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RootAnn

Dr. Hive: Stomach Pain in 16 yr old female Updated 9/21

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So sometimes my 16 yr old has cramps when Aunt Flo is going to visit. Sometimes she has a sharper pain in her intestinal area after having eggs. She says this is neither of those. All day yesterday & today, she's had a pain in her general stomach area - lower than her ribs, maybe around and above her belly button. She says it is "inside" and not shooting/stabbing, just an ache. It almost always feels better when she's sitting but it comes back when she is standing/walking. Upon questioning, she says it also hurt when she was laying on her back and breathing in earlier today.

I'll take your questions & ask them to her tomorrow when she gets up. She is usually a very active kid but couldn't do gymnastics yesterday because of it or do her usual running the last couple of days. I have not tried to give her any pain meds (she doesn't like to take them unless she's really hard up).

Any ideas?

Update on Sat 9/21:  She feels better today. She was able to go running & biking with her siblings, so I don't know what it was, but she might be on the other side of it. Thanks for your help!!

Edited by RootAnn
Updated 9/21

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25 minutes ago, RootAnn said:

So sometimes my 16 yr old has cramps when Aunt Flo is going to visit. Sometimes she has a sharper pain in her intestinal area after having eggs. She says this is neither of those. All day yesterday & today, she's had a pain in her general stomach area - lower than her ribs, maybe around and above her belly button. She says it is "inside" and not shooting/stabbing, just an ache. It almost always feels better when she's sitting but it comes back when she is standing/walking. Upon questioning, she says it also hurt when she was laying on her back and breathing in earlier today.

I'll take your questions & ask them to her tomorrow when she gets up. She is usually a very active kid but couldn't do gymnastics yesterday because of it or do her usual running the last couple of days. I have not tried to give her any pain meds (she doesn't like to take them unless she's really hard up).

Any ideas?

Could be appendix. My son just had his appendix out last weekend. He was complaining that his stomach hurt, but didin’t really have any other symptoms. I thought it was gas, but DH, who has experience with appendix, said he was taking him to the ER. They did tests and it was an inflamed/infected appendix and he had it out on Saturday. Fortunately we caught it before it ruptured.

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Isn’t there a test where you tap the bottom of the afflicted’s foot to check appendix trouble.  Ruled out constipation?

Hope she feels better soon!

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I’d say appendix as well. Appendicitis pain often is felt around belly button initially but then as inflammation increases, the pain is felt lower around the right side. The pain can intensify quickly and, if it does, take her in. Maybe take her in anyway to rule out appendicitis.

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Gah! DH is my appendix specialist & he didn't seem concerned. But he just looks for the lower stabbing pain, I guess. I thought it had lasted too long to be a ruptured ovarian cyst.

If she wakes me up with a shooting pain, we'll head to the Children's Hospital to tonight. (How much time will I have? Because it's a long drive...)

Otherwise, I'll try the heel drop test in the morning & call her doc to get her in, hopefully, in the morning. (Her little bro's bday is tomorrow.) 

More input welcome. I'll update y'all tomorrow.

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I read that if the pain gets worse to not press hard on it. I guess that makes sense. Maybe the pain will be gone by tomorrow. 🤞 

Happy birthday to your son, btw!

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I would have her evaluated for an ovarian cyst. A fairly sizable one can cause pain even if it doesn't rupture. GYN or PCP if she doesn't have a GYN can order an ultrasound to look. 

 

My appendix was acutely painful, way worse than labor or c-section recovery, so if it doesn't let up, definitely get her in. ETA: I was feeling a little bad at around 10 am (like, maybe have bad gas), and by 2 PM, I was crying in pain.  Around 4 or so, the pain suddenly let up while we were in the ER, even though the appendix didn't actually rupture. I had surgery around 11 PM, so half a day after it started hurting. But I had zilch, zero, nada the day before. 

Edited by happypamama
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She says it is better this morning in that when she stands up, the pain doesn't get much worse. So, I'm not sure what that really means because I didn't think it hurt much (at all?) when she was sitting down before but what she says now makes it seem like there is always some level of ache. Also, it seems like it gets worse throughout the day, so this could just be because she was laying down all night. (She didn't say it got worse through the day but that is what it seems like to me.)

She does not want to go to the doctor.

There is no additional pain if you push on her stomach. In general, she says it hurts just a bit more on the left side (just left if belly button) than the middle or right side.

I did the heel drop test & she did not have any reaction. I'm conflicted now on whether to take her in. I will call the doctor's office when it opens and see if a nurse will call me back.

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16 minutes ago, RootAnn said:

She does not want to go to the doctor.

Is this a dc who normally has some anxiety? I think if someone is having continued pain and they're under 18 and living in my house, it isn't really their choice.

I'm glad you're calling the doctor. Way better safe than sorry. Is there anything else that could explain it besides something needing a doctor? Like did she fall and her back tight and she needs a chiropractor or some ice? And did you check for a fever? 

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I have IBS and get pains like that too.  I've had my kid evaluated for appendix a couple times and it's always amounted to nothing.  So if it's causing issues still, have her looked at.  But I wouldn't panic.  

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9 hours ago, BarbecueMom said:

I have/had a duodenal ulcer and that’s pretty close to the location that hurts when it’s bothering me.

How is this diagnosed?

35 minutes ago, PeterPan said:

Is this a dc who normally has some anxiety? I think if someone is having continued pain and they're under 18 and living in my house, it isn't really their choice.

I'm glad you're calling the doctor. Way better safe than sorry. Is there anything else that could explain it besides something needing a doctor? Like did she fall and her back tight and she needs a chiropractor or some ice? And did you check for a fever? 

No other reason that I can think of. No fever or nausea & eating like she normally does. If the nurses say to bring her in, we are going. I was just adding to the information - that it may be that she says the pain is better because she doesn't want to go. But she also is the type that would push me to take her *this minute* if she thought it was serious. So, I just don't know.

Waiting for a call back from the nurse to see what they think.

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1 minute ago, RootAnn said:

How is this diagnosed?

No other reason that I can think of. No fever or nausea & eating like she normally does. If the nurses say to bring her in, we are going. I was just adding to the information - that it may be that she says the pain is better because she doesn't want to go. But she also is the type that would push me to take her *this minute* if she thought it was serious. So, I just don't know.

Waiting for a call back from the nurse to see what they think.

It’s probably nothing. But in our case, DS had no fever, no nausea.  He did complain of not feeling good and the stomach pains, but that evening we were watching movies and he would alternate between laughing and enjoying them, and then complaining of stomach pain. I’m glad DH took the bull by the horns because my first inclination was just to wait and see. 

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Is your dh a doctor? If not and given distance from hospital, I’d get her checked out even though she doesn’t want to. Appendix pain doesn’t always present the same.   If something like appendix, you really want to deal with it while it’s relatively mild, not a ruptured one. 

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My guess is a large ovarian cyst too, which can definitely cause pain before they rupture.  If it gets to a 6-8 on the pain scale I'd take her to the ER just to make sure it isn't something like ovarian torsion (when the ovary gets twisted around the ligament supporting it, reducing blood supply).  That would need surgery.  Either way I'd schedule with her doctor.  If it's endo or an ovarian cyst she'd probably be best on either the pill or drastically changing her diet to lower estrogen (basically more fiber & broccoli; less fat, dairy, & meat).

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16 minutes ago, RootAnn said:

How is this diagnosed?

Endoscopy.  Treatment is usually antibiotics for the H. pylori if it’s the cause, and OTC heartburn/reflux meds to help it heal.

I didn’t read the first post well, the pain from this is all above the navel for me, about halfway from diaphragm to belly button (and I have a pretty short torso).  If the pain is lower, ulcer’s probably less likely the problem.

Hope she feels better soon!

Edited by BarbecueMom
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What did the nurse say? Are they getting her in? Yes to me that sounds like she knows it’s significant and is scared to go in.

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@Pen DH is not a doctor but in the 20+ yrs I've been married to him, I've learned he knows a heck of a lot more about medical stuff like this than me & he's my first go-to for kid's symptoms. He usually steers me correctly on what further to ask the kids or what info to collect that I haven't thought of. The only time he's been wrong (so far) was for a female issue (plus he wasn't sure on what turned out to be a burst ovarian cyst but told me to take her into the ER). We've been through roseola, Bell's Palsy, an intussusception, hand/foot/mouth, ringworm, and other issues both major & minor. But I also know when to ask for help here or call the doctor.

@BarbecueMom Thanks. I'll keep that in mind.

I talked to the nurse about an hour ago. I told her everything I said here plus anything else I could think of. She asked several more questions, put me on hold, then asked a few more. (It sounded like they were thinking it was constipation based on the extra questions.) She consulted with the doctor & called me back about 20 minutes later to double check a few of the symptoms & then said the doctor is not concerned about appendix, that if it is a cyst they'd just treat for symptoms, and to give her a daily probiotic & monitor for blood in the stool. Call them if she has a fever, increased pain, or nausea/vomiting. So, I'm going to continue to keep an eye on her.

ETA: They also asked about diet-related issues & UTI symptoms. 

Edited by RootAnn
added a couple more things they asked about
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