12yo DS constant diarrhoea - do I take him to A&E today?

[MrsCrumpets]

Sorry it’s a long one, just don’t know what to do anymore.

My DS (12) has had diarrhoea on and off for months now. Some days it’s just once or twice, other days he’s back and forth to the loo all day. GP keeps saying it’s probably anxiety but he doesn’t seem anxious at all – he’s fine in himself most the time, goes to school, eats alright, seems his normal self. School have been great with it. He’s had all the basic tests – bloods, stool sample etc – all came back normal.

GP also told us to try changing his diet which we did, tried cutting out dairy and all sorts but it didn’t help at all. He’s just fed up now and I’m starting to worry more.

This morning is the first time he’s said his stomach actually hurts when he woke up. He’s already been to the toilet a few times and said the pain got worse after the last time. Now he’s lying on the sofa with a hot water bottle, says he’s tired. I gave him paracetamol. No vomiting, just diarrhoea, sore stomach and tired.

We’ve taken him to A&E before on a bad day and they just gave him fluids and sent us home. I don’t wanna waste their time or sit there for hours again if they’re not gonna do anything, but I also don’t wanna ignore it if it could be something more serious.

Would you go? Or wait and see how he is later? Not sure what to do anymore tbh.

Yes I would

I would go back to gp and ask for blood tests for coeliac and general blood count.

Without hesitation. Take him now.

GP sounds most appropriate. 111 (if in England) if no luck getting an appointment.

I wouldn't. Sounds like it is just ibs if he has already had all the tests. Don't waste a&e's time. It isn't an accident or an emergency. Get another gp appointment if you want.
No wonder the wait is so long!

Yes I would. Make sure they’re testing for coeliac disease and also doing a morning cortisol blood test to check for Addisons / adrenal insufficiency- this is very rare but the constant diarrhoea is often a classic sign. The cortisol blood test needs to be done between 8-9am, no later. If under 300 he needs referring to endocrinology for more tests.

Poor lad - that sounds awful - and having no answers is so upsetting and frustrating. I'd probably ring the surgery and ask them what they suggest you do. He's not getting any better, their suggestions haven't resulted in a solution/diagnosis and he's suffering and in pain, so what do they recommend you do?

Thanks so much everyone – really appreciate all the replies.

GPs have honestly been useless. We had to keep chasing them just to get the results of the tests and they just said everything was “fine” without really explaining anything or offering what to do next.

We did the diet changes they suggested, nothing worked. Just feels like we’re going in circles.

I do feel like if I call the GP again they’ll just say the same old thing, but I’m also really torn about A&E – like I know it’s not technically an emergency, but at the same time he’s getting worse not better, and now with the stomach pain I’m second guessing everything. Poor lad’s just lying there now looking completely exhausted.

Going to give it a bit more and see if he perks up at all, otherwise might just take him in. Just feel like no one’s taking it seriously.

This happened to one of mine. There seemed to be no rhyme and reason to it. Somedays were better than others and then it was continuous or urgent. In the end we need an exclusion diet. Stopped basically everything and then reintroduced foods slowly (details can be found on line). In my child's case it was dairy and once we knew that it more or less cleared up. You have to give it time. Your son's intestines are probably very inflamed so will take time to recover.

I really don't think going to A&E will get you anywhere. The only time diarrhoea becomes an A&E issue is if the person is becoming dangerously dehydrated and needs admission for fluids. Everything else would be handled as an outpatient. They will tell you to go through your GP.

Gp or 111 triage is appropriate

It’s neither an Accident nor an Emergency. Take him back to the GP

No I wouldn’t go to A&E.

Have you tried the FODMAP diet? Kept a food diary to see what his triggers are?

If he can take paracetamol and keep down fluids he doesn’t need a&e. Get some dioralyte to slowly sip and lots of rest.
Low residual diet until he’s feeling a better, this could take some time. Keep a diary of everything he eats and symptoms. Only introduce 1 thing at a time.
Good luck with the gp I hope they will help. If they won’t help a 111 call.

This recent stomach pain and feeling really unwell is in addition to the diarrhoea but feeling well in himself thing so I would take him to the GP tomorrow or A&E tonight if he starts getting serious pain and/or a fever.

They may be related or they may not.

For me it's neither an accident or an emergency.

I'd phone 111 and ask their advice and try and get an appointment with GP. It's frustrating when GP doesn't appear to be doing anything buy sometimes you just need to be forceful with your words and refuse to leave until something is done.

Back to GP and insist on referral to gastro paeds . Has he been tested for coeliac ?

Very random response but he doesn’t have a pet reptile or another type of pet does he? DS went though similar diarrhoea along with vomiting on and off for weeks and weeks and it turned out to be salmonella from his pet, which he handled a lot. Once he started using gloves, it cleared up.

Just out of interest has he just gone back to school after the easter hols?

Could something be bothering him at school?

Its incredible how much emotions/anxiety can affect the digestive system. Given the doctor has said the probable cause is anxiety, have you explored this at all, tried to establish if anything is bothering him deep down?

This

He’s still in pain, hasn’t moved much from the sofa all day and hasn’t really eaten anything – which isn’t like him at all. He’s not even been on any devices, just lying there with his hot water bottle. He got up earlier to go to the toilet again and said he felt dizzy when he stood up.

We’ve been keeping a food diary for weeks now like the GP suggested and there’s no clear pattern – nothing that seems to set it off or make it worse.

He’s not back at school till next week after Easter and he’s had a nice week overall – seeing friends, family, no stress, been in a good mood. He doesn’t seem anxious and when I asked if anything was on his mind, he said no. I really don’t think this is in his head.

My son is berh similar to yours, in that there doesn’r seem to be a reason for it and it comes and goes, tried all the GO suggestions, the whole shabbang. Have you pushed for a colonoscopy at all? My other suggestions are low FODMAP Diet like someone else suggested, and as little added sugar as possible. Is it consitently bad for him? Or does he have good and bad days?

If he’s in pain and dizzy please take him. He may have something like appendicitis. It’s better to be safe than sorry.

Next step would be referral to gastroenterology
Go back to gp demand gastroenterology referral
What blood tests have been done eg coeliac?
Did gp order poo sample test?

The stomach pain could be unrelated. Dc was bent over double when had appendicitis.