Help re DD (4yrs) with tummy pain - what to do next?

[mabelbabel]

I took my daughter to the GP this morning, with tummy pain. She's been complaining of this pretty constantly for a few days now. Yesterday told me (twice) she thought she would be sick as well. Wants to go to bed early, but otherwise is more or less her usual lively self.

When I thought about it, actually she's complained many times of tummy pain over the last few weeks/months, particularly feeling tired and sorry for herself at bedtime, which is unusual - Hence the visit to the doctors. Her appetite is low at the moment, particularly in the evening. She has no other serious/on-going symptoms, other than a few patches of excema (which was much worse at times when she was a baby). She is not constipated.

Doctor was very friendly, did all the usual stuff, said there was nothing wrong. Possibly she's coming down with an infection of some sort, but that tummy ache is very common etc. All of which is fine, and I understand. I asked her under what circumstances I should consider bringing her back - eg if it is persists for a length of time, and whether we should keep a record. She said there were only three circumstances in which a repeat appointment would be required:
(1) if we notice DD is not growing properly in relation to her peers;
(2) if she has constant diarrhoea, or
(3) if she cries when she goes to the toilet.

I'm a bit sceptical of this (these sounds like extreme symptoms!). My plan was to keep a record. If the pain is constant for another week or two, then I think it deserves another look. Or if it goes but comes back frequently over the next month or two, then also it deserves another look.

Does this sound like a sensible approach? WWYD? Any other advice in the meantime?

My 10 yo DD saw 9 doctors over a few weeks recently for non specific abdominal pain, including 3 visits to A&E because she was grey,sweaty and screaming. Despite that we were pretty much ignored for several hours on each visit, and when we did see someone we were told that in 90%+ of these cases no organic cause was found or it was all in her head. She was palmed off with various (useless) painkillers and anti spasmodics. Eventually, as the medics were uninterested, I took her to an osteopath who listened to us and diagnosed spasming of the psoas muscles linked to her hypermobility. She's treating it with exercises and the pain is finally receding, she's eating again and has gone back to school. She us back to her old talkative, cheerful self. Now we just need to nail the sleeping!

Spoke to someone recently who had a similar experience with GPs and hospitals with her DD. Turned out her "no organic cause" was a severe dairy intolerance.

A friend of a friend recently had a similar experience with her son. His "no organic cause" was atypical presentation appendicitis. By the time they diagnosed it his appendix was gangrenous and there was pus in his peritoneum.

In all three cases the medics were too blinkered to look past their own preconceptions. No organic cause? Poor diagnostic skills IMHO.

Advice- treat your child holistically. If the GP can't or won't help, try an osteopath. Good luck.

Timeforabiscuit worms could be a possibility. Will consider that and keep an eye on the mouth too. Just glad she's a bit happier today.

My youngest had complained of a sore bottom for a good few months on and off, I'd periodically check her bum (never spotted anything), assumed that lazy wiping was to blame and bunged on some sudocreme.
Usually looked at her poo and again nothing - but it was only the other night I actually spotted the worms (and bleached the house).

Apparently 40% of children have them at any time (so say ovex!) With kids at nursery I'd be concerned they didn't get them at some point seeing as they've managed to tick off every other pestilence and communicable disease.

Fingers crossed for you that you get to the bottom of it.

Just a quick update: Tummy ache seems to have resolved for the time being, though I am keeping a very close eye. Mouth is still sore, BUT since the first ulcer came up (which was definitely spontaneous) I'm aware that she has been biting her mouth - the remaining sore bits don't look the same as the ulcer. Fingers crossed.

UPDATE:
I'm resurrecting this thread with an update. Well the tummy aches resolved and came back less frequently. I guess we moved on with life and starting school etc and didn't worry about it too much. She's complained of tummy ache a few times since, but tbh I haven't been worrying as generally hasn't lasted long, and no other symptoms (plus with starting school etc I put some of it down to anxiety or similar).

HOWEVER, this week, she has complained of a sore tummy - pointing around belly button area - every day, and she is sleepier than normal, and being a bit picky with food (though this is not especially unusual). What has really caught my attention, though, is that she's also developed a mouth ulcer again, which hasn't happened since I last mentioned it above - and I think it's odd that this has again coincided with a prolonged period of complaining of tummy ache. I've also noticed that some patches of dry skin on her legs seem to have flared up a bit (she had some excema as a baby).

I'm not unduly concerned, as she is generally getting on with normal life and I assume this will all pass soon. But do these symptoms sound familiar to anyone? Is there something I should be doing, or should we see the GP again? The problem with monitoring for milk, wheat etc with a food diary as suggested above is that these foods are very common in our diet and wouldn't account for these bouts of happening so infrequently. I can't think of anything else which has changed for us recently.

Anyone? She's 5 now by the way.

I really think you should get her tested for coeliac. I have 2 coeliac DCs, I had frequent mouth ulcers and low energy before diagnosis, the other had tummy pains and sickness. Both would get dry skin at times, was told it was eczema, but this has cleared up in both of them since they have been GF.

Just wanted to add, that the symptoms developed very quickly in my youngest. He went from being very healthy and active to being sick daily and having chronic fatigue in a few weeks. DS1 however developed symptoms over a much longer period, we only got him tested after DS2 was diagnosed, otherwise it would have taken us even longer to realise he was coeliac.

My DD was also diagnosed with coeliac at 4. Only symptoms were occasional stomach pain and frequent reflux (also turned out she had low iron). GP would not have referred for testing if we hadn't insisted (it's in the family).

DD also had red skin patches on backs of knees now resolved, but I had put that down to being or easter softened!

Oops Water softener!

It's that which makes me think not coeliac, MsDran. I would assume symptoms would start followed by gradual decline in health. But whatever is happening here seems to be something which comes and then goes - DD is otherwise happy and well - and slim but not skinny and at least average height. Doesn't seem to have any other obvious digestive issues (except very rarely, which I take to be normal).
Not sure that anything is severe enough to warrant asking GP for a test. But maybe I should mention it to GP?

Just to mention DD's dry skin are some patches on her thighs. There's one or two which are there most of the time and seem to cause no trouble. Last few days they have got bigger/a bit redder and possibly a bit itchy.
As a baby she had really horrible excema on her face for a while.

There's no other coeliac or wheat intolerance in the family that we know of. Though reading around a bit, I think I might mention it to SIL.

(SIL is DD's biological aunt).

My oldest was 14yo when diagnosed. He was prone to mouth ulcers for a few years before diagnosis, the tiredness only kicked in 6 months before (blood tests showed he was deficient in Vit D), the eczema came and went, not too bad just little patches from around 10yrs old. He never had any tummy troubles. We also had no family history.

Can ceoliac symptoms come and go like this without steady decline in health in between?

DD complained of sick in her mouth from about 2 years old but it was very intermittent eg nothing for 6 months. I'm not sure how much her age/communication skills played into that. I don't think you can rule it out because symptoms can be so varied (or none at all)

hmmm. Maybe I should go and speak to the GP, worried they might think I'm over-thinking things.

You need to rule it out, it's only a blood test. Symptoms don't need to be severe but if she has it it will be causing long term damage to her. Your child fits (more than one) of the NICE guidelines for testing and you need to push this with the GP if they are dismissive as not all GPs are on top of current guidelines. Do not agree to a 6 week exclusion diet for example. Phone coeliac UK helpline if you want to discuss they are very very good.

1 in 100 people are thought to be coeliac but only a quarter of them have been diagnosed. It is not rare. This is why NICE want GPs to be screening many more people than they currently are.

They say the average time it takes from first symptoms to diagnosis is around 10 years! This is because symptoms are so varied and can come and go.

Yep if DD didn't have a (wider) family member with it we wouldn't have even taken her to the GP. And it took us 3 visits.

I spoke to the GP on the phone and they've made me an appointment for next Tuesday, but they didn't sound particularly concerned. Which is fine, because symptoms aren't severe etc. When I have the appointment should I ask outright for a coeliac test? Or wait and see what they suggest? I'm fairly uncomfortable about not just taking their advice, and worried they might think I'm paranoid/pushy.

ask for testing for coeliac disease .