ongoing tummy ache in DD (5yrs old) - very worried

[allag]

she has been complaining on and off for a few months now but it for the most part disappeared after she went to the loo. it is always around her tummy button that she points at. Since she started school this year the pains are more frequent and more severe (she sometimes bends down and doesn't want to stand straight). She had one episode of diarrhoea - a couple of weeks ago when I think we all had a mild tummy bug - but since then the stool has been infrequent and hard. On Friday she complained in the morning but i took her to school as I had kept her home the previous day and she seemed absolutely fine all day. The teacher called us at lunchtime saying to pick her up as she was unwell - complaining of the tummy again, off her food. We picked her up - she looked very very pale but not in pain. Took her straight to the Ped at the Portland who asked for urine and blood sample (both done, waiting for result) and abdominal and renal scans - to be done on Monday. Today she is not in pain but still very pale and low in energy - we went to the Park for a little bit and after 40 mins she was crying of tiredness.
I know we are hopefully en route to getting aswers but would love to hear if anyone would have any thoughts on what this could be. She is generally healthy although after having glandular fever about 18 months ago (a bit more) she is always picking up bugs. Had a skin prick allergy test when they were testing her for asthma (she often has ongoing coughs but the doctors have not diagnosed it) and tested negative for all the main ones. Never had any food intolerances that we knew of although dislikes meat intensely and eats very little of it. Sorry this is long and disjointed but am very concerned about the ongoing nature of this (went to GP twice who fobbed off, basically) as well as her tiredness and paleness.
Any thoughts hugely appreciated. Thank you.

Sounds very like my four yr Ld ds before he was diagnosed coeliac. Six mths later he is a different child. Make sure yr dd is tested for this.

I took dd2 to the GP after a year of tummy aches. She was constipated. I hadn't picked it up but she was quite compacted.
They scanned her tummy to check, and then put her on Movacol, and was mostly better quite quickly.
She also gets abdominal migraines, particularly when excited/stressed, but that doesn't really sound like your dd's tummy aches.

Did they feel her tummy? They should be able to feel constipation and possibly appendicitis. The tummy button area could be apendicitis, which I assume they will check with the blood test and scan.

Don't let them fob you off. Our GP said that sometimes children do get tummy aches as a "outlet" for excitement/stress, but a continual one should always be checked. They're doing the same checks as dd2 had for tummy ache, so I guess that's the first level of checks.

thank you so much for replies. For some reason my imagination has been running away on this - but I am always a bit of a worrier I think.
The Paed said the first things he wants to check for are a urinary infection and constipation. I have wondered about the latter - as she goes quite infrequently and struggles at the moment. I can only guess x-ray/scans can confirm that either way? He has not mentioned appendicitis - I will make sure I mention it when I am back to see him once results are back just to be sure, although had assumed it is something that comes on fairly rapidly and is more severe; I suppose I assumed he would check, too.
Coeliac - will make sure i get her tested for that too. i asked him about possible allergies/food intolerances (I forgot to mention she got a one-off episode of hives recently when she had a cold and been slightly itchy too occasionally - which he appears to be dismissing for now). Will certainly "pursue" those unless something else obvious shows up.
I HAVE been told by GP that it is common for children to get tummy aches but will certainly not be fobbed off any more. I have also wondered about stress/anxiety - she mentioned a sore tummy very briefly a few times in the summer but it always seemed to be fine seconds later. Sinces starting school, they seem to have got much worse. In terms of a diet change, there is nothing that makes me suspicious as the lunch menu does not appear to contain anything new to her. She probably eats more meat there than at home because she is not a meat fan but will eat it there to please the teaches (the poor thing).
Thanks again. Will go researh coeliac in the meantime.

sounds like my DS who had misdiagnosed chronic constipation. impaction was only found by xray not by examinations. worse with stress of starting school. it causes low iron levels so bloods should identify that. It did in our case but was still not diagnosed!

DS had really bad tummyaches which worried me no end at the time. We never got a definite cause but were reassured that pain that is central (i.e. near the navel) is usually nothing serious and, most likely related to constipation, stress, etc.

(Btw, he is now 24 and very healthy!)

viper - never be fooled by central pain. If it persists or has other symptoms always always get it checked out. Don't be fobbed off, especially if there's high temp involved.

calorie, fascinating what you say about low iron levels - the paed observed that she was very pale and she indeed was, and still is. she tires quickly at the moment, so I have been sure that when the bloods come back it will show low iron levels. she had aneamia before - during and in the aftermath of glandular fever - and she also looked extremely pale then. The doctor is wanting her checked for constipation and she had her x-ray (plus U/Sound) today - the ultrasound doctor said everything looked normal but we haven't had teh x-ray results yet. Not sure if constipation would have shown on the scan but I had no idea that it can cause low iron levels. Very useful to know and could be my Dd.Appt with the doctor on Wednesday by which time all the tests should be ready.
And then there is the stress. She has missed so much school with this tummy ache and after not having complained all weekend (other than being tired), and seeming completely fine today, tomorrow morning I am SURE she will be saying her tummy hurts. i honestly don't know how to handle it at all then. feels wrong dragging her to school but i worry that - if there is indeed an element of stress to it - keeping her off will only make everything worse.
it is probably another thread - perhaps I should first find out if anything comes up this time around.
Frazzled - no temp, and only paleness another symptom. But will not fobbed off.
thanks again all.

OP - just to let you know that low iron (paleness & anaemia) are very very common with coeliac as well (because the damaged gut can't absorb dietary iron). I would really push for the coeliac blood test, and full bloods.

A question - when she passes stools, what do they look like? A common (but not always present) sign of coeliac is that the stools are pale in colour (or have pale patches), and are floaty - all means that food isn't being properly absorbed.

I totally agree with bedhopper re coeliac but had presumed that would be being checked by your bloods as it is the most obvious. My DS showed all symptoms of coeliac and despite negative blood test needed biopsy to confirm for certain. Impaction was not shown by scan only xray in our case.

Hope you get this sorted soon. It does sound very much like my dd when she became constipated. I didn't realise because she was still going without too much distress but apparently she was just ''backed up'. After a little while on lactulose she is back to her normal self, so hopefully that's all it is. Being pale, tired, intermittently complaining of pain is exactly how she was.

bedhopper, the past few times the stool was hard and normal colour - i don't think i ever noticed it being pale but i guess she has had about two loose ones in the past couple of times. i didn't ask the doc whether the bloods were tested for coeliac - he said he wants to "test for the obvious things" - I honestly did not think of coeliac at the time. I will ask and push for it tomorrow. Thank you all very much - i hadn't realized that this could paleness and anaemia. lots to think about. I will see what we are told tomorrow when we go to get all the results.

may well be just a case of severe constipation ask for xray to confirm. but they shoudl also text for coeliac, iron levels ec .

Sounds very like my DS who had chronic constipation. The bowel gets clogged so while there are some poos getting through they may be infrequent and either very hard or sometimes rather squitty as they are squeezing through the build up on either side of the bowel.

DS1's got to crisis point and he was admitted to hospital where he was given large doses of stool softener. This sorted it out.

At times of stress or when his routine is changed (like the start of the school year) he can get irregular again. I keep track of his pooing and if it gets irregular I start the dose of Movicol again, and keep it up until things have been regular for a week or so.

It was diagnosed with an Xray of his tummy.

I should say it got to crisis point because of our GP's repeated misdiagnosis.

x-ray found considerable constipation - we got results last night. You are all amazing - diagnozed it before any doctors did. :) Thank you. Have got movicol so fingers crossed that is indeed ther reason. MissBetsey, all as with your DS - some coming through hard and not as much as normal. and yes, i think change of routine was waht started it as we spent a month in France and she refused everything bar pancakes, pretty much.

Very pleased you got it diagnosed. Too many cases of children seriously misdiagnosed with this condition. Dont come off movicol too soon as children often need to be on it long term.

Great news !

That's great news. I forgot to add that the consultant who diagnosed him (when the registrars were all still scratching their heads) also recommended a poo routine. So after breakfast for example, we always send him to the loo to 'try'. Sometimes he goes, sometimes not.

In his case, it was repeated tonsillitis and then chicken pox that started it, then his bowel just never got a chance to get rid.

And YY to all caloriesupplement says - the temptation is, when everything's 'normal' to stop suddenly. She will be able to come off it but very, very slowly. We were advised to step down the dosage over about a fortnight.

as well as movicol a regime of daily probiotics can really help - i use biocare powder for my son half teaspoon a day you can get it from good health food shops or pahrmacies (look in the fridge)
www.realfoods.co.uk/product/10483/biocare-strawberry-acidophilus-powder-plus-probiotic-vegan-60g bottle lasts a long while

Our DD has ongoing poo and wee issues. It took ages to get a diagnosis and despite a healthy diet she is still having poo problems. I was really interested in the low irons levels. She had bloods tested and was diagnosed as having low iron but not anaemic. She's not tired or pale! She's having an iron supplement at the moment. Is there more info somewhere about low iron levels? I haven't been able to find anything online so far. Interested in the link between this and coeliac as consultant didn't mention it at all.

Thank you for the movicol advice - the doc prescribed a 3-week course, bringing the dose down from the 2 sachets initially to 1. We have only just got the prescription and i am slightly worrying about such a prolonged use of a laxative (is it???) and whether she will grow dependant on it but don't see an alternative considering it is not being cleared out by itself and it has been making her so unwell.
I have been warned to finish the course and that she may need to stay on it for longer and I know not to come off suddenly - thank you. He also explained she needs to go every day and to encourage her at a certain time every day. (as well as to examine it :)).
soupmaker - her iron levels this time are apparently completely fine - the doctor thought the paleness and tiredness were caused by pain and discomfort which I can believe. So sorry, don't know much about the connection between poo issues (or coeliac) and iron - i had no idea it existed, either. if I come across anything, will share.

My DD was on Movicol for about 3 or 4 years. She now uses it occasionally but not very often. Her bowel habits have righted themselves with time and I think Movicol is fab. It isn't absorbed into the body at all, just travels to the bowel where it absorbs water which softens the poo.

Don't worry, it's fine. All the docs I've every spoken to about it are totally 'meh' about it, including our consultant friend.

"meh" as in "it's OK"?? :) thank you. must start as have been sitting on it (wondering if I should do a suppositary instead - worked so well on DD2 but then she was a baby and she couldn't go as opposed to having a long(ish) term backlog. But DD1 still in discomfort.

My 3 dc had severe constipation over christmas a couple of years ago, following a bad bout of a virus. Dd1 was reasonable and sorted herself out. Dd2 was bad, very bad, not going for a poo at all for 11 days. Ds2 was absolutely horrific! Didn't poo anything at all for 17 days! He was by far the worst affected although dd2 was not far behind. Ds2 was prescribed lactulose, then movicol, then senna. He was eventually taking twice the adult dose of senna but still nothing happened! I have never seen a child look so desperately ill. I was convinced there was something seriously wrong with him. Pale doesn't even begin to describe his colour. He was beyond any pale I've ever known. He eventually got to the stage where he didn't even move anymore, he was just so lifeless. It was horrible, horrendous. We were prescribed suppositorys for both dd2 and ds2. My sister (a nurse) came and put these in for me (I'd tried with no success), they both absolutely blocked FILLED the toilet within half an hour!! Ds2 got off the toilet, got sorted, ran downstairs and played like he used to. He literally went from deaths door to bouncing normal with minutes. All because his backlog of poo was gone. Doc said the toxins were building up inside him making him so poorly. I thank the Lord for those torpedos that sorted/saved my dc.