To ask you to help me diagnose my daughter before I take her to the GP?

[BonjourMonsieur]

Before I get flamed… I’ve taken DD to the GP about the same issue multiple time’s and we’re getting nowhere with it. Im going back on Thursday with her and need some ideas of what could be causing these symptoms so I can push to have it investigated further.

Since December last year, DD has been suffering from persistent nausea. It started around the time of an increase in Covid cases and lots of isolations happening amongst her friends. We initially though it might be anxiety. Fast forward to now and it’s still going on. The main issue is nausea after eating and nausea preventing her eating her full meal. She has a small appetite now and seems worried to eat sometimes incase she feels sick. But on occasions where she doesn’t seem worried to eat, she’ll eat some and then the nausea will kick in. This was very problematic at the start because it would result in her spending half an hour with her head over the toilet. We gave suggestions like “try going to the toilet” or “let’s get some fresh air” and we’d take her outside to the garden to try and almost distract her out of it. She now believes that both of these things help, to an extent.

So she’ll only have a small breakfast, because otherwise she’ll feel sick and won’t be able to brush her teeth and then will be late for school etc. There are all these scenarios that she’s dealing with daily to try to mitigate it. And she shouldn’t have to. There have been time’s we’ve been about to go for a day out, to a place of DD’s choosing and then the sickness will come on after breakfast/lunch and she’ll say she can’t go. I know for 100% that she isn’t faking this in any way.

I’ve also noticed, on the odd occasion she forgets to flush the toilet, her stool is lighter in colour than I would expect.

So far, the doctor had put it down to anxiety. We’ve also been advised to give a daily actimel which we do. She says at school she goes to the toilet immediately after eating lunch and then straight outside to play (fresh air) and that stops it from getting too bad at school.

Can anyone help? What could be causing this? 😢

Could be fructose intolerance if it's after sweet foods. My son had horrendous nausea and stomach cramps for about 18months at 10/11yrs. Tested for lots of things all negative over period of about a yr. Ended up going private so we could get directly to paediatric gastro specialist. At first appointment he suggested fructose intolerance, arranged test which was positive.
For around a year he had to avoid fructose which was very limiting but eventually he seems to have grown out of it except for very occasional relapses.

If her stools are pale smelly and floating then definitely get her tested for coeliac disease. Does it smell a bit like baby poo?
Don't eliminate anything at this point but do maybe start to keep a record.

My 8 year old had this after covid in January. She barely had any actual covid symptoms Went on for months being fobbed off as anxiety (which o agree she also has)
Finally someone listened and about 2 weeks of gaviscon advance three times a day (prescribed) and issue was resolved!

Can't give advice re the physical symptoms but if your GP thinks it's anxiety related and it's having a significant impact on her wellbeing then he should be referring to an appropriate mental health professional, not just dismissing it as nothing to worry about, particularly given that it's persisting.

I'd say stop messing about with the GP fobbing you off and ask for a referral. In our area any step up goes straight to the paediatrician at our hospital and they decide - there'll be one with a special interest in gastroenterology you can google it. Ask to be referred to him/her. This has been going on since LAST CHRISTMAS?!

OP eliminate nothing before getting bloods (or scope) testing. Nausea,.low weight and pale stools can all be signs of Coeliac disease (1 in 100 people in the UK have CD) and you need to be eating lots of gluten for the tests to detect antibodies.

Age 10 my GP thought my tummy pains were anxiety. Age 20 my GP thought my stomach issues were IBS. Age 32 I was finally properly diagnosed with Coeliac disease.

I'm a coeliac and honestly it sounds like some of the my symptoms pre diagnosis. I would ring the gp and ask for a blood test ASAP. I was most likely a coeliac for years before I realised. Unfortunately I am still dealing with the damage to my stomach nearly three years later.

No one can diagnosis her based on your post. And when I say no one, I mean no one - including her GP. Her GP cannot diagnosis her when they haven't performed a single test.

She needs tests done to rule things out. She needs full blood work at the very least. Urine and stool sample etc.

If all the tests come back clear then your GP can suggest it's a mental health issue. But given she has physical symptoms those need to be reviewed first.

If her GP is as unhelpful again tomorrow, call your surgery back the following day and ask to see someone else.

Coeliac

It would be worth seeing if lactose could be the issue which you could do by trial and error.

Regarding gluten/celiac it's really important that you don't reduce or remove it from her diet before she's tested as the test result won't be valid if she's been avoiding it.

I'd push for stool tests to be done and a referral to pediatrics. It's been going on long enough that they should say yes to that.

Following with interest.
My daughter, 16, similarly regularly feels nauseous (no vomiting) with stomach feeling full and can't eat. It's random. We've had GP diagnose in order: anxiety, then acid reflux, then IBS. It's none of these and none of the meds helped. We're waiting for a referral - yes it's been almost a year waiting with this.
We haven't kept a diary - that would be most useful - when it comes on, for how long, what was eaten for dinner. I've tried to ask DD but it seems strenuous to do!
She's had celiac blood test so don't think it's that, my best is something like gastritis, but we'll see.

Coeliac disease

Addisons disease

I also think ceoliacs.

Dysautonomia of adolescence, gastric component.

I also think coeliac disease is a real possibility. My youngest is celiac and the symptoms started this way, nausea and vomiting after meals. A simple blood test will almost confirm if she needs to be on a gluten free diet, and I say "almost" as the only way to fully confirm it is with a biopsy, but rarely doctors ask for one when it's a child. It really is worth mentioning it to the GP.

@BonjourMonsieur my GP diagnosed my daughter with the same things - gastritis and anxiety. Turns out, it was coeliac disease. Can you ask for a blood test? Ask to see a different GP.

Your daughter needs to be referred to a paediatric dietician, not a bunch of strangers on the internet.

Please push for a referral when you see GP but be warned it will take a while. Hope all goes well.

@BonjourMonsieur Question for OP to take to the doc (and maybe force them to consider) or to maybe someone on thread who knows more about stomaches than me: a ton of posters are mentioning coeliac’s disease (pain after eating, floating, smelly poos, etc) and OP’s daughter has quite a few of the symptoms, and others are mentioning gastritis, which is stomach inflammation. Why not both? Is it possible she has coeliac’s and it’s causing gastritis? Inflaming her stomach and even esophagus causing that vomitous feeling? Just seems like that would make a lot of sense. Then the fresh air is not so much helping by itself as it’s a “time delay” - the initial sharp pain of the inflammation may just be lessening as she stops eating and a small amount of time passes, even if she still has a sore belly.

Good luck, OP. And I’m so sorry to hear about your eating issues as a teenager. If they do ask you to keep an eye on your daughter’s weight with a scale, remember, it’s just a piece of information, you’re doing it just like the doctor’s office - there’s no “bad or good.” We all just try to follow our doctor’s advice (unless your doctor is a judgmental arse; then get another).

I was like this from the age of 10-13. Couldn’t eat, felt like I was going to vomit after meals, got scared to eat anything because of it. It was caused by anxiety and emetophobia and turned into an eating disorder. That is one possibility.

other things to look into that could cause it are gastritis, h-pylori or food intolerances. Coeliac disease could be it if her stools are pale but you could also try exclusions diets for dairy and nightshades. Obviously not at the same time as that would be very limiting.

I’d be tempted to try a strong multi strain probiotic. Actimel won’t do anything, but a high strength capsule or probiotic drink that you buy online or from a chemist might.

ARFID?

Please don't let the gp blame "anxiety" or anything psychological until they have ruled out possible physical causes.

My dd had similar symptoms just before covid started (aged 17) - idk about the stool colour though.
She didn’t have much of an appetite, got full quickly and lost weight. I was really worried.
GP did stool test and it was normal and then prescribed mebeverine to increase appetite. This was going into first lockdown time.
She does have anxiety (is on meds now), and it did all resolve and she’s now a normal eater and at a normal weight for her height.

If you are female and present with a gastro intestinal complaint most doctors will spring into the 'it's all merely psychological' dance, because everybody knows that the female body doesn't consist of organs and biological processed like every other body on earth but its more an ethereal thing brought into being by feelings.

On a serious note though the first things that spring to mind are lactose intolerance and coeliac disease. At that age and with it going on for so long it's likely to be something that needs identifying to ensure her long term health. You'll have to push as you're both female so you won't be taken seriously, even by female GPs, I've been there plenty of times.

Scrolling through the comments could it be crohns? Although usually causes diarreah not hard stools. OP, your GP is failing you and your daughter. Insist on a referral - to gastro, to mental health both. Or pay privately if you can xx