Another one of those shall I go to A&E threads...

[QueenArseClangers]

DD who's 11 has had tummy ache since Monday eve. Thought it was period pains (she has horrible ones bless her) but she was sick Tues morning twice.
Thought it was a bug so kept her off 48 hrs etc. No diarrhoea or any other sickness.
Last night her pain increased, it's near belly button and radiates to right lower side Abdomen tender upon pressure and she felt quite warm.
She's been off food for days which is not like her at all and not had a poo for 2 days.

So, rang 111 last night. Sent her and DH to OOH where GP palpates abdo, tests urine and does obs.

Diagnoses bowel pain and gives her Buscopan and says to give it 24/48 hrs to let it work.

She's still sore this morning and not at school.

Actually, reading what I've written, I've come to the decision that I am going to take her today. Very worried it's appendicitis.

What GreenTureen said.

OP if you can't get through on the phone, go to your GP surgery and speak to reception.

I often think these threads only warrant a gp appt but I think your right to take her to A&E

The fact that the pain is down on the right hand side screams appendicitis. I've seen friends told that they have constipation or ibs or indigestion before having emergency surgery for appendicitis. GPs are often shit at spotting it.

Is she passing wind?

When my son had appendicitis, one of the symptoms they kept asking him about in A&E (along with everything else you've mentioned) was being unable to fart.

We also suspected a tummy bug to begin with but ended up ringing 999 when he woke up and doubled up in agony.

If it was me, I'd be heading to A&E but ours is fairly rural and, although busy, I've never experienced the queues down the corridor that have been on TV recently. Thanks to triage, DS was pretty much straight through to a cubicle once they suspected appendicitis and waited an hour or so for the doctor but had blood tests and pain relief in that time - they won't just stick you in the waiting room with the stubbed toes if it's serious.

Not pulling out of my arse. Often in adults GP's do refer to surgeons via a surgical assessment unit for bloods before admission to a hospital bed. In paediatrics urgent referals from the GP come in via A&E. Even paediatric patients admitted after concerns at outpatient appointments come via A&E. Only a few patients have rapid access onto ward like oncology patients and those with hickman lines.

The reason they do this is to avoid uneccessary admission to a hospital bed. They wait until the bloods come back positive or the surgeons have seen them before admitting.

Hope you are able to go to a & e soon Poor DD

But you don't need to go to bloody A&E if you have appendicitis. It actually slows your treatment down. I'm a consultant surgeon. If you come to A&E in my hospital with abdominal pain you'll wait (on a good day) 2-4 hours to be seen by a nurse practitioner or junior doctor, have blood tests done, and then get referred to the surgical admissions unit for assessment. It might take another hour to get transferred down to SAU, where you'll finally see someone who can actually do something about your appendicitis. If you see you GP and they think you might have appendicitis, they pick up the phone and talk to me, you come directly to SAU, where I will see you within 15 minutes or so of arriving and make a decision as to whether you go directly to theatre, have some blood tests done or need a scan. A&E is brilliant for accidents and true emergencies. But for this sort of thing it's just adding an extra, completely unnecessary, step. Does no one understand that?

This is neither an accident, nor an emergency though. As PPs have said - GP. If you can't reach them on the phone, take her there in person, but you will wait longer in A&E than by seeing the GP.

DS1 and DBro have had appendicitis. Neither of them could tolerate the doctor palpalting their abdomens and they were in a lot more pain than bejng a "bit sore".

I don't understand this. She saw the GP last night. He gave instructions and said unless she was worse then give it 48hrs. So why ignore it? At most visit the GP.

Some of us do welsh.

Please read what welshweasel has to say.

Diagnoses bowel pain and gives her Buscopan and says to give it 24/48 hrs to let it work.. So what part of that makes you want to go to A&E today

When I was 18 I had similar symptoms, I was in absolute agony with stomach pain and was given buscopan from the Gp. The pain got worse and I went to a&e where severe constipation was diagnosed where it was impacted.
Honestly never knew that constipation could be so painful.

This is exactly why A&E is in the state it's in - all these people saying go there. It's not an accident or an emergency!

A&E is for the following:

Choking, chest pain, blacking out, or blood loss.

GP surgery is for abdominal pain.

Take her back to the GP today. If it were appendicitis in all likelihood wouldn't the GP have found this and diagnosed already?

I don't think the message gets through welsh. For all the sensible approaches you will always get a few who say "no you must take her to A&E" for pretty much any illness out of hours.

Agent I agree. It's worrying yes, but it's not an accident or an emergency and A&E will triage in the same way that the GP would.

In fact, going to the GP will be the best thing in the end as they can do a direct referral in to hospital should any additional treatment be needed. GPs would be able to identify the signs of appendicitis.

The likelihood is your daughter has trapped wind, OP, especially if GP has already diagnosed this. It can be exceptionally painful.

When DS had suspected appendicitis I took him into the GPs to ask for advice (only 4 doors away from home). GP saw him and told us to go straight to A&E. So no, Welshweasel, it appears that even GPs don't understand this!

We spent all day there before being diagnosed with a gastro bug. He spent the next day in agony at home, then we saw GP again first thing the next day. He sent us straight back to A&E and having got there at 10am he was finally diagnosed with appendicitis at about 4.30 and operated on that evening. We most definitely did spend hours and hours in the waiting room on both days, along with stubbed toes, children who had fainted etc. Age 12 he particularly enjoyed the Peppa Pig DVD on a loop!

His symptoms sound exactly like your daughter's only difference in our case was the GP was convinced it was appendicitis and it was the A&E doctor who disagreed.

emergency GP, and 111 whilst you wait to get fast tracked

Definitely push to see GP ASAP. If they can't see her this morning, go to A&E. When I went there with suspected appendicitis (referred by walk-in centre) they were brilliant in whisking me straight through for pain relief and blood tests (admittedly this was high summer, not depths of winter, so it was probably a bit less busy).

Fairy the GP may have got this wrong. They are human. Pain on an 8/10 that's radiating to the right with lack of appetite sounds like classic appendicitis. Diagnosing 'bowel pain' gives no clue about what may be causing it. If the GP is indeed wrong, and it is appendicitis, it can be very dangerous to leave it. It sounds like it definitely warrants a second opinion/blood tests.

and what Welsh said

people seem to think A&E have some mythical healing powers and will solve anything undiagnosed

Poor OP, hope you get seen today

NHS website on appendicitis says see a GP or out of hours. If unavailable phone 111.

I should add that both GP and second visit A&E doctors said appendicitis is very hard to diagnose. I would not be surprised if OP returns and says it was appendicitis. Good luck OP, go with your instinct.

Always OMG who took their kid to A&E with a stubbed toe?

GP. I had appendicitis in the summer and they referred me direct to the surgical assessment unit rather than having to wait in A&E. I didn't have surgery in the end - they treat with IV antibiotics nowadays where possible. I was in hospital 4 days though.

Even if the GP advises A&E, they will usually call ahead to let them know you're coming etc.

In paediatrics urgent referals from the GP come in via A&E. Even paediatric patients admitted after concerns at outpatient appointments come via A&E

Nope. Not in my experience with ds. The GP referred him with suspected appendicitis, we were sent straight to a hospital paediatric ward where blood tests were taken immediately and the specialist came to see him.

The process was pretty much the same with me, as an adult, when the GP referred me for appendicitis last month. And has been the same with the two other cases of people I know who have had it.

Never known a GP to suspect appendicitis and then tell the patient to get themselves to A&E where the whole process (wait/triage) is begun from scratch.