Persistent Low Right side Abdominal Pain in 10 yr old - Help - HMS related? Any Ideas Please??

[rockinhippy]

I'm wondering if any of you have had any similar experience & if so what was the outcome/cause as after 2 nights without sleep for both myself & DD, I'm at my wits end with this & not sure I'm trusting the vague GP diagnosis.

Back ground just incase its all relevant?

DD is 10, some health problems, IBS, intolerances, frequent accidents, eventually all leading to a Hyper-mobility Syndrome Diagnosis, which links these all together, mentioning that incase it could be relevant.

We've all had a very nasty flu bug over Xmas, her cough persisted, so saw GP the first day back at school who said her lungs were clear, but her throat was looking sore, diagnosed shed picked up another little bug, but nothing too bad, she managed school, though was exhausted & come Friday was sent home as she looked awful & her IBS was playing up, but she picked up over the weekend.

Monday she was fine, though tired, which due to HMS can be normal for her - I took her & her friends swimming after School & she seemed okay, though after her friends had left she complained of feeling nauseous & exhausted.

By 6pm she was complaining of a bad pain in her lower right abdomen, this got worse as the night went on, but she begged me not to take her up to A&E/OOH GP as she was exhausted & sure she was fine - she looked green to me, so I slept with her to keep an eye on her & insisted she wake me if the pain got any worse, I though bad wind trapped due to IBS, tried her with yoga like moves & massage & Andrews to try & shift it, but nothing :(

So I googled checked appendicitis symptoms in kids & was reassured as she wasn't being sick, also that she was writhing all over the bed, apparently they are very still with appendix - I've also had mine burst when younger & I know from that vomiting is a sign of it getting bad, so from that felt there was no immediate danger, so gave her heat pads, paracetamol etc, which didn't really help - give her Ibruprophen in the early hours of the morning which did help a bit.

We saw the GP first thing, she seemed puzzled but reassured me that it wasn't acute appendicitis, but that she couldn't rule out a grumbling appendix, she felt it very unlikely as the site of pain was a little too high to be appendicitis.

She did a urine test, which meant us hanging around the surgery for 2 hours in order to get a tiny bit of wee out of DD, something I noted as odd, as she was drinking plenty of water whilst waiting.

Urine sample showed white blood cells, but the GP commented that it didn't look infected as it looked very clear - though DD had just drank 4 cups of water - GP did say white cells were a sign of infection,but it didn't have to be urinary, but she was sending it off to the lab to check it, results back Friday & she would look at Antibiotics then - she also asked if DD had had any flu bugs & then checked DDs chest/lungs, which she said sounded okay, but she couldn't rule out a chest infection 100% - DDs cough is much better, though her throat a little bit sore still - GP then said she thought it could be DDs stomach lymph glands hurting as it fought a viral infection - DD argued with this herself, saying shes had that before, but this pain is different & worse & only on one side, its always been both sides before - GP said then lets wait on the test results & take it from there

so basically we left with no definite diagnosis, but told to keep DD home from School, warm, rest, lots of fluids & carry on with Ibruprphen & heat pads

DDs pain has not let up at all, she says it spikes, in that its the same, but it continuously gets worse & lower again - sound like its throbbing, it hurts her to walk much & she is worn out from it, she can't sleep & looks grey, it hurts more if she moves certain ways.

I noticed during the course of yesterday that DD was drinking lots, but not weeing much at all, which made me think more likely a UTI, but then as she was weeing so little I was a bit concerned about a blockage - I've had kidney trouble in the past & new this was something the Docs used to get concerned about, having me measure what went in against what came out, so thought I'd best be sensible & ring the out of hours GP for advice -

I spoke with a Nurse first who agreed this was looking more like a UTI & that I was doing all the right things giving her cranberry juice etc etc & that a Doctor would ring me back soon - 2 hours later one did finally ring back - by this time it was nearly midnight, I was exhausted as had little or no sleep & DD had finally dropped off, but was whimpering in her sleep & obviously still in pain -

I was only really wanting reassurance over the amount of fluids she was drinking x over the little she was weeing & to know whether this was something to worry about & if so danger signs, but this Doctor insisted that as DD was whimpering in her sleep, I was looking at a probable acute Appendicitis & it was an emergency & our GP was probably wrong as the Appendix isn't always in the same place, she wanted to send an ambulance - but we are very close to the hospital so I stopped her & rang a taxi, I hated having to get DD up & take her out into the cold when she had finally managed to sleep, but was made to feel I had too :(

OOH Doctor was lovely & pretty much said the same as our GP, most concerned about ruling out appendicitis, which he said it wasn't as shes not vomiting & didn't understand why we had been told to go there :( - he diagnosed virus & the pain is her Lymph gland when I queried this as DD saying its a different pain to previous gland pain, he said it can be like bad cramp - he didn't seem concerned at all about her drinking lots but not weeing much, did a check on a urine sample & said no sign of infection

DD did sleep a little last night, but not at all well & still no change in the pain at all :( - she looks awful, pale, green & black holes for eyes & yelps every so often if the pain spikes or she moves awkwardly :( - shes managing to eat a bit & drinking fine, but says she feels shaky & nauseous, but not as if she will be sick.

I'm just wondering if anyone can throw some light on this, as I'm used to my DD being a real little toughy, she deals with pain amazingly well - this is the kid who wanted to run a marathon on crutches with a newly fractured foot & bad ligament damage - but this is flooring her, so I KNOW she IS in a lot of pain & Im not sure I believe its her glands - as she says, its always been both sides in the past & its a different & from her reaction, I can see its a much more severe pain

Any Ideas please ??

Your obviously aware that a pain in the right hand side can sometimes point towards an appendix problem. Has she been going through puberty for a little while as it could be ovaries kicking in?

My daughter had to have an emergency appendectomy two years ago. She had had persistent tummy ache for about 24 hours and out of the blue was sick, it was like a green clear goo. I put a thermometer on the inside of her bikini line and it shot up on the right hand side. Didn't want to panic but phoned NHS Direct and they said said it sounded like her appendix or blocked rectum - if we couldn't drive her to the hospital to call an ambulance. Within two hours she was transferred by ambulance to another local hospital where the daytime theatre team stayed on 3 hours late to operate.

If symptons get any worse then I'd go straight to A&E. The doctor in the first hospital said that 1 in 7 who present with symptons have their appendix out, but the operating team said in my daughter's case they were 90% sure that was the problem as the tests confirmed infection and it really hurt if they gently touched around that area.

I'm not saying it's her appendix, but hope the symptons I came across help eliminate that possibility, if not hope you decide if further assessment may be required soon. Hope she is feeling better soon.

Thank you madmog no definitely no signs of puberty, I think she has a way to go on that one yet -

we have had similar happen in the recent past, but much shorter lived pain, that time we took her up to the kiddy hospital & they went as far has hooking her up to a drip ready for surgery, but they had a more senior doctor treble check her & he decided it wasn't acute appendicitis, but again thought it could be grumbling - so I am worried it still might be appendicitis if I'm honest, especially having just having been reminded that our friends 12 yr old had it & he also wasn't sick, but turned out it was very much an emergency - his mum & step Dad both missed the symptoms & they are both Doctors -

also thinking back, I had mine burst on me in my early 20s, again not typical symptoms, GP insisted I had Gastric flu, I was sick, but not much & my pain was also in the wrong place, I was refused an ambulance, but it burst getting out of the taxi at the hospital & I was rushed through & operated on immediately.

She's no better, the pain keeps spiking & she's yelping a bit as a result, think I'm going to give up with GPs, DH is on his way home now & going to take her up to kids A&E, think I'd rather look barking mad over protective mum than take the risk

Thanks for the kick I needed

Sounds like mesenteric adenitis

My 5 year old had a very similar illness back in October/November. She had lots of time off school because she went from the same symptoms you describe to vomiting or diarrhoea every 3 days - I think she was worn down and picked up serial viruses.

At one point we had an emergency doctor booked to visit in the early hours because she was writhing in pain, but then after an hour or two she vomited copiously and we called the OOH doctors to cancel as she started to feel a little better.

She was diagnosed with mesenteric adenitis, but it took quite a few weeks for her to get her energy back.

Thanks everyone :)

Just to update, we did go up to our kiddies A&E & we finally have an answer - no UTI & Appendix unlikely, but DD was right, it turns there was more going on than the stomach glands (mesentric adenitis)' which she does also have -

It turns out she has some impacted stool with a large pocket of wind trapped behind it, which is the source if this bad pain - the doctor could feel it & so could I when she showed me, the doctor reckons this is also the likely cause of her drinking more than she is weeing, but as DD has been to the toilet in the last day or so it's not looking like anything too serious, DD just needs to drink lots & get something laxative in her, so she's on pints of apple juice, fresh orange & has had some Senna -

the Doctor did say if it gets any worse, no improvement etc to take her back, but I feel a lot more relaxed about now we have a probable cause

Funny though lougle that does sound a lot like DD has been going through too, just been one bug after another lately, with a real bad on flooring us all for 3 weeks over Xmas, so the mesentric adenitis does make sense, it's just that DD was so insistent that it felt worse than when she's had that before

She's still very sore & miserable so not out of the woods yet, but fingers crossed it will be on the mend once the senna etc does its job - I hope :)

I'm sure you're relieved to know what the problem is now and it will help with any further treatment if a similar problem re-occurs. I was coming at my reply above from an appendix point of view, but as I said NHS Direct thought the other option would be a blocked rectum which even if the problem was in a different part of the stomach can obviously cause the same symptons.

Hope she is feeling better soon.

Thanks madmog we both managed to get some decent sleep last night, which has helped a lot, she's still in pain, but says the sharp spikes of the worst pain are becoming less frequent & she looks a little fresher than she did, so fingers crossed she will be better soon, poor mite has had a rough time of it lately & she hates missing school

have her take daily probiotcs either powder (i use biocare for my son) or yakult or similar - it can help keep things moving.

make sure this impaction is completely cleared out

Thanks cest we do already give her Viridian powder, but will make sure she gets an extra dose this week -

thankfully the Senna eventually did its job this evening, she felt very ill for a little while as it was a big clean out for her & left her pretty shaky, but within half an hour she had colour in her cheeks again & had a bit of her usual bounce back, by bed time she was almost back to her old self & was gabbling on about looking forward to going to school tomorrow :) - fingers crossed its actually open :)