6 year old - long running tummy pain and school distress

[Corilee2806]

I’ve already posted elsewhere about my younger child who’s awaiting an ASD assessment, but now things are escalating with my 6 yr old DD too, and I could use some shared wisdom from parents who’ve been through similar.

She is bright, kind, and academically flying — but over the past year, she’s developed regular tummy aches that are now constant. We’ve been back and forth to the GP since Reception, and last week it got even worse and she was diagnosed with a UTI and constipation. She’s on Movicol and has just finished antibiotics, but the pain is still there.

She’s visibly distressed, crying at drop off and resisting going in most days, rocking at night, crawling on the floor, saying things like “my tummy will never feel better.” We went to A&E last night but no tests were done and we’re back to square one.

I’ve started wondering if this is anxiety or even early emotionally-based school avoidance (EBSA). She’s also highly sensitive, reacts very strongly to noise, smells, and social tension, avoids children’s films and flushing toilets, and has real trouble sitting still. Some signs of possible neurodivergence are creeping in now that we didn’t see before.

The school are ok, but not exactly on the front foot. We have a paediatric referral pending but no date.

Has anyone been through this? Could it still be something medical? Or does this sound like a neurodivergent child in distress? How did you get support for school anxiety that doesn’t look like outright refusal (yet)?

Feeling broken and desperate to help her, but I don’t know where to turn next.

It was anxiety in DD. Started around year 3 and didn’t end until I removed her from school in year 9 - she is autistic and it was very much related to the distress of being in school

Leftie?

Poor thing. Sounds like the distress of trying to cope in the school environment and she just isn't able to articulate it.

This is my fear. Last night at bedtime she was telling me about how she has ‘thousands of worries’, it’s like she seems to keep a file of them and goes through them. She told me some of them but they are very much not rooted in reality or things that could really happen but she seems to have a vivid imagination. I don’t really know where to start.

Has she been tested for coeliac disease? This is what my DD had in the end.
What was suggested to me re DC anxiety was a worry box to write the worries down and put them in. Do that every evening and when your DD is old enough, she can develop the habit of journaling which is another way of managing anxious thoughts.

Sounds similar to my daughter, who's on the pathway for ADHD assessment.

She has a lot to cope with - parental ill health, difficulties sustaining friendships, dwells on the death of her grandfather. Recently we started counselling for her and it is helping - a safe space to share her worries and a trained person helping her to identify coping strategies. She's 8. Helpfully for us her school is very supportive and her tummy pains have definitely eased recently, but still flare up now and again.

DS was similar at that age. We paid for a short course of counselling with an NLP counsellor which was quite useful for the worries and I did guided meditation type stories with him at bedtime. Something I wish I'd done was engage with the school a bit more, a lot of his distress came from being on the learning difficulties table (he is dyslexic & dyspraxic), there was a child there who was quite violent and another who used to scream loudly and unpredictably and these really added to his stress. At the time I thought it best not to interfere with the teachers judgement (and I didn't fully know the extent to which he found this stressful and how much it happened) but really, him moving tables would have helped I think.
My sympathies OP, I used to drag and coax him into school crying and spend the rest of the day worried sick.
FWIW things are much better now he's in sixth form.
Get in there with the school and work out what about it is stressful is my advice. They should be able to make adjustments.

What’s going on at home and in life around her? Can you ask the school for a referral for play therapy?

That’s not to be like, this is all in her head. But I was exactly like this as a child with tummy pain and school refusal. It’s probably that my home life was very stressful and the people around me weren’t able to help me deal with some of the difficult stuff I was having to deal with.

Beyond that though, I do think getting upset going into school, crying, clinging to parents, being upset talking about school is still very normal at 6. One of mine was definitely like that at 6. I have no concerns about him at all. He is NT and walks happily into school now. But 4-6, yes, it was a battle. It’s still very new and overwhelming for them and it, by itself, doesn’t necessarily mean something is ‘wrong’ but I think you are right to address her vocalising that she is worried. And I think it’s quite possible that is related to the tummy pain.

She’s been tested for celiac a few times and about to one more time just to rule out and do some other tests to check for any physical causes. She has a very restrictive diet due to her sensory issues which I’m sure doesn’t help.

a worry box is a great idea - I’ve already got her one of those happy journals which she uses at school.

Home life is pretty settled on the surface - no major life stressors or events and we work hard to try and keep everything on an even keel, but it’s hard with both of the kids struggles. She is highly sensitive and I’m sure has picked up on my stress, until recently I was working in a very high pressure job which I’m now signed off from and have quit, so I’m sure my stress and distraction affected her which I feel awful about. Her brother also has a lot of meltdowns and outbursts, sometimes physical which affects her. She has taken on a bit of a caregiver role in terms of anticipating and translating his meltdowns which is very sweet but must be hard for a 6 year old. We’re really trying but getting very little support as a family currently. It makes me very sad.

The school have said they’re putting a pastoral support plan in place for her which is good

Not wishing to remotely dismiss her physical pain or the need to investigate that but yes anxiety can manifest as tummy ache in children. It's a way they can describe stress. I remember feeling overwhelmed and "tight" like a coiled spring as a primary aged child. Bless her she sounds overwhelmed so glad you're progressing pastoral support alongside medical.

I agree I think it’s mostly anxiety and emotional. I think some of the other factors in the last week or two haven’t helped eg with the UTI - but I think it’s all part of the underlying emotional and sensory issues. She’s a very sensitive little girl. Seeing lots of myself in her at that age, but more exaggerated.

Does she still have tummy troubles during the school holidays? And is she in Year 2 or Year 1?

We’ve had similar and now a diagnosis of autism - school nursing were helpful, I was very pushy at school for some support too which is variable, I’m now looking into an OT assessment. Changing our approach at home has helped too; I don’t push with homework, try to keep to a routine, low demands etc

Abdominal migraine? My friend's son started with this at a similar age, or maybe slightly older.

Don't rule out real pain, it's easy to go with it's just stress but it may well be something physical, I would want any possible physical problems ruled out first. UTIs for instance can be very painful and be very frequent in some young girls. Any infections can cause glands to come in the tummy which cause pain, and the appendix can be inflamed, or bowel problems, etc. If she gets worse go to A&E.

Have you excluded dairy and soya? It could be a non-ige allergy which won't show up on tests.

Have you checked for Coeliac?

My daughter is awaiting tests to rule out anything else (had them all done age 6 but now age 8 her GP want's to check again) but her GP thinks she has abdominal migraines, have a Google and see if the symptoms fit, they can't be helped other than Calpol but it could be an answer.
My daughters come on randomly and she'll be in tears, says it's like a stabbing pain around her belly button and she'll feel nauseous, won't eat, will just go to bed, generally ok or at least better the next morning, they can be made worse by stress and anxiety.

We ended up at A&E on Monday night - she suddenly deteriorated in the evening and was sleepy, wouldn’t eat then couldn’t seem to walk, was crying, rocking and wouldn’t speak. Called 111 and they said they had to send an ambulance! Predictably then got a call to say it was a 4 hour wait and to drive her - of course by the time we got there she perked up and after a very long wait they said they couldn’t find anything wrong, just saying to treat the constipation and ‘eat more vegetables’. They said her UTI had cleared. So I took her back to the GP yesterday to get them to make her paeds referral urgent and they’ve agreed to do more tests. The A&E doctor mentioned tummy growing pains - will ask about this as I don’t think his discharge letter even mentioned it. Abdominal migraines definitely fit.

she’s a very selective eater and doesn’t have much dairy and the pains aren’t really linked to after eating - but one of her blood tests showed slightly raised eosinophils, which could be linked to an intolerance. We tried cutting out tomatoes but it made no difference.

Reactions to dairy can take 72 hours so she could eat dairy (and it could be as small as some milk powder baked into a biscuit) 3-4 days before having to be stomach pains.

This is a good point. You have reminded me that my DD was lactose intolerant tolerant from a young age. I think she was given simethicone, if I remember correctly, when we ended up in hospital and after that, we cut out dairy. People with coeliac are more prone to be lactose intolerant but it can obviously exist independently. She got something else when she was a bit older which breaks down the lactose enzymes but she still cannot really have much dairy (she occasionally does because gluten free and dairy free is hard-going and then regrets it)

my DD needed a gastroscopy for her coeliac diagnosis as her blood tests were inconclusive.

Can dairy intolerance suddenly show? She was a very chilled baby and never showed any signs with milk etc

DD’s started when she was two, that’s when we went to the hospital as she was screaming in pain, she was better when she was in her teens and it came back after she had been sick with a gastrointestinal virus in her late teens and then didn’t go away. However, I am not sure if she was actually fine as a teen or the symptoms were just less/more manageable.

I would try a gaviscon as a one off (it's not for general use under 12). If that works like magic its likely acid indigestion for which you can ask GP for Omeprazole.