Calling Dr. Hive--teenager suddenly having accidents!

[Ravin]

DD has started having accidents. 2 BM, one urination so far over the last few weeks. When it happens, she doesn't feel she needs to go until right before it just...comes out. Without her control. Once it happened while she was just chilling in the car waiting for me, and twice (the BM incidents) happened at school.

She recently started a new medication, but the prescribing nurse says it's not a side effect of the new med.

At this point, we're going to schedule her an appointment with a new PCP (her old one up and left the practice she was at so we need a new one). She has fibromyalgia, migraines, anxiety, ADHD, and mood disorder NOS. She doesn't need this on top of it all.

Anyone have a clue what this MIGHT be?

[Jean in Newcastle]

Encopresis? 

[gardenmom5]

37 minutes ago, Ravin said:

She recently started a new medication, but the prescribing nurse says it's not a side effect of the new med.

riiight.   

I've had side effects from drugs that I had to really hunt down obscure side effects to say "yes, it was the drug causing this!".  most are only familiar with "common" side effects.

 is this nurse overseen by a MD?  talk to them.  if not, demand another drug.

[SKL]

I don't know what it is, though I too would suspect he medication.  But maybe you could advise her to go to the bathroom every hour or so whether she needs to or not.  Poor girl, I hope it resolves soon.

[Ottakee]

Encopresis is my first guess.....likely constipation which may or may not be caused by  the new med.  An x ray to check for blockage is very easy to do.    You can be constipated even if you "go" every day.  Constipation can also cause urine leakage.

[J-rap]

Reflux?  There's a reflux of the kidney, a condition that my dd had.  Usually you notice it first with UTI's, but not always.    In a nutshell (and my understanding -- which could be slightly wrong!), it's when the "valve" between the kidney and the bladder isn't working properly.  Once urine leaves the kidney and empties into the bladder, it's not supposed to re-enter the kidney again.  If that valve isn't working probably, urine can actually back-track back into the kidney again.  Sometimes it can go back and forth, leaving you with an instant and overwhelming feeling of having to urinate and not being able to stop it.  My dd was absolutely horrified when she had an accident in the car as a teenager.  It just hit so fast, she couldn't control it.  She also happens to have a super-sized bladder -- not sure if that plays into it.  

Sometimes this fixes itself over time on its own (as was my dd's case -- we actually first found out about it when she was quite young, because of numerous UTI's), but sometimes it requires surgery.

ETA:  I realize this doesn't really address the BM issue though.  I'm really sorry this is happening with your dd!  Hopefully you'll be able to figure out quickly what's going on.

Edited February 20, 2019 by J-rap

[dirty ethel rackham]

I would think encopresis as well.  She could have a backed up colon and the softer stool could be leaking around it.  Also, the constipation can cause urinary incontinence as well.  Btdt.  

[Ravin]

She has had constipation in the past when she was younger. That might be it. We may try a run of Miralax, see if that helps before going in for expensive testing. 

The urination incident was not a little bit of leakage, though. It was a flood. She realized she needed to go, stood up, and there it went. It is to date an isolated incident, though.

[Jean in Newcastle]

Btw-  I have IBS and related problems as part of the cluster of symptoms that are all part of  my fibromyalgia. 

[ktgrok]

I'd want to see a neurologist, and soon, honestly. Here it takes weeks to get in, so I'd call and schedule something now, and if she is better by then, fine. If not you have the appointment. But urine AND bowel incontinence makes me worry about something with nerve conduction. Has she had any falls or other trauma lately that could have injured her back? Sciatica symptoms?

Edited February 20, 2019 by Ktgrok

[itsheresomewhere]

You may have already done this but google the drug and odd side effects.  Sadly, IME I find the doctors don’t know about all the side effects only to the big ones.  

If nothing comes up, I would be at the doctor ASAP. I would be worried about neurological and spinal issues. 

[Catwoman]

Don’t be surprised if the doctor recommends a colonoscopy, just to be safe. Did either you or you dh or anyone in your immediate family have cancer when they were quite young (like in their 20s or younger than that?)

I don’t want to scare you, but we are friends with a family where the teen dd started having bowel symptoms and her mom got concerned. She did some research because her dh had colon cancer when he was in his 20s and they had lost another child (still a toddler) to brain cancer a few years before, and she found out that his children could be genetically predisposed to getting certain cancers very young, so she insisted that her teen dd be tested. The doctor basically told her she was crazy and that the dd probably had something minor, but the mom insisted, and the dd had early stage colon cancer. Thank goodness she is fine now.

Anyway, it’s a rare thing and it probably doesn’t apply to your dd, but it is something to test for if early cancers happen to run in your family. 

I wasn’t going to post this because I don’t want to seem like an alarmist, but if my friend hadn’t done a lot of research, she never would have known that her dd might be prone to cancer at such an early age, and if there is any chance that your family has a similar history, I couldn’t take a chance on not telling you.

[whitestavern]

I find that pharmacists have a much better handle on drug side effects than doctors, so you could also check with them.

[kristin0713]

This is a common symptom of PANS/PANDAS. It happened to my daughter exactly like you said, complete flooding urinary accidents. This was when she was completely overtaken by PANS symptoms two years ago when we didn’t know what was wrong with her.  She did not have BM accidents though. 

Has your daughter always had the symptoms/diagnosis’s you listed or have any of them come on suddenly? PANS/PANDAS can look like many things because the brain is literally inflamed. Anxiety is a classic symptom, and I’d bet it could manifest as a “mood disorder” too. My DD became completely withdrawn, terrified, anorexic, OCD consumed, among other things. (She had a classic case brought on by influenza.) 

Psych meds have been found to make kids with PANS worse. It is also very under-diagnosed and very treatable. 

I’m not saying your daughter has PANS/PANDAS, but it might be something to look into.

https://kids.iocdf.org/professionals/md/pandas/ 

 

[Katy]

It could be any of the things already mentioned, but I would start by stopping that new medication. ALL of the diagnosises you listed are related to nerve function, and what you described is related to nerve function.  I don't care what some idiotic nurse said, it's probably the drug.  Stop that first, if it doesn't improve then look at other things.  And keep in mind drugs for those sorts of conditions can remain in the system for 6 weeks.