Ongoing tummyache

[DeWee]

Dd2, (11yo) is a bit of a drama queen, particularly when it comes to illnesses etc. She can use it as a bit of an attention getter, and to get out of doing things she doesn't want to. So I don't tend to take immediate agonising cries of pain too seriously.

However I don't know what's happening with her tummy at present.

She started tummy aches round her tummy button mid September. I took her to the GP when she was crying because it hurt. As I said I wasn't too worried as it's always "absolute agony", and when the GP (registrar) said abdominal migraines, which she's had before, I was quite happy to accept that.

She continued to complain generally about her tummy in similar place, but just in a generally sore rather than anything else.

At half term, we had a night of her not being able to sleep because of pain, her temperature then shot up and she vomited (once I think). So we went back to the GP and saw the lovely sympathetic GP, who is very careful, who sent us to A&E with a note to scan for apendicitis.
A&E looked at her, prodded her tummy and decided she wasn't that bad and sent us away with a scan for a later date, and instructions to cut back on milk and gluten.

3 weeks later I had to take her to the senior partner GP about her migraine tablets. He's canny and doesn't worry uneccessarily generally. Lot of trust in his ability to know when things are not right.
He took one look at her, and was concerned by how pale she was. Felt her tummy and said there was definitely some physical reason not abdominal migraine. She also had a sore throat, but not needing antibiotics. Took bloods.

Had scan, told all normal. Bloods came back basically normal with slight infection markers up.

1 week later she started having "sharp attacks". Where she would curl up and say it was suddenly much more painful for 30-45 minutes about once a day. Again with her "drama queen" tendencies, difficult to know how much more painful. She did this last Thursday morning, when she knew that she would miss 2 clubs she liked at school, plus was likely to need more blood taking (which she hates).

Senior partner GP sent us straight back to A&E where we waited a long time to be asked if she's had a cold recently. When we said sore throat last week were told it was probably a virus, go away. Apparently a sore throat virus can backdate tummy pain by 2 months.

Now she's not having these "sharp attacks" any more. She's still very pale. Her appetite is sporadic (having been a very good eater before all this). And she seems to have constant tummy ache round her tummy button. Generally not enough to stop her doing things she wants to, nor get out of things she doesn't want to. Her temperature's only been up that one time, and she only vomited that once too.

MY thought is that if it's stll painful by Wednesday ask the GP to take bloods again. He said that would be a good idea to see how things were changing.

In some ways (knowing her) I wouldn't be that worried if it wasn't that the GP is worried. It's unusual for him to be that concerned. He'll see her at a moments' notice etc.

My two thoughts are

1. I think the GP thinks it may be appendicitis. He's definitely concerned round that.
2. Possible Coeliac. The "sharp attacks" came just after we'd restarted gluten. She has other markers which could be that too. The blood test wouldn't show it because she was off gluten at the time.

Any other thoughts.

My first thought was allergies/intolerance

coeliac

maybe puberty

anxiety maybe?

If she's pale though that would make me think. It was more likely an intolerance or coeliac as that would inhibit absorption of other minerals and vitamins

Thanks, I'm thinking along the same lines, which is good.

Not puberty. She's some way off that, and it's been checked.

Could be anxiety, she does suffer from that, but it doesn't go with the GP saying there's a physical cause. In fact we see him regularly over dd2's anxiety and he's said specifically he doesn't think it's that.

She was low on the vitamins on the blood test, though not badly, which was another thing that made me think coeliac. But we saw no improvement in the weeks we had where we cut down to almost nothing-may not have been long enough, 3 week, to see a total improvement, but if anything she got worse in that time.
She's very pale. She's naturally pale, but she's almost grey at times now, and it's the first thing people notice.
But she's not noticably lacking in energy either, despite not eating much.

I'm still guessing coeliac though. Dd2 says it isn't because she can't live without donuts. So if anyone knows if you can get/make gluten free donuts that might be a good start.

there must be recepies online

You can get gluten-free everything, including donuts. I get a mix from the Wheat-free bakery direct.

If I were you, I would ask to be referred to a paediatric gastroenterologist. It sounds like coeliac disease is a possibility - but you have to be eating gluten in reasonable amounts for at least 6 weeks before the blood test, otherwise they're pointless.

My coeliac DS had the symptoms you describe before diagnosis. He is also a bit of a drama king. I sometimes suspect that stems from years of internal discomfort that got ignored before he was diagnosed. He is very well now. Really important to get coeliac tested properly. Cutting down on gluten isn't enough to make a coeliac well - you will just incur ongoing internal organ damage.

Please have a look at the Coeliac UK diagnosis page, and get your DD properly tested.

Wolfbasher Thanks. Donut's will relieve her mind. They look pretty good on the website.

The cutting down was suggested by the paed in A&E. I was a bit about it as I suspected that either you needed to go totally off, or it wasn't worth bothering about as it wouldn't make it better. Judging by my GP's face when I said what they'd said to do he was thinking that cubed. . It sounded at the time a bit placebo ie pretend you're doing something as don't know what to do.

Assuming it doesn't get better, I'll request another blood test at the end of the week (the GP will want to do that if she doesn't get better to see if there is any change) and request that we are down for coeliac test in 5-6 week. Just after Christmas.

Thanks.

Shocking that a paed recommended "cutting down"! I know a lot of GPs are clueless, but I'd expect more from a paed. Although I don't know why because we saw one for 18 months who was convinced that DS's problems were down to our vegan diet (we are not, and never have been vegans, as I kept telling him).

That sounds like a good plan. Blitz your daughter with full-gluten doughnuts and whatever else she likes for 6 weeks, and then do the blood test. You might want to keep a food diary of what she's eaten, and what symptoms she gets.

Other things to watch out (as well as stomach pains) for that may indicate coeliac

• pale 'floaty' smelly stools (because the damage to the small intestine prevents fat from being absorbed by the body)
• bloating to the stomach (DS's looked like a 6 month pregnancy at times)
• anaemia
• tiredness/listlessness
• 'zoning out' - having short periods of up to a few minutes at a time where they just stare into space and seem not to be aware of what's going on around them
• headaches
• leg/joint pains

I don't think cutting down on gluten would show an improvement if she's coeliac. It has to be eradicated completely - then improvement starts very quickly (within a few days/weeks in our case). BUT - once you've given up gluten, then when you have it again, the symptoms are often much, much, much worse (hours of projectile vomiting and writhing in agony on the floor for 5yo DS when he had a bite of the "wrong" sponge pudding at school). So, you don't want to go gluten-free until testing is complete, as it may be a dreadful process if you have to re-start gluten after being gf (if she is coeliac).

i definitely felt that the paed suggesting it (he said dairy as well) was probably what he said to anyone with tummy ache rather than because he thought it was specific to dd2.

I've been keeping a diary:

That list isn't really dd2.
She tends to constipation.
Bloating-yes a bit
she was slightly anaemic on the blood test
doesn't seem particularly tired-she's full of energy
never seen her zone out
she does get migraines and is on medication for that
she did have top of the leg pains, but not joint pains.

She's come out of school looking terrible, although she's quite cheerful in herself. All yellow with black eyes.

I've also just taken her temperature. Rather strangely she seems to be measuriing under-around 35.2 in her ear, but was 36.5 in her tummy button (I only did that to make her laugh). Not sure if that's my thermometer though. I shall check again shortly.

When I was 17 I had gradual fever with which affected the glands in my tummy, so much so the emergency doctor thought I was in labour !!!

Just with you saying she had a throat virus ....

That's glandular ..damn predictive text lol

Fluffy I had glandular fever and was warned about that so I did ask the GP about that. he was "fairly confident" it wasn't that, despite having some glands up in the neck.
I think it was checked on the blood test too.