GP or Hospital for Daughter?

[AskingforAdvice87]

My daughter is 8 and has autism and has always been healthy and had a good immune system.

Over the last few weeks I’ve noticed she always seems to be unwell, particularly with feeling sick and being sick, it’s now getting to the point where she is physically sick once a week and feels sick every other day.

She was vomiting over the weekend and now she’s up again this morning after being over a sick bowl for the last 2 hours. I have spoken to the GP and they haven’t really said or done much but it just doesn’t seem normal?

She’s definitely not lying to get out of school or has anxiety about school etc - because of her autism her mental age is probably half of her actual age - I don’t think she actually knows what a lie is if that makes sense! Plus she enjoys being at school because she hates being stuck at home.

Something just seems not right, do I try again with the GP or there is a specialised children’s A&E unit at one of our local hospitals… do I try there instead?

I’m just getting quite desperate now, and it’s always in the mornings this is happening and I know that can be a bit of an alarm bell for perhaps some more serious things going on (although highly unlikely I know, not to be dramatic!)

GP.

it’s neither an accident or an emergency.

GP but a different one if you can. You’re entitled to a second opinion.

GP. It's not an A or an E. If worried the GP will refer.

Could it be food related? Friend’s daughter has just been diagnosed coeliac and presents with similar symptoms.

I will definitely try another GP… but what if they don’t actually do anything about it again? Surely it’s not normal for a child to be vomiting every 4/5 days?

@MyLovelyPen that’s a good shout thank you!

GP, A&E won't make any referrals or anything. I would try a different GP and if you can remember instances of sickness make a note of them to demonstrate the pattern and that its now been quite prolonged. I agree it doesn't sound overly normal, especially if it's not usual for her.

GP - it’s definitely not an emergency . Perfect for GP who can see her several times and refer if needed

Go back to GP

Definitely document everything and see if you can get a referral to a specialist if it continues.

GP

Thank you everyone I’ll give them a ring this morning and start keeping a log of it all!

As a GP I would refer to Paeds Hot Clinic (where the child is seen in the next few days) for persistent morning vomiting. GP is a sensible first port of call. However I wouldn't judge a parent who took their child to A&E in this situation.

@CakeIsNotAvailable thank you I wasn’t aware about hot clinics, do they have them all over the country? I’m down in the south west…

I'm not sure (I'm up north), but if they don't, the GP can still either write an urgent referral, or pick up the phone and speak to Paeds verbally for advice. If this is genuine persistent morning vomiting I would phone Paeds on call for advice if you came to see me, because I'd want the scan doing within a week or so.

@CakeIsNotAvailable the actual vomiting is around once a week (every 4-6 days at the moment) but she feels sick and looks off colour most days (I would say for half the week at least)

Is she also doing large poos and I'd her stomach bloated or distended? Does she eat quite a lot but say she is starving? If so my 3yr old had the same and within about 6 weeks was diagnosed celiac.

GP, for tests I would say, may be a bug that will pass or intolerance to gluten or dairy? Keep a food diary.

I’ve known a couple of children who were like this. Both were autistic. You need to ascertain if she is vomiting due to an illness or not. I taught one boy who could literally vomit at will.
I think most vomiting caused by illness is spontaneous, the vomit is very smelly and has food in it. The boy who did it at will, his vomit was more watery, like clear mucous. He didn’t go pale or clammy as most people do when they vomit.
Your DD may subconsciously be making herself vomit for a number of reasons.

How long is it between her last meal at night and her waking up? She could be feeling hungry but describes it as feeling sick, and may settle if she has something to eat - perhaps give her a plain biscuit as soon as she gets up. Avoid anything milky or buttery like cereal or toast.

I’d contact her GP again, then have a discussion about what could be causing this. If she’s thriving, not lethargic and has no other signs of illness then try not to worry, it’s probably nothing much. I do think going to A+E is a bit extreme. She may well have a very long wait, and they can’t do much different there than your GP can do.

GP and insist they investigate. Good luck. Your poor DD.

@Boomboom22 she is always really constipated which has been the case for years, but when she does go they are usually really large! Can it cause constipation?

Constipation can certainly cause vomiting and nausea. Go to your GP and see what they make of all this.

My friends son the same.

Keep a complete diary; food, vomit, poo.and discuss with your GP to refer on, but keep going with the diary as that will help with diagnosis/seeing patterns
and yes; constipation can cause nausea IME

Have you checked her blood sugars? Vomiting can be a sign of diabetes