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?

I have celiacs, and before I was diagnosed my symptoms varied.
Do not remove gluten from her diet before testing as the results could be wrong.
Also something else that can cause tummy pains with mouth ulcers is chrons.

DS1 had recurring gastric problems and he also mentioned that sometimes he was sick in his mouth.

Turned out he was suffering reflux like symptoms, and probably had been for years, but this was his normal and he only complained if it was worse than usual.

All the usual treatments for reflux made no difference - medication, tilting his bed, not eating and drinking at the same time etc etc. An endoscopy showed nothing other than irritation and some sort of crystals as a result of the reflux.

This was because it wasn't reflux as in a problem with the valve at the top of the stomach, but because he was swallowing down air when he ate and it was coming back up and bringing stomach juices with it, causing pretty much the same symptoms as reflux.

I read on here about the link between tongue tie and gastric problems. Digestion begins in the mouth, and if the chewing and swallowing is compromised, it can have a knock on effect on the whole system. I found someone to revise his tie and it stopped overnight. The change in him was incredible. I had no idea it had been affecting him so much. He suddenly had a heap more energy and was willing to try different foods.

The gastric problems were only one part of a puzzle though, he had also been an inefficient breastfeeder, terrible sleeper, snorer, mouth breather and had allergies amongst other things. Mouth ulcers were also something he got a lot.

He is 9yo now and we managed to resolve every one of his problems with revision and orthodontics. There are pictures on my profile from before any work was done.

I have no way of knowing if your DD is similar, but I know that it is very hard to see your child unwell only to have the doctors dismiss you

mawbroon, I have seen some of your posts before. The effect of tongue-tie on your DS does sound remarkable, and thankfully I don't think DD is suffering to the same extent. However, she does have a tongue tie which was clipped when she was quite young, but I'm not convinced it was done terribly well. I've mentioned it elsewhere but DD1 and I also have uncorrected tongue-ties. It doesn't cause me any problems, and although DD1 struggled to breast-feed (we didn't realise what the problem was at the time) we have otherwise had no trouble. Though of course everyone is different and it is possible that DD2 has difficulties that DD1 and I do not.

I'm not surprised in the slightest to hear she has/had a tongue tie.

Sadly, not everyone who revises tongue ties understands about them.

Total speculation here, but it is not impossible that she still has a restriction. Possibly an anterior (obvious) tie was revised leaving a posterior one. Or a posterior was incompletely cut.

Posterior ties are notoriously hard to diagnose unless you know exactly what you are looking for. DS1 had no speech problems, and could stick his tongue out really far and lift it really high. It was the back of his tongue that was tied down. HCPs seem to focus on speech, breastfeeding and licking ice creams. That is unless they have taken a specialist interest in it.

I would certainly encourage you to also investigate the tongue tie issue as well as the other suggestions on the thread. I do need to stress though that we were extremely lucky that the revision stopped ds1's gastric problems overnight. It is not a magic bullet, but it can be a starting point.

If I had known then (2011) what I know now, I would have not bothered with my GP or other NHS docs about this and I would have gone straight to see a specialist. Dr Levinkind in London is the one I would recommend if it is at all possible. I saw him for DS2 and although we decided not to do revision for DS2, I would certainly have been happy for him to do it. He is very knowledgeable.

There are also a couple of tongue tie groups on facebook which you might want to look at joining.

Thanks, will add this to the list for consideration.

Good luck x

One more thing! DS1 was also screened for coeliac because the symptoms seemed similar. Unsurprisingly, it came back negative because that was not the problem!

Argh. I chickened out! We went to the GP, and I described symptoms exactly as I have done here, but I couldn't bring myself to ask outright for testing. I did ask in what circumstances they would start thinking about checking for other things, and the response was as in my OP - it would have to be losing weight, blood in poo etc.

Her diagnosis was possible constipation. Though it doesn't quite fit I don't think.

I've made myself a note to check how things are in one month and two months, and follow up with GP if symptoms return or do not completely go away (it's easy to lose track of time once an issue is not at the forefront of your mind). I'm not sure what else to do. .

Symptoms are not severe, no school time has been missed, DD is generally happy and bright. But something is not 100% right.