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.

NOT an A&E problem - the clue is in the name

Take her. This is clearly unusual and the continued pain would be a red flag. It may be an emergency - none of us know. Best to be safe.
For those saying no, a good friend had a serious illness diagnosed in A&E that had been missed by many GP appointments. Sometimes a different eye is needed. Hope your DD is OK.

As others have said it's not an accident or emergency. Go back to your GP surgery and ask to see another doctor if you wish for a second opinion, if that's not helpful then go back again and see another doctor and ask for a hospital referral.

I would also keep a food diary for the GP to view exact quantities and foods the dc it eating.

How much movicol is she on?
I would try contacting the consultant again.

Moving away slightly from the topic of whether or not you should take your daughter to A&E, please ask your GP to test your DD for coeliac disease. DD1 looked exactly like this - petite, skinny, no bum, but huge tummy. She veered from chronic constipation to awful diarrhoea (she also vomited regularly). Doctors didn't take any notice of me for ages - wrote me off as a neurotic first time mum - but eventually someone properly assessed her and referred her. Basically the massive belly was because she was malnourished - in someone with coeliac disease, gluten damages the gut so no nutrients are absorbed - so nothing she ate was doing her any good at all. Within two weeks of being on a gluten free diet, she was pooing normally, eating like a horse and her tummy had shrunk in size.

I'm not saying your DD isn't constipated - if she does have coeliac disease, it's highly like that she is - but as well as trying to sort that out, it would be well worth trying to find out why she is so constipated, and coeliac disease could well be the cause. Full details of the symptoms are on the Coeliac UK website.

I have one dd with a sticking out tummy, typical of younger girls, but your dds looks completely different. It does look as distended as the abdomen of a child with malnutrition. I think as she is in so much pain then A+E isn't unreasonable. Especially as she is a young child when the picture can change quite rapidly.

I have read all the replies and had some really great advice and it's been really helpful to hear your experiences, I've been feeling like the only one who has this problem and very isolated.
It must be more common than I realise.
I called the consultants secretary on Thursday and was told we can't be seen till August! The continence team day we are far down the list for an appointment. Have a very supportive HV but she now doesn't know where to turn. She says it's the worst case she has seen/ heard of.

She has been on disimpactment plans before and it's been messy but she has passed lots of sloppy stool and is relieved for a few days after then it starts again and is back to its worst within a week or so even with a maintainance dose. And we begin again.

Asking to go to the pead ward is actually a good idea I am much more comfortable with that.

I haven't considered food allergies/ intolerances and it will get looking into that ASAP. Thank you very much for that advice!

Her tummy is rock solid at the bottom and squidgy at the top.
She weights 11kg and is on 5th percentile, although I agree she looks 'soft' she wears 18-24 clothes and is significantly smaller than her peers.
Last time she pooed was 21 days ago, which is good for her.
she has gone 6 weeks in between before and that is quite typical.

I agree with most of you to some extent on both sides of the coin.
I am a firm supporter of the nhs and hate the thought of wasting time and money. I always think very carefully about this before making appointments etc.

And no one wants to sit in A&e for hours and put a tired and poorly child through that.

On the other hand my fear is, like another poster said, that there is an underlying problem like a cyst and I am not being a good mother by not doing everything I possibly can to rule that out.

I am going to call 111 and see that they say. Thank you so much everybody for your responses you have been very kind to me. Xxx

Best of luck, and hope she feels better soon. The poor wee sausage must be suffering.

21 days? My god. I'm an experienced constipation mum () but that is terrible.

Have they ruled out Hirschsprung's Disease? That's the first thing my DD was assessed for when she first saw a gastro as a baby.

Not sure what A&E would do but if she's in pain I wouldn't judge you for taking her anyway.

www.gosh.nhs.uk/medical-information-0/search-medical-conditions/hirschsprungs-disease

Iv'e seen the tummies of a lot of three year olds and the pics of the tummy in the OP is not normal! Most small childlren have a smoothly round sticky out tummy, not on obvious V shape. I can well imagine the bottom is hard!

But I'm not sure if A&E can help either, so usually wouldn't advise going, but if she is in pain and aren't getting help from elsewhere then you really have to do something. I'm glad you're calling 111.

You can't just leave this OP, you really need to fight for your DD here. She's very tiny, and this really isn't normal.

I really think this child needs a scan of her abdomen. Has she ever had one ?

Protruding tummies are normal anatomy up to age 4/5 (lowish down, there isn't much room in the abdominal cavity for all the organs until they grow taller). But that tummy starts to stick out right under the rib cage. Something isn't right, love

Everything she has eaten in the last 21 days is still inside her and people are saying don't go to A&E...if a 3yo is in pain with that much food inside them, then at some point it's going to become an emergency.

Thank you so much for that vagueideas!
She had none of the newborn signs however it sounds spot on to her problem now and why even on movicol she can't be regular.
And it always looks healthy when it comes out never hard and dry like constipation.
I will ask for the gp to arrange test ASAP. I have never head of this before

But I'm not sure if A&E can help either

They can. They can do an abdominal x ray and give an enema.

I would lay on the info about how long since she pooed.
Surely most people go every day. is she eating normally.
If she is then she has all that digested food jammed in her little abdomen.

I would def lay on the length of time since she pooed, emphasise that she has only leaked liquid (as they may think you are exaggerating the situation).

She needs an enema as surely all that faeces shouldn't just be allowed to clog up inside her. But as she is bloated probably you need it done under medical supervision so A/E is the place to go.

Make sure you describe her crying with pain for hours.
Really someone should be helping you by now. Crap NHS.

My Ds had extreme constipation & was on movicol his tummy wasn't that shape.
I agree with pp that she needs a scan & I would trust your instincts & push for one.

I would also have no hesitation in taking her to A&E when she's in pain,no child should be left to suffer like that bless her.

VagueIdeas I think Vagueldeas is spot on.

Glad to be of help OP. This is something your gastro should have considered, but maybe they ruled it out because her bowels were normal as a newborn? IIRC it's a condition that is present from birth and it would be unusual to present later in life. But definitely worth mentioning.

Frankly I'm shocked that your DD isn't having a bowel movement for 3-6 WEEKS and this is dismissed as typical childhood constipation. This is far worse than typical childhood constipation.

What about her small statute/low weight? It would all point to a gut problem preventing her body from accessing nutrition from food. Possibly coeliac disease, as previous posters have mentioned. Again, your gastro should have considered this.

Sorry about weird post, but you all know what I mean.

She has been refused scans at every point.
I was told that if it was anything serious she would be a lot more poorly by now as the rational for this.

I understand the doctors at the hospital see seriously ill children everyday, so to them this may be trivial and low priority which I don't blame them one bit for.

Just told to give 10 sachets of movicol to a child who so too ill to drink 1 drop of water and been made to feel I'm being difficult.

I am at a loss now as to where to turn, I have gone down every avenue that I can think of.

I'm dreading taking her to a and e if they dismiss us again I will be crushed for my poor little girl. She is so sweet and it breaks my heart seeing her suffer

That's disgraceful. Her bowels barely function and it's "not serious enough"? I'd be furious.

Have not read the second half of the thread as got irritated with all the smug 'not what A&E is for' head tilty posts.

As someone with Crohn's Disease I have been to A&E for similar and absolutely needed to go.
If there is a blockage and it gets too impacted there is a very real risk of bowel perforation which is life threatening.

Go to A&E and don't listen to the naysayers.