Recurring abdominal pain, nausea and vomiting (DD14)

[Rodneynotdave]

I'm looking for advice from other parents who may have experienced something similar with their daughters.

Since November last year, my daughter has had around 10 episodes or periods of illness involving various combinations of headaches, dizziness, nausea, vomiting, diarrhoea, fatigue and abdominal pain. My log records approximately 25–30 school days missed, plus several partial days when she was sent home or unable to manage a full day. This has had a significant impact on her wellbeing and education.

She's now on day 6 of persistent abdominal pain. She's had three particularly notable episodes of abdominal pain, in March, May and now October, each lasting several days. This time she has also experienced nausea and vomiting.

I've been keeping a detailed symptom log on the advice of another doctor at the practice earlier this year, including dates, symptoms, school absence and menstrual dates. I've noticed that the three main abdominal pain episodes have started at roughly the same point in her menstrual cycle, although I don't know whether that's significant.

We had blood tests and a physical examination, which were reassuring. However, I saw a male GP this morning who was “100% certain” that her symptoms were psychological and related to a gut–brain link. He said we needed to identify the external stressors causing them. I brought my symptom log to the appointment, but he didn't read it, despite it having been recommended by one of his colleagues.

I'm really struggling with this. I'm not saying psychological factors can't contribute, but no obvious stressors have been identified, and I don't feel the recurring pattern or wider history has been properly considered. I left without any clear advice about what to do if the pain continues or returns, or how long this can go on without further assessment.

Has anyone else's daughter experienced recurring abdominal pain, nausea and vomiting that turned out to be related to her menstrual cycle or another women's health issue? Or has anyone been told their child has a gut–brain link, and how was that conclusion reached?

I'd really appreciate hearing about your experiences, particularly if your daughter had repeated episodes over many months before getting answers. I 'd welcome some perspectives on what possibilities to discuss and how to advocate for her when I feel I'm not being listened to.

One thing that isn’t proven to be related to your cycle - but that’s probably because they haven’t looked properly- is digestive efficiency

or extreme constipation driven by hormones

and that leads to pain, and nausea

so diet and exercise would be factors alongside hormones

and also perhaps trying her on the pill to see if that has any impact - I know she’s young

Can you ask to see a female GP at your practice the next time she's having these symptoms? I'd keep up the recording just so that there is a record should someone take the time to read it. Good luck.

My dd had this at a similar age. We were told it was like an abdominal migraine; stress related. She used to have flare ups before school tests and sport competitions. So not linked to a female health situation, but thought this might still be useful.

She always had quite low confidence (school) and is very competitive (sport) so always had high expectations of herself. We have worked hard on building her self confidence.

I would seek a second opinion from another gp within the practice.

How was she prior to last November?. What have her periods been like to date?. Is she now starting to get pain midway through her menstrual cycle?.

My cousin’s DD had similar symptoms. She’s been diagnosed with coeliacs. Has your DD been tested for Coeliacs @Rodneynotdave .

She needs a full autoimmune screen. Lots of autoimmune issues present like this initially, mine did. Blood tests needed for coeliacs, adrenal insufficiency, lupus, hypothyroidism etc. With the cortisol blood tests it needs to be taken between 8-9am, no later, otherwise it isn’t diagnostically reliable. If it’s under 300 she needs a sst test with an endocrinologist. It’s very, very rare to have Addisons / adrenal insufficiency but can be easily excluded via a blood test so worth checking. They won’t have done this as part of the standard bloods.

Thanks for your comment @brownbootsandhats. I'll look into digestive efficiency. The Dr was so dismissive this morning!

@SylvanMoonThanks for replying. We saw a lovely female junior doctor last week who went through all of the notes I'd kept - she ran the bloods and said to come back if it was still going on this week (or if it got worse). Daughter was complaining of more pain this morning so we went back. She asked for a second opinion from the main male doctor who took one quick look at her and said its psychological. Nothing serious as she could lift her legs when laying down and clear bloods. It was a separate female junior Dr earlier in the year who suggested I keep a log who again was lovely and very professionally curious. I was raging when I left this morning as he shushed me when I was trying to give him a bit more info (im not a helicopter parent - i just have a very shy daughter which I told him!!)

@AttilaTheMeerkatShe's been having periods since age 10. I've tracked her periods over the past year. Her cycle lengths have ranged from 27 to 34 days more recently, averaging around 30 days overall. I've noticed that the three main episodes of abdominal pain in March, May and October seem to have occurred at a similar point in her cycle (between day 18 and 22) and I'm wondering whether that could be relevant. GP not interested and shut me down when I said could it be cycle related!

@AnabolicannaNo we havent - its a good shout. What kicked this latest episode off last week was her eating a bowl of pasta on Thursday morning (as she does most mornings randomly). It was a different brand/type ( white instead of wholemeal) and she then promptly vomited 3-4 times before school. Since then shes had this abdominal pain and nausea. I think I should look at this in a bit more detail 🤔

Yes…. Experienced similar with DD2. Turned out to be anxiety, which was probably caused by undiagnosed and untreated ADHD.

@SparrowsandbudgiesThank you for replying.Thats really helpful info. I'm going to share this with my husband. The only thing that came back on the bloods was a slightly raised Ferrutin (?) level but it was the junior doctor whi mentioned that on the phone to me - not the male GP this morning.

Have you considered endometriosis as it seems linked to her menstrual cycle? It can start this young in some women/girls.

Yes she definitely needs testing for Coeliacs. Don’t limit her diet before the test.

Dd had this for a couple of years before her periods started and they thought it was abdominal migraine, the doctor said that she might develop more typical migraines when her periods started, but that hasn’t happened. She is 21 now and so it’s nine years since the last episode. Hers were fairly brief though, lasting a few hours each time.
I am interested in the comments though re auto immune disease as she did develop one at around the time they stopped, and we have a family history of coeliac disease although her bloods are negative for that so far.

Unless there were particular events in the diary happening that line up with the symptoms (I'm thinking exams, sporting comps, presentations) then I think the anxiety thing is bollocks. If it was generalised anxiety then the symptoms would rumble on all the time, she'd feel sick every morning before school etc. but it's worth casting your eye back over the dates just to rule out specific stress-triggers. My brother thought he had stomach bugs every time he had exams and because he was a boy, he was investigated for all sorts but it was stress all along. On the flip side, my sister in law was totally ignored and told it was in her head for years, and in the end it was ulcerative colitis. So I do fear a sex-based bias in these situations and I'd be on the look out for that in doctors.

She should keep a food diary and see if it occurs when she’s eating certain foods to rule out dairy intolerance/ coeliacs

I developed my autoimmune disease at the same time as my periods. The pill taken back to back settled it down, but it flared up again after pregnancy. Oestrogen is a natural anti inflammatory but when it drops each month that can cause a flare. My consultant was very aware of it, but found it difficult to get funding to research it as nobody would make any money out of women using the pill to settle autoimmune symptoms.

Maybe endometriosis? I’d want more tests. That GO sounds awful! Try to see the female one again

I wonder about if its an abdominal migraine. Does she access to any support services via school?

what did they do blood tests for? Request a copy of her results to see if they have already screened for coeliac disease (anti-TTG) as surely this should be a fairly obvious thing to test for!?

Raised ferritin at needs looking at- were there any inflammatory markers done?

I would be open to the possibility that there is a psychological cause. But would expect physical causes to be excluded first, before that diagnosis was reached.

A friend of mine dealt with similar recurring abdominal pain and nausea, and she noticed that her symptoms often appeared around the same time in her menstrual cycle. She eventually discussed the pattern with a gynecologist, who helped her explore possible period-related causes and ways to manage the symptoms.
I think the symptom log you've kept is really important, especially since you've noticed a pattern. I'd suggest getting a second opinion and asking whether a pediatric gynecologist or specialist could assess her. Six days of ongoing pain with vomiting deserves prompt reassessment, even if earlier tests were normal. I really hope your daughter gets some answers and starts feeling better soon.

Raised ferritin can be a sign of inflammation.
I’d say push for Coeliac testing and also Crohn’s and colitis investigation. All these conditions quite commonly flare up in the teenage years.
Stress can cause abdominal issues but other conditions should be ruled out first before dismissing everything as psychological.
And also if it is psychological it’s still causing very real symptoms so your DD still needs help with that.

I’ve heard of similar cases where recurring abdominal pain and nausea were eventually linked to menstrual cycles, including conditions like endometriosis. The fact that you've noticed a pattern in your daughter's symptoms seems worth investigating rather than assuming it's entirely stress-related. I'd consider getting a second opinion and asking for a referral to a paediatric gynaecologist. Since she's been in pain for six days and has also been vomiting, I'd seek an urgent reassessment rather than waiting. You're doing the right thing by keeping a detailed symptom log, and I hope she feels better soon.

Mcas? Often linked to hormones.