to go to A&e with my dd3 *pictures*

[littlemaemae]

My DD who is 3 has been having stomach/bowel problems for the last year. Diagnose as constipation. She can not pass a stool for weeks despite fantastic diet and laxatives and weeks is in severe pain most days. She is very petite and skinny but her stomach has swollen to look 9 months pregnant. Getting no where with doctors/hospital etc.
Aibu to think this is not how a heathy child's stomach should look.

A&E will not do anything about this except advise you to go back to your GP/consultant. Having just grabbed my own 3 year old to compare, your DD's abdomen is a little distended but not much different. A&E are certainly not going to want to subject her to an abdominal X-ray just to show that she is indeed constipated.

The effects of increasing Movicol do take time and the leaking stool is a very unpleasant but necessary stage to allow the impacted stool to soften sufficiently to be passed. Often it takes a surprising number of doses over a long period of time to deal with things along with a lot of patience.

Trying to find the way to word this gently, but I would imagine that your anxieties are not helping you or her either. She doesn't "look 9 months pregnant". I think going back to your GP to discuss her and how this is affecting you both would be eminently sensible, as well as following their advice on the Movicol.

We really need a before pic in order to gauge how distended your dd's stomach is, you clearly feel it is not normal for her so I would go to the GP and ask for an urgent appointment. A&E have scanned people I know and discovered impacted constipation for which they have given enemas before. The GP may refer you?

Although I should have said that DOES look very swollen to me in the other pics you put up. My DC had protruding tummies but that looks quite distended.

How much have they advised you to increase the movicol by? There is either a disimpaction regime where you go up in twos until you achieve tidal waves of poo, then back to a maintenance dose.

The other option is to increase the daily dose. DD has had this problem for years, we were veering between 2 sachets (diarrhoea) and 1 sachet (no action). The last couple of weeks we have been advised to up it to 4 daily. I thought we would be swimming in poo but actually it seems to be producing a daily bowel movement which is more formed.

So you might either need to do the disimpaction or to be bolder with the daily dose. Id suggest GP is likely to be a better bet. They were happy to give us an emergency appt when DD was in a lot of pain with it age 3.

Yes, sometimes you have to bypass slow doctors. She needs a scan I would have thought to find out why she is so constipated. It could be something else. This happened to someone's dd I know...she was 'constipated' for over a year, with the gp keeping her on laxatives and she was in intermittent pain. Then one day she had severe pain and was rushed to hospital - she'd had a benign cyst growing on her ovary for years. It was benign, I hasten to add - just needed removing.

So I say if you don't think the gp and specialist are getting to the bottom of the cause, go and tell them you have tried everything and that she is often in pain and it does not sit right with you that it is just constipation. At the very least it will confirm the current diagnosis. She is your child and you do what you think is right.

her chest and arms look quite chubby so I am not sure her tummy is much out of proportion tbh.

There are tens of THOUSANDS of emergency admissions for constipation in this country every year - it certainly can be an emergency, especially if there's considerable pain. Sounds like faecal impaction if you're getting the watery stool coming out but nothing solid. That in itself can cause problems as well as the immediate discomfort.

They may be able to do a (brace yourself) manual extraction - this is something that a hospital practitioner or nurse would have to do, it's not something your GP is likely to perform.

It's your call, of course - I think getting an urgent (same day) appointment for a child in pain with your GP is perfectly reasonable, and I also think a trip to A&E for a child in pain with possible faecal impaction is perfectly reasonable.

THose are just my opinions of course - I'd rather waste a doctor's time (and my own) taking an unhappy little one to A&E when it wasn't needed than stay away out of dithery worry. But then again we are always being told about people misusing A&E which ramps up the dithery worry!

I suppose all I'm trying to say is whatever you do will be the right thing.

Yes, sometimes you have to bypass slow doctors

This is absolutely not what A&E for. If you're not happy with the response from your GP then you have the option of asking for an appointment with a different GP at the same surgery or moving to another practice.

OP could you ring your Consultants secretary and ask for her next review appointment to be brought forward?

My dd (9) had a swollen tummy and severe pain for months, she was sent home from school most days crying. Dr told us it was a bug, then said she was constipated, eventually we were referred to a specialist who diagnosed her as lactose intolerant. We've had to cut out so many things from her diet including some flavours of crisps and I have to check the ingredients of everything in case it contains lactose. Might be worth trying a lactose or dairy free diet see if that makes a difference. Hope she gets better soon x

Has the specialist scanned her stomach? If not I reckon she should have one just to check what is actually going on in there. It's good you are seeing a specialist, but in my experience there are a few that just aren't too great. I'd tell your GP what you've said on here and that you don't feel happy to carry on with things as they are as dd is often in a lot of pain and distress. I'd press for an urgent appointment and if in the meantime dd's pain gets any worse or lasts longer, then I'd take her to A&E. As rickety says, she is your child and you know her best and if you aren't happy then follow your instincts.

York did you read the bit about her being in 'severe pain most days' and unable to pass a stool for weeks? Surely this makes a trip a necessity? Why wait for consultant appointments, which will only happen if the gp refers you? Doctors can get it wrong. A scan is needed to get to the bottom of it and if the gp won't give her one, then she has no choice but to go to A&E. No one should be in severe pain on a daily basis.

OP said her DD is already open to a consultant, which means that A&E would most likely just tell her to go back to the consultant anyway as this is an ongoing problem. Based on the OP's description, this is a pre-existing problem rather than an emergency, as many other posters have also pointed out. I'm not minimising the issue, I'm saying that the purpose of A&E is not so you can go over your Doctors head if you aren't happy with their care plan.

My good friend S is an A&E nurse and she always tells me to not think twice about taking my little boy to A&E if I am really worried. She can't stand the adult timewasters who go in with a hangover or a sore throat - they get very short shrift - but she says no-one on her team ever feels that a parent is wasting their time.

On that basis, don't worry about taking your daughter to A&E. Her stomach does not look like typical toddler swell to me. I'd be worried too.

It doesn't look like an A&E emergency to me, but yes do seek medical attention. Out of hours GP or GP appointment will be a much better use of your time.

It's a GP condition, not an accident or emergency.

You need to ask for an emergency appt with your GP, or if you like, with a new one.

her stomach looks like my nephews, he was diagnosed with coeliac disease but it took until he was 6 fir a diagnosis as they kept saying he was just constipated... my sister has been through hell with it all and hes left with bowel issues still from years of relying on movicol. He never had the ither signs of constipation you mentioned either. Hope you can get your DD sorted.

How many sachets a day of movicol is she on? As someone mentioned, there is a disimpaction regime with medical which I sounds like your dd needs. With impaction you basically have a big lump of solid poo that the bowel can't get out, and the movicol helps the bowel absorb more water until it's soft enough to come out. It takes time though and can mean increasing up to 12 sachets a day, so 2 on day 1, 4 on day 2 etc.

If she's been seen by a consultant before you could try and call their secretary and ask them to speak to the Dr on your behalf to get advice? Or if you get an urgent gp app. Can they refer you to your local paed ward for assessment rather than going via a and e? That's what happens here but don't know about other places. Hope she's better soon.

You need to go back to your consultant, you should find the secretary's number on the appointment card if you have one or on an old appt letter. Ring them today and tell them your daughter is in severe pain and needs to be seen as a matter of urgency. To me, that tummy is not normal and going weeks without pooing is really not great. When did she last poo and what was it like?

Is it possible she has a food allergy? What does she eat?

But if she's very impacted then only an enema can treat it - Movicol is excellent but the OP's DD may be past the point of being able to wait a couple of days before the Movicol really kicks in.

Badly constipated children can start vomiting faeces. So constipation can change from being a chronic condition to something more acute.

If you want to take her to A&E, OP, then do.

Her tummy looks more distended than my DDs was at the same age. I'd be as worried as you are if she was experiencing the symptoms you describe for that long. Poor wee thing. Could you call NHS 24 and talk them through it now? They may send you to A&E.

OP, please don't listen to people telling you not to take her to A&E.

I'm not saying you should. It's entirely your call. But it's all very well saying that Movicol takes time, and that she's under GP and consultant care so these should be the first port of call, and that A&E is for emergencies - but in the meantime, constipation can quickly become something nasty. No-one at the other end of a keyboard knows what's going on with your child better than you do.

If you feel that going to A&E will help, go to A&E. You might have to wait an age while acutely ill patients are prioritised. You might come out with no answers. But if you are worried as a mother, and feeling helpless, do what you feel is right.

she needs medical treatment

I don't think A&E or walk in centre is an overreaction in the circumstances of her age, symptoms, and lack of progression at home - things can quickly go awry and it may well be you cannot do anything to sort blockage at home. Then needs a gastro assessment

Taker her. I'd rather wait and been seen than risk her not seen.