Any GP’s? Child tummy aches

[NeedthatFridayfeeling]

Just wondering if any GP’s could give any insight, I’m going to get an appointment sorted on Tuesday when they open.
For months now my 8 year old gets random tummy aches, early evening mostly at weekends, it’s before dinner and happens no matter what the meal, even something she loves so i don’t think it’s to get out of eating, she’ll go to the toilet a lot during these episodes and will take herself to bed early.
She’s had this before when in Y1 at school, had stool and blood tests, all clear, the paediatrician thought anxiety and not drinking enough (true! We’re still working on that)
I thought anxiety around her school play but that was weeks ago and they are still happening. She’s mostly ok on weekday evenings.
Loves school, wants to be there, great teachers and friends though can a ‘frienemy’ situation with one girl.
Other thing is she’s waiting on a dyslexia assessment regarding her spelling and i know it bothers her despite us and her teachers reassuring her.
Just worried and so sad for her.

Have you had a look at abdominal/stomach migraines.

I’ve never heard of them, will take a look, Thank you

Dyslexia is often related to ADHD. Is there anything that might suggest neurodivergence?

I had unexplained tummy aches a lot as a child and they were due to anxiety caused by undiagnosed AuDHD. It all made sense but only decades down the line. There didn't necessarily have to be predictable triggers (eg upcoming performance, change in routine, friendship issues). It was more an overall inability to regulate sensory issues and not even being aware of becoming overstimulated. I also developed emetophobia around age 8 so I was hyper aware of bodily sensations (emetophobia and anorexia are very common in ND girls). Going to the toilet frequently and going to bed early sounds like anxiety and sensory issues and just having to deal with "too much" during the day. Weekends tend to be out of regular routine so that might easily cause dysregulation.

The best remedy is really to give her enough downtime to self-regulate. This includes unstructured free time, enough time to relax and engage in something that is fun for her (including screentime, video games etc). Planned activities like clubs or sports also caused sensory stress because of the mental and physical transitions involved. The best routine was coming home right after school and decompressing with whatever activity I wanted until dinner. Weekends should also be unscheduled if possible or with only half-day activities. Full day weekend activities still stresses me out, even as an adult.

The stomach migraine sounds very much what she’s experiencing, thank you! I’ll raise that with the GP when i get an appointment, sounds like it could be the cause.

Nothing to suggest neurodivergence at all, her teachers did an assessment for the dyslexia assessor and no flag. I struggle with anxiety so do wonder if that is playing a part.
She has lots of downtime at weekends but does get bored, does Brownies and gymnastics clubs in the week which she adores and we try and keep other evenings for relaxing

We've had about a year of unexplained tummy pains; initial symptoms suggested her dairy allergy was back so we cut it out and things have improved slightly but never went away completely. She's also not a good drinker. Long story short we are now under children's hospital for chronic constipation and fecal impaction; we're just going through disimpaction. May I add all this time she has been going to the toilet. I'd definitely look into possibility of constipation and also have her wee and stool tested (nurse initially thought she might have IBD as stool results showed very high levels of calprotectin that's how we ended up with gastro consultant who did x ray on her and could see she's bady constipated). Her tummy was soft to the touch neither nurse, peadiatrician or even gastro consultant couldn't feel impaction through tummy exam alone.

My DC both had abdominal migraines as children. It can be related to stress but not always in our experience. They both grew out of them but it took a while.

I had the same as a child but nobody used that term back then.

Don’t want to state the obvious, but she seems to have anxiety at the same time in the evening at weekends…does she see her dad then, or any other male figures?

Does she get up to use the toilet in the middle of eating? That is a common flag for IBD.
Is she skinny, or losing weight? Pale? Hair condition? Does she have diarrhea during these episodes?

If so, might be sensible to ask the doctor to consider a fecal calprotectin test to check for inflammation in the bowel.

How much water is she drinking?

Has she been tested for coeliac disease?.

I have none of these symptoms and normal calprotectin, and have IBD. You can get a constipated type IBD too.

I had the symptoms of OP's DD at OP's daughter's age and it was dismissed as anxiety. It took until adulthood to find out I had IBD all along.

No we’re together, it just comes out of nowhere, can have been playing/watching tv then boom, tummy aches.

Hair is gorgeous, yes she’s skinny, usually 25th centile but dropped to 9th a few weeks ago when these tummy aches were at their worst she wasn’t eating much and going to toilet a lot, during a tummy ache she will leave the table to go to the toilet. I’ll look into this too.

Not enough water, we’re constantly reminding her to drink more. Not sure what they tested for last time but I’ll ask when i get an appointment

Yes, iirc the small bowel IBD doesn't show as much in calprotectin. However mentioning IBD is a good call to get it on the radar.

Thank you all so much for these comments, given us a lot to look into and ask the GP about.
There don’t seem to be any food triggers, can happen or not no matter what she’s eaten during the day.

Sorry it took so long to get a diagnosis, i hope it’s manageable now.

Roughly though, how much do you think she drinks in a day? Or is she eating lots of water-containing foods such as fruit and veg, soups, stews etc?
Could you increase those in her diet?

There is a good patient info leaflet from St. George's Hospital about this type of pain which is often what's called "Functional Abdominal Pain" - https://www.evelinalondon.nhs.uk/resources/patient-information/functional-abdominal-pain-disorders.pdf

Includes some recommended lifestyle measures too.

A pint a day at weekends, sometimes not even that, despite us constantly telling her to drink, not sure at school.
She has soup every weekend but only tomato, eats a good amount of veg with every meal and snacks at home are an apple/pear/grapes or strawberries plus a good pile of cucumber/celery or pepper, she loves all of those so we do give good amounts. I could start sending that to school for snack time too to increase what she eats.

Thank you I’ll have a read.

Will she drink other liquids? Cordial? Juice? Or ice lollies?

Mine is not in the small bowel. My calprotectin last month was 4. It's not severe but the symptoms sure can be. Definitely a good thing to investigate, keeping in mind that the tests are only part of the picture. At least OP is listening to her child and not writing it off as anxiety as I'm sure many of us experienced. Good for you OP.

Ice lollies yes so we always have sugar free ice pops ready for her, the rest no, not interested in them, only really likes water. Her bottle is easily available to her in the fridge as she likes it cold, i think she forgets to drink.

Thank you @PawsAndTailsi just really want to get this figured out so we can manage it and while i don’t expect to fix it if we can at least do what we can to reduce it happening.