Cystitis in a 7 year old?

[moosemama]

Dd has been having intermittent Cystitis symptoms since Wednesday. We've had her drinking lots of water and making sure she goes to the toilet regularly and it seems to come and go.

Last night it seemed to get worse, plus she's been tearful, clingy and not herself at all. So, she's been to the OOH GP this morning. Her temp is normal, there was not trace of anything in her urine and despite her telling us she keeps having pain under/around her navel, no tenderness in her abdomen at all .

Yet, she has urgency (to the point of sobbing when her brother was in the toilet room when she needed to go) and when she's finished wee-ing she says she feels like she needs to go again. There was one occasion, the first instance actually, where she said she had a stingy pain when she tried to wee, but couldn't go. Now she says it doesn't hurt, but it's uncomfortable and feels weird.

Bowels are regular and normal, no constipation. No symptoms of worms. No itching or discharge.

She is never ill normally, in fact we couldn't remember the last time she needed to see a GP, it was that long ago. She is also not one to complain and this clinginess/tearfulness is not like her at all.

She has both us and the OOH GP flummoxed. They've advised us to keep up the water intake and make sure she goes to the toilet regularly and bring her back if her temp goes up or she starts to be in pain.

I asked if they have anything like paediatric cystitis powders they can give her, but they said no.

Has anyone come across anything like this before and if so, how was it resolved?

Do you know if she is drinking enough/going to loo enough at school? When my dd went into yr2 I didn't realise for over a term that the staff no longer filled water bottles (they did in previous years). The lack of liquid for weeks led to dreadful constipation for months. At the same time she didn't want to go to the loo at break and miss her friends and was too shy to go during class! Once all this eventually became evident to me I spoke to the teacher who said she would be allowed to go to the loo without asking any time and gave her a bit of encouragement to drink. Also my ds is currently going through something similar. Having just started reception he hasn't got confident about drinking at school yet and is getting intermittent constipation and discomfort weeing. I'm hoping I can sort it in half term next week. Lots of encouragement to feel confident at school, talk with teacher/ta, listening/really trying to get to the details of what's going on when you are not there seemed to help.

I'm sorry to raise this, but did the OOH GP do a finger prick or urine glucose test?

Hi, thanks for answering. Things have moved on since I posted last week.

memememum Yes, she drinks plenty and always goes to the toilet at break and lunch. They are allowed to refill their own water bottles during the day and drinking regularly is encouraged by the teacher.

She hadn't had any constipation at all.

Teacher was great reminding her to drink and allowing her to go to the toilet whenever she wanted.

T1mum3 no they didn't. She isn't weeing excessively though, it's more not being able to go or feeling like she still needs to once she's finished.

I found some cystitis powders that are suitable from the age of 6 (Cystopurin) and started those on Sunday. They definitely helped the symptoms, but didn't get rid of them completely.

She was no better on the Monday morning, so we had her triaged at our main GP surgery. They dipped her sample for 3 minutes and found trace leukocytes so gave her a three day course of trimethoprim. That gave her an upset stomach, but didn't help the symptoms at all. Called the GP to be told the sample that tested for leukocytes was sent to the hospital and as completely clear - not even any white cells.

She's was off school Monday and Tuesday, back in Wednesday, but then the symptoms came back full force and she was off again on Thursday. Today is an INSET day for her school and we've been back in to see the GP.

Our appointment was at 9.20 am. We saw the doctor at 9.45 and she asked for another sample. Dd was unable to produce one, so we went to the waiting room, where she drank a 500 ml bottle of water, on top of the large tumbler of water she'd had at home. We went to the toilet twice, both times she said she felt like she was desperate to bursting, but not a drop came out.

We were called back in to the GP, she examined her stomach, took her temperature and sent us home to try again for a sample, which we then had to drop off within the hour to catch their hospital lab pick up. Dr wanted us to keep half the sample in the white-lid bottle for them to dip in case it was anything acute and pour the rest into the one for the lab.

She managed to go at home, but while we were there I decided I'd properly check for any signs of swelling or discharge, as she'd been insisting she had no itching or soreness, so no-one had checked. I checked her before she did her sample and the area around the urethral opening was imo v swollen. So I called the surgery, explained and said I thought she needed to be re-examined and as a result we were put on the triage list.

Went back to the surgery, sample again dipped completely clear. Dr called us back in and examined her, but said all seemed normal. I had a look and the swelling had gone. Think the dr thought I was barking at this point, but it was definitely swollen before she did the wee for the sample and had gone down afterwards.

Dr still at a loss, decided to try her on a thrush cream. I asked twice if she thought everything appeared normal and if so, why thrush cream and she just said it was worth a try, but if things get any worse or develops a temperature or new symptoms bring her straight back.

The one thing dd has consistently reported is pain around her navel, but this has been dismissed by both the OOGP and the one we saw today, who both declared her abdominal exams normal.

I am so frustrated, we're getting nowhere, dd is now getting increasingly anxious about going to the toilet, this has been going on for 10 days in total and we are no closer to an answer.

If the canesten cream doesn't make any different I am going to ask for an urgent referral to someone who knows what they're talking about.

Between that and the arrogant fracture clinic consultant who accused my ds of lying about dislocating his shoulder, despite A&E staff seeing it out of place (consultant failed to read the notes and see that ds has hypermobility syndrome) and then tell him that if he was hypermobile it would dislocate, but not hurt, I am at the end of my tether. Four weeks of almost constant hospital appointments for two dcs and all but one of those appointments has been totally useless.

I went through this when I was about seven. I think what caused it was that I had thread worms so they were spreading gut bacteria forward into my vulva?
One thing that worked to help me pee was having a jug of lukewarm water (with a bit of baking soda in it) to wash over while I tried to wee.
It was a horrible, uncomfortable time, hope your daughter is ok!

Thanks Wonderflonium. We have considered threadworms. I suggested that to the GP and she just shrugged it off. I've bought some Ovex to give her just in case, plus planning a thorough deep clean of her room this weekend. Trying to cover all the bases.

The thing that's odd is that she says it doesn't sting to wee, she just can't go, even when she feels like she's bursting. That and the lack of anything showing up in her samples would suggest inflammation, rather than infection to me.

She's been wallowing around in a bath most of the afternoon, just keeps topping it up when the water gets cold. She'll have to get out soon though, I have to take ds2 to physiotherapy shortly.

Spoke to dh on the phone and we've agreed to try the canesten cream today and tomorrow and if no better give her Ovex on Sunday, after thoroughly cleaning her room and washing her mountain of cuddly toys. Not chuffed we'll have to treat the whole family, but it will be worth it if it helps dd. I have two ds' aged 14 and 12 and we've never had to deal with threadworms until now. I don't want to give both treatments at the same time, as I don't want to confuse things. If she improves, I'd like to know which one it was, so we can treat quickly if it ever happens again.

Thank goodness it's half-term, as it'll give us a chance to try and find out what's going on and sort it out without her having to miss any more school, plus she has free access to drinks, toilet and nice warm baths. She's happy enough for the moment - currently singing full volume!

One thing I'd forgotten about, you reminded me...
My mum put me in the bath too because I had the same thing (the urge to pee but nothing coming out). I pushed and a tiny bit of blood came out. About a year or so later, I started regularly having my periods. It might not have been related.
Glad she's feeling better and she doesn't have to go through this at school.

We decided to switch things around and try the Ovex first, as she really wasn't showing any signs of thrush.

Sure enough, within 24 hours she was symptom free. I was more than a little cross that both nurse practitioners and two doctors shrugged the idea that it could be threadworms off when I asked them directly.

So, we've all had the treatment, deep clean of her room completed, we're staying on top of the vacuuming and damp dusting and she's having a bath first thing every morning, with pjs, underwear, towels and bedding going straight in the washing machine as soon as she's out of the bath.

She has a second dose due Friday next week and fingers crossed that will be an end to it.