other symptoms depression, strange pale poos, behaviour issues can all be attributed to coeliac disease as well. I thought my DS change in behaviour was because he was becoming a teenager but after diagnosis and removing gluten I had my sunny son back. It may not be but it would be worth investigating.

Equally it could be that she is wheat intolerant for example - a friend had severe behavioural issues with her DS (including violence at school) which were sorted out by removing wheat from his diet.

You must be on a normal, gluten containing diet for the coeliac blood test to be valid so don't experiment with removing wheat/gluten before that is done. Good luck in tracking down what is causing the problem.

Hi, I know 9.5 is quite young but could it be the start of puberty? I suffered quite a lot before I had my first period at 11 - do you think it could be related to this at all? Is it worse at certain times of the month?

Couldn't the poor diet and subsequent constipation be a cause of the other symptoms?

I was also thinking of coeliac disease. My 8 year old DS has just been diagnosed with this. Low mood is often a feature of coeliac disease in children and a lot of the other symptoms you list would fit too.
Have a look at the coeliac society website www.coeliac.co.uk. Your GP should do a simple blood test in the first intance, then further tests if that proves positive.

I was going to say gluten issues (whether coeliac or not).

have you considered seeming a homeopath. I think they are really good at diet/emotional related stuff.

probably not relevant to all her problems but does she do any excercise/ outdoor activities at all? i only ask because it's something which is always recommended for adults who suffer depression so i imagine it would help kids too.

this would also increase her appetite which i agree with Tinker could well be causing a lot of her other symptoms. agree also that the onset of puberty might be another possible cause/factor.

it's possible that there isn't just one over-riding cause of the things she's experiencing. it could well be a combination of different factors which just happen to coincide.

other thing I forgot to ask about is school. If there are problems there (bullying or just smelly toilets?) it can also cause some of the problems you are describing. Should have asked about that before as you mention school refusal. Does she have friends who visit the house? I found with one of my children that it was better to get information from their friends than to ask them direct. I'd also be inclined to quietly check out the toilets at the school!

Depending on how long you are going to have to wait to see a paediatrician you may have time to experiment first. Although Coeilacs are under-diagnosed suspect other explanations first.

Cheers for the answers.
Don't think it could be puberty - i think she's too skinny! also not worse at a particular time of month. she does exercise - walks to school, rides bike - or at least did until she began to feel too awful. I was thinking wheat/gluten but was also erring on side of caution not wanting to jump on celebrity band wagon or making any issues but may indeed be worth looking at. will contact G.P again tomorrow. And yes i do think there are lots of small factors all contributing but did want to run it by some wise women before getting my pants in a twist (again)

There is no harm in a wheat free diet. You could always try and see what happens. It does mean a lot of work, having had to be wheat free myself at various times. Nearly every packet mix or ready made food has wheat products in it. If it is that you should notice a change reasonably quickly, but I would say if there is not change after 2 weeks it might not be that. I certainly noticed the difference within days myself, but it can take different bodies longer IYNWIM.

Forgot to add-do NOT cut out gluten before having her tested as they will not be able to do the test for coeliac disease unless she has gluten in her diet. Your GP should be able to do the screening test without referring her to a paediatrician. It really is worth asking for it to be done. I have 2 DSs with coeliac disease-the eldest was only diagnosed a couple of years ago (and he is in his twenties). I had been fobbed off throughout his childhood with various reasons for his being so underweight. I really wish I had been more forceful now-some of the effects on him of being undiagnosed are long-term(lack of bone density for example.)

Salute pasta - available from Sainsbury's is really great gluten and wheat free pasta. It is sold in the larger Sainsburys. And is much much nicer than some of the other brands. It is so close to normal pasta that even my DH eats it.

If you are cooking any wheat free pasta, the trick is to make sure the water is boiling before adding the pasta and don't over cook it. otherwise you end up with a white soupy concoction!!!

Oh sorry other sources of carbs are polenta and potato!

You siad she is a fussy eater. what does she eat?

Good point Tiggiwinkle!

Just a random thought from me - as your dd has some similar symptoms that my dd had as a baby. Paed eventually gave us metronidazole (and AB) in case it was a persitent giardia infection. Giardia
Not sure if it was this or not, but a few weeks later her symptoms went - after over 2 years of issues. Might be worth a thought (dd was lactose free during that time, but issues continued. Tests for coeliacs inconclusive and didn't want to go down the biopsy diagnosis route as she was so young).
Good luck - I wouldn't be all all surprised if her emotional/behavioural issues were health-related as others have suggested...

I agree with the diagnosis of coeliac disease - all the symptoms are consistent with it. Your GP should be able to arrange the blood test. If that is positive, the definitive diagnosis is done by biopsy (my brother and I have CD). Your DD will then have to follow a gluten free diet for life.

If negative, giardia is also possible (DS was tested for CD, but turned out to have giardia). The cure for giardia is a course of antibiotics.

The symptoms you describe sound very like those my DD1 displayed prior to her coeliac diagnosis. Her problem was more often constipation than diarrhoea, she was very lethargic, her complexion was grey, she was tiny (she was 2.10 when diagnosed and hadn't gained any weight for over a year - my DTs, 20 months younger, weighed the same as she did), she was clingy and weepy.

If you think it is a possibility, then she will have to stay on a normal diet while the tests are done. This will involve an initial blood test, followed by a biopsy of the intestine to confirm the diagnosis if the blood test is positive. But if she is coeliac, then once she is on the gluten-free diet, she will be a different child very quickly. My daughter was transformed in 2 weeks and 18 months later had gained 45% of her weight at diagnosis and grown 14cm!!

I hope you find out soon what the problem is. Feel free to CAT me if you'd like any more info.

Thanks for your replies. I really don't know if I'm barking down the right route - I know that a girl can pick up a medical encyclopaedia and have symptoms for any random illness but my gut feeling (see the joke) is that all her probs may be diet related. Have appt with GP tomorrow. will throw my considerable weight around and demand a few tests.
She refused to go to school again today.

Hmm...

How is her weight? Coeliac - or other gluten intolerance problems, but especially coeliac disease - often causes problems with the absorption of other nutrients in the food.

My DS2 stayed resolutely on the 2nd percentile for weight from the age of 18 months until we took him off gluten at the age of 4. He was on the 25th for weight within 2 months.

If weight's a problem and gluten is the cause, you'll see a pretty big improvement pretty quickly.

Note however, tkband3's advice above not to take your DD off wheat before any coeliac test: it could reduce the strength of the result.

Let me/us know if this is the issue - you'll probably be wanting advice on gluten-free cooking...

How did it go at the GP? Hope you got some satisfaction and your DD has been referred for further tests.

Well
GP wasn't keen - could see her mentally labeling me after i'd already explained that i'm not that mad or paranoid and haven't got munchousens . but agreed that if DD is up for another blood test she'd do it so have got appt for next Tuesday.
since then have been feleing a bit mad/paranoid - maybe i'm reading into things too much, maybe she is just depressed/psychotic.
Last week at a particularly low moment I decided she had all the signs of Aspergers.
Next week i'll have diagnosed her with something else - Ebola perhaps?
It has to be said that if she does turn out to be wheaty/gluteny/coeliacy she'll probably starve as all she does eat is bread and biscuits with the occasional potato or chocoalte thrown in.
Oh and another Q - if blood test is negative is that conclusive? or can you be intolerant without a positive coeliac test?

If the blood test is negative, it doesn't necessarily mean that wheat/gluten isn't a problem. There is such a thing as a false negative test - they are not 100% foolproof, although I think they are much improved recently. But it could be that although she is not coeliac, she cannot tolerate wheat/gluten. If that is the case then you could try eliminating it from her diet anyway to see if it makes a difference.

There is a massive range of gluten free foods available now. All the major supermarkets do their own range - bread, biscuits, pasta, cereals, gravy, stuffing, naan bread, pitta bread, pizza, sausages, fishfingers! They are a bit more expensive (if you are a properly diagnosed coeliac, you get quite a lot of dry goods - pasta, bread etc - on prescription which is really helpful, particularly for a child). But your DD would definitely be able to continue eating bread and biscuits .

If this is her staple diet though, then it does sound like this could be the problem. It becomes a bit of a vicious circle - what she eats makes her uncomfortable and gives her tummy ache, so she doesn't want to eat anything else. Certainly with my DD, her eating habits improved dramatically once she was diagnosed and wasn't 'scared' of eating any more.

Hope this is helpful and not too much of a ramble . Feel free to ask any other questions.

As tk says, a negative blood test is not conclusive (a positive is pretty much certain though-a bit like a pregnancy test!) If the test comes back negative, I would ask for referral to a paediatrian who can organise more tests to confirm a diagnosis.
My youngest DS, who has just been dx with coeliac disease aged 8 does have Aspergers by the way! His diet was extremely limited anyway as a result of the food avoidances due to the Aspergers. His favourite food was cereal, so the diet has been something of a challenge! The improvement has been almost immediate and dramatic though. One of his teachers, who has known him since he was 4, said the other day that it was the first time she has ever seen him with colour in his cheeks. Behaviourly, the teachers have also noticed a big change-he is actually going up and initiating conversations for instance, which he would never have done before. He also has much more energy-he loves playing football but used to get tired and breathless very quickly-he has much more energy now. And we only started the diet about 6 weeks ago.