DS15 Should I be worried?

[BaconAndAvocado]

DS15 says he feels nauseous most of the time.

About a month ago I took him to the GP as he was having palpitations. She told us to go to A and E.
After 2 ECGs, a chest X-ray, blood tests (I wasn’t told what they were for) the paediatric consultant said that what he was experiencing is not uncommon and around 10-15% of people will experience something similar in this lifetime.
They referred us to a paediatric consultant for a follow up appointment.
We decided to go private for this and saw a paediatric cardiologist who, again, ruled out anything serious.

That was a month ago.

As he was still complaining of feeling sick, I took him back to the GP 3 days ago, who asked for a poo sample, prescribed Buscopan and has asked us to remove gluten from his diet for a month to see if that makes a difference.
I’m due to get the results of the poo examination either today or Monday.

DH wants us to go back to the GP and ask for more tests, he’s thinking the worst but I feel that Cancer would have been ruled out already at A and E?

DS is eating normally, going to school and doing a paper round. I feel that if he felt nauseous all the time, he wouldn’t be doing this.
Although he strongly denies it, I wonder if he is anxious about something.
I think he has a good friendship group and is doing okay at school.His school is a grammar and there’s been lots of pressure there recently - he sat one GCSE and has had end of year exams.

I feel so frustrated as he doesn’t seem to be getting better but, equally, I’m worried that it might be something to do with his mental health but he won’t discuss it.

I feel frustrated as it’s the first time I’ve been unable to solve a health problem.

I had these symptoms as a kid for years.

Coeliacs rules out.

I cut wheat from my diet a few years ago.

That was the issue.

So I think the GF diet is a good place to start.

itsgettingweird thank you.
How long do you think missing out gluten would have a positive effect? ( If that’s what the problem is)
We are on Day 5 and no noticeable change yet.

A&E were mainly looking at his palpitations and you have followed that up with a cardiologist .Along the way a chest x ray has shown that there is no obvious infection in his lungs and nothing obviously more sinister.His heart appears normal and the palpitations are therefore not likely to be due to any heart problem.He probably had a 'full blood count' ( you can check this) which if normal rules out significant infection, leukaemia and anaemia.Anaemia had various causes including cancer but is a sign rather than a diagnostic test and serious illness can be present without anaemia.
He has certain symptoms and your doctor is being proactive in trying to track down the cause.Unfortunately if the history isn't clear cut and examination is normal it is detective work and often things resolve without a cause being found. All you can do is keep track of symptoms and signs and keep your doctor in the loop.There is no test that checks everything.
It seems rather early to be pressing for more investigations without further symptoms or signs, what is it that is particularly worrying your husband?

Just to had, palpitations and nausea are very common symptoms of anxiety and some people, more commonly males, can get a lot of symptoms without even tuning in to the fact that they are anxious. My own DD , who is generally very switched on about feelings had been attributing shortness of breath in crowded places to sensitivity to cigarette smoke for some time before it became clear that she was having panic attacks.

He should try keep a food diary and a stressor diary where he records time place sights sounds etc to see if there is a common theme or trigger.

Cutting out gluten is a mistake lots of GPs make. If you remove gluten then any blood tests for coeliac disease would be inaccurate as you need to be eating it for six weeks prior to the test. The correct approach if they want to rule it out would be a TTG blood test, not stopping eating gluten on the off chance it quickly improves symptoms.

I concur with the anxiety. DD is 15 and used to faint quite often. We had ECGs and other tests done but nothing sinister was found. She's currently experiencing some chest pains which I will get investigated just to be sure but I think it's anxiety again. She's a shy, introverted sort. Even if she wasn't anything going on in the background can cause the fight/flight reaction.

DH who has ASD and ADHD gets nauseous a lot and in fact vomits reasonably often . He has done this when anxious since he was a child though. For him it is 100% anxiety though he still denies this is the case . Of course he also occasionally gets stomach bugs so I know it is often very difficult to tell the difference at first

I think if it is a new symptom though I'd be reluctant to attribute it to anxiety yet and would go along with your DH to try and investigate further in case it has a physical cause

After coeliac is ruled out, the number 1 most likely cause, especially as you are already suspicious of it, is anxiety.

Palpitations are classic for anxiety. As a teen and into my 20s I rolled through pretty much all the physical manifestations of anxiety. There are quite a few!

My palpitations were caused by aneamia due to poor absorption of food (I got given iron and my HB went down 🤷‍♀️🤣).

Hence suspicion for coeliacs.

My dd had frequent nausea, weight loss, pale. Was crohns. Hopefully they have ordered fecal calprotectin.

MumofCrohnie Yes, he has had his poo tested. All clear.

We seem to have finally got to the bottom of it.

DS has told me today that the feelings of nausea generally only occur when he’s sitting down in class.
I think these feelings have become a habit, maybe started when he once felt physically sick in the past and was worrying about asking to leave the room.

What we now need to do, in readinesss for September, is tackle this
problem.

Does anyone know of any good CBT ( I think this might be the way forward?) websites for teens?

You could ask school for a red card so he can leave lessons when he wants, without having to verbalise it. That might remove some anxiety.
I’d also ask school if there’s any help for his anxiety, perhaps getting the pastoral team involved.

Is he anxious about GCSE’s and the future ?
Is there any chance he’s smoking weed ?

Kooth is online mental wellbeing support for teens. Many schools are signed up, worth asking yours.